Exercise as a non-pharmacological intervention for the management of sleep disturbance in adults with primary brain tumours and their caregivers

This study comprises a self-controlled, 14-week longitudinal study comprising a 4-week period during which participants will undertake usual activities while having their sleep monitored and 8-weeks of individualised, home-based exercise delivered via telehealth. A longitudinal study design allows for tracking of participants sleep measures over a longer period of time, with continual monitoring performed by the Oura ring for objective sleep measures, as well as 3 study time points (baseline, mid-way, post-intervention) where subjective questionnaires will be completed. Furthermore, a longitudinal study design address the following points: 1. It can capture changes in sleep quality and architecture over time as opposed to one time point; 2. It can account for an individual’s variability in sleep – sleep disturbance can have different causes and symptoms in different people. By following the group for a longer period of time, it allows the research team to account for these individual differences in sleep disturbance; 3. It can examine potential mediators and moderators that may influence the effectiveness of exercise on sleep disturbance (e.g., age, sex, anthropometric measures, severity of sleep disturbance, pre-intervention exercise levels). A self-controlled study design is ethically appropriate as it would remove the necessity for a control group that would not be given an exercise intervention that may elicit clinically significant improvements (e.g., improved sleep, enhanced QoL). All participants, both caregivers and PBT survivors, will be required to attend 2x telehealth sessions per week, which will be timetabled prior to commencing the exercise intervention in consultation with participants at a mutually agreeable time. Sessions will be with individual groups; if both a PBT survivor and their caregiver are recruited at the same time, the sessions will be conducted at the same time. However, if there is only one participant, then it will be an individual session. Another example is two PBT survivors/caregivers recruited separately will not have sessions together. All sessions will be supervised by an Accredited Exercise Physiologist (AEP). Each session will go for approximately 1 hour adhereing to the following format: - 10 minute subjective consultation/check in; - 5-10 minute warm-up/flexibility/aerobic; - 30-45 minutes of resistance exercise (e.g., seated rows, crab walks, shoulder press, chest press, side lying clams, crab walks, squats/glute bridges w/ band around knees, kettlebell swings). Participants will also be encouraged to perform 30-minutes aerobic activity on at least 2 other days of the week, individualised by RPE prescription and modality – some participants may be more capable of performing a different modality (e.g., walking vs. running vs. bike vs. swimming). Session intensities will be moderate, assessed with by the Borg RPE scale (6-20). Exercise session adherence will be tracked using an exercise diary for participants to complete, as well as session attendance checklists completed by supervising AEP. Participants will be provided with an equipment pack containing the necessary pieces of equipment to perform the intervention, including: - Resistance bands (Handle) of varying tension (e.g., easy, medium, hard, very hard) - Fabric “booty” bands of varying tension (e.g., easy, medium, hard) - 28kg Kettlebell set (1x 4kg, 6kg, 8kg, 10kg) - Exercise/yoga mat. Pieces of furniture (e.g., chairs, benches, tables, steps, etc.) will also be utilised to complete these sessions where necessary. The study duration is 14-weeks in total if allocated an Oura Ring, otherwise it is 10-weeks total. Not all participants of the study will be given an Oura Ring; rather, alternation will be used - rings will be provided to every second participant we recruit without allocating specific numbers to them. This includes: - A 4-week ring calibration period if allocated an Oura Ring (weeks -4 to -1) where participants will perform usual activities - the only time where participants NEED to wear the ring is at night for accurate sleep tracking, though they will be encouraged to wear the ring at all times unless charging; - Baseline testing performed (week 0); - 8-weeks of individualised exercise (weeks 1 - 8) - participants allocated an Oura Ring will be required to continue to wear the ring for the entirety of the exercise intervention; - Post-intervention testing performed at the end of the 8-weeks of individualised exercise (week 9).