A Home-Based Exercise Program to Improve Function, Fatigue, and Sleep Quality in Patients With Stage IV Lung and Colorectal Cancer: A Randomized Controlled Trial

Abstract

Context Exercise benefits patients with cancer, but studies of home-based approaches, particularly among those with Stage IV disease, remain small and exploratory. Objectives To conduct an adequately powered trial of a home-based exercise intervention that can be facilely integrated into established delivery and reimbursement structures. Methods Sixty-six adults with Stage IV lung or colorectal cancer were randomized, in an eight-week trial, to usual care or incremental walking and home-based strength training. The exercising participants were instructed during a single physiotherapy visit and subsequently exercised four days or more per week; training and step-count goals were advanced during bimonthly telephone calls. The primary outcome measure was mobility assessed with the Ambulatory Post Acute Care Basic Mobility Short Form. Secondary outcomes included ratings of pain and sleep quality as well as the ability to perform daily activities (Ambulatory Post Acute Care Daily Activities Short Form), quality of life (Functional Assessment of Cancer Therapy-General), and fatigue (Functional Assessment of Cancer Therapy-Fatigue). Results Three participants dropped out and seven died (five in the intervention and two in the control group, P = 0.28). At Week 8, the intervention group reported improved mobility (P = 0.01), fatigue (P = 0.02), and sleep quality (P = 0.05) compared with the usual care group, but did not differ on the other measures. Conclusion A home-based exercise program seems capable of improving the mobility, fatigue, and sleep quality of patients with Stage IV lung and colorectal cancer.

Symptom Clusters in Advanced Cancer Patients: An Empirical Comparison of Statistical Methods and the Impact on Quality of Life

“…Interventions involving physical activity (44,45) and systematic self-monitoring of physical symptoms (46) should be included in a fatigue-pain management pathway for advanced cancer…”

Daganatos betegek fizioterápiája

“…Inkább több alkalommal, kisebb intenzitással és kevesebb ideig alkalmazzunk gyógytornát [27]! A beteg életkora, testsúlya, egyéb betegségei, szociális és családi háttere is befolyásolhatják a gyógytorna típu-sát.…”

“…Ki-emelten fontos aktív tumoros betegeknél stabilizációs gyógytorna alkalmazása, amely révén a fájdalmas ízület-vagy gerincszegmentum terhelése mérsékelhető, ezáltal a fájdalom enyhíthető. Az izomerő növelésével pedig a beteg önellátása könnyebbé válik [4,27].…”

Pulmonary Rehabilitation in lung cancer

“…In the series by Morris and co-workers [44], not only solid tumors (among them not only NSCLC) but also hematological malignancies are included; the Authors concluded that an aerobic exercise program determined significant improvements in exercise tolerance; moreover, in a randomized clinical trial carried out by Cheville [45], patients with advanced stages of lung cancer and colorectal cancer were enrolled and underwent home training regimens: results showed improvements in exercise tolerance and quality of life, although very often worsening of the disease can lead to a high dropout rate [46]; finally a recent meta-analysis performed by Jones et al [47], examined six randomized trials within a controlled group (a total 571 patients with breast or prostate cancers or lymphomas), and found that anaerobic training programs may produce a significant increase in VO 2 peak, without any major adverse events. Based on these studies, our opinion is that when feasible, a structured program of aerobic exercise training should always be offered to patients with lung cancer, as a safe and effective method in improving physical performance and quality of life; therefore, it should become part of the overall management of these patients with the same relevance given to the symptoms and pain control.…”