Individualized rehabilitative instruction may lead to improvements in quality of life and significant physical benefits for cancer survivors, according to findings presented at JADPRO Live Virtual 2021.
Researchers led by Laura R. Trissel, DNP, AGACNP-BC, RN, AOCNP, of Sentara Nursing, hypothesized that focused rehabilitative interventions may help improve acute and long-term treatment side effects as well as overall health and well-being among cancer survivors.
Dr. Trissel and colleagues evaluated the physical outcomes, quality of life (QoL), and fatigue of 52 patients with solid tumor or hematologic malignancies who were referred by a physician or nurse practitioner to participate in an individual-focused cancer rehabilitation program conducted by a community oncology center. The Cancer Rehab and Renewal (CRR) program consisted of 60-minute exercise sessions supervised by a physical therapist and/or clinical exercise specialist three times per week for a total of 12 weeks.
The patients' mean age was 66 years. The majority of patients in the study were white (89%) and female (65%). Their most common primary malignancies were as follows:
- breast (46.2%)
- colorectal/GI (13.5%)
- prostate (11.5%)
- lung (7.7%)
Most patients in the study had TNM stage I-III disease (71%), received multi-modality treatment (75%), and were undergoing treatment at enrollment in CRR (64%).
Out of 52 patients who enrolled in CRR, 30 completed the program, and 23 of the 30 completed the six-month follow-up assessment.
The researchers compared paired t-tests performed on physical components at baseline and program completion (TABLE), finding significant differences in six-minute walk test, 30-second chair stand test, plank test, and dynamic gait index.
Additionally, the researchers compared paired t-tests of Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scores at baseline and completion. Significant differences found in four of the five subscales and total FACIT-F scale waned by the six-month follow up assessment.
These findings are limited by the CRR program's relatively high attrition rate (58%) due to a variety of personal and disease-related factors, most commonly travel barriers and lack of time. In addition, the researchers wrote, "further studies with a larger sample size and/or division by primary malignancy are needed to validate the types of improvements that may be expected from rehabilitative programming."
Reference
Trissel LR, Reid KB, Howe MD, et al. Effects of a 12-week individual cancer rehabilitation program on physical and quality of life indicators for cancer survivors. Clinical poster JL906. Presented at JADPRO Live Virtual, October 7-17, 2021.
TABLE. Data collected
| Baseline | 12 weeks
(program completion) |
Six months
post-program |
|
| Physical
|
|||
| Body measurements (height, weight, waist/hip circumference | X | X | |
| Chest press (1 repetition max weight) | X | X | |
| Grip strength (dynamometer) | X | X | |
| FEV1 (by spirometer) | X | X | |
| Six-minute walk test (distance) | X | X | |
| 30-second chair stand test | X | X | |
| Plank test (time held) | X | X | |
| Modified clinical test of sensory interaction in balance (CTSIB-M) | X | X | |
| Dynamic gait index (DGI) | X | X | |
| QoL/fatigue | |||
| Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) | X | X | X |
