A Progressive Postresection Walking Program Significantly Improves Fatigue and Health-Related Quality of Life in Pancreas and Periampullary Cancer Patients

Abstract

A progressive postresection walking program significantly improves fatigue and health-related quality of life in pancreas and periampullary cancer patients. Recommended Citation Yeo, Theresa; Burrell, Sherry A; Sauter, Patricia K; Kennedy, Eugene P; Lavu, Harish; Leiby, Benjamin E; and Yeo, Charles, "A progressive postresection walking program significantly improves fatigue and health-related quality of life in pancreas and periampullary cancer patients." (2012 Methods:One hundred and two patients with resected PPC consented to participate in this study and were randomized to either an Intervention Group (IG) or a Usual Care Group (UCG).Subjects completed visual analog scales, the FACIT-Fatigue Scale (FFS) and the Short Form36v2® after surgery and again 3 to 6 months after hospital discharge. Results:Patients in the IG and UCG were comparable with regard to demographics, comorbidities, cancer type and staging, type of resection, pre-op fatigue and pain levels, adjuvant therapy and baseline walking distance. Patients in the IG had significantly improved scores on the FFS at study completion, improved fatigue and pain scores, as well as overall physical functioning and mental health composite scores. At study completion, participants in the IG were walking twice as far and were significantly more likely to have continued walking or another form of exercise as compared to the UCG. Using hierarchical cluster analysis three mutually exclusive symptom groupings were identified in the cohort. Kaplan-Meier survival analysis did not indicate an overall survival benefit for the IG. Conclusion:This is the first prospective, randomized and controlled trial to report that participation in a home walking program confers a significant benefit in resected PPC patients

Exercise for People with Cancer: A Clinical Practice Guideline

“…Of the sixteen studies involving patients in active treatment [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] , six demonstrated that, compared with the control group, the intervention group experienced significant improvements in qol 30,31,33,[38][39][40]43 . In the thirteen post-treatment intervention studies 10,12,14,[45][46][47][48][49][50][51][52][53][54] , two reported similar significant differences between groups 46,49 .…”

Exercise improves fatigue during and after breast and prostate cancer treatment, with benefits seen for aerobic exercise

“…A 2012 RCT of a home walking programme in 102 postoperative pancreas and periampullary cancer patients also demonstrated reduction in fatigue levels, as well as improvement in anxiety and depression, in the walking group as compared to the usual care group. 1 Although resistance training and mind-body techniques did not achieve significance, this may have been owing to small sample size or insensitive outcome measures and are not indicative of the individual benefits realised with those programmes. These modalities remain to be prospectively evaluated in large-scale longitudinal investigations.…”

Exercise for people with cancer: a systematic review

“…Seventeen rcts [22][23][24]27,29,[30][31][32][33]37,39,42,45,47,[51][52][53] found that no adverse events or side effects were attributable to the exercise program. Seven 26,28,34,35,40,46,50 did not report on adverse events at all. Three rcts 25,41,44 reported adverse events that were deemed not to be related to the intervention; two 36,38 reported events that were attributable to the intervention (3 patients experienced muscle soreness, and 2 experienced musculoskeletal injury).…”

“…Fourteen systematic reviews [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] found an improvement in qol for people with cancer participating in an exercise intervention during the active treatment or post-treatment periods (Table v). Of the sixteen rcts involving patients in active treatment [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] , seven reported significant differences between the intervention and control groups (Table vi) 23,24,26,[31][32][33]36 . In the thirteen posttreatment intervention studies [38][39][40][41][42][43][44]…”

“…Four rcts 26,35,46,47 used only aerobic interventions. Three 26,46,47 showed no significant differences between the intervention and control groups for qol, but in one 35 , paired pre-post t-tests showed a significant difference between groups on the Short Form-36 mental component summary (p ≤ 0.05).…”