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Faculty Advisor(s)

Mary I. Fisher, PT, PhD

Description

Purpose/Hypothesis: Cancer related fatigue (CRF), a sense of physical, emotional and cognitive tiredness not relieved by rest, negatively affects function. Prevalence is reported to be 59-100% throughout the care continuum. Exercise and psychosocial interventions are supported as effective treatment options, yet barriers to personalized care include time and distance to travel for care. The purpose of this pilot study was to evaluate the effectiveness of personalized exercise prescribed by physical therapy (PT), and occupational goal setting and tasks prescribed by occupational therapy (OT) on physical function.

Number of Subjects: 16 adults with cancer and fatigue ≥4/10.

Materials and Methods: Over an 8-week intervention period, participants met weekly with PT and OT for individualized exercise instruction and progression, and personalized goal setting and progression via video conferencing. Physical function was measured by the 30-second sit to stand test (30STS), 6 Minute Walk test (6MWT) and the Canadian Occupational Performance Measure (COPM) at baseline, 4 and 8 weeks. Heart rate (HR) during exercise and rate of perceived exertion were collected weekly to monitor response to exercise. Participants were prescribed exercise by physical therapy using baseline 30STS and 6MWT compared to age-appropriate norms. Exercise videos were posted to personalized participant websites and were to be completed 3x/weekly at 40-60% of HRmax; exercise consisted of warm-up, strengthening, aerobic, and cool down portions. With OT, participants set goals based upon personalized important activities identified on the COPM. Performance of and satisfaction with goals were evaluated on a 1-10 scale. During weekly meetings, exercise modifications were given as needed in order to ensure completion, and problem-solving strategies were used to meet personalized important activity goals. Intention-to-treat analysis was performed and paired samples t-test was used to analyze pre-post outcomes with alpha 0.05 a priori.

Results: Participants who completed at least 4 weeks of the program are included in each analysis with the last measure carried forward (n=14). The mean age of all participants was 46.4 years (29-67); all but one participant were female (93.8%), 9 (56%) had breast cancer, followed by 1 each with leukemia, pancreatic, and endometrial cancer, and 4 with a different cancer. At 8 weeks, the 6MWT distance was not statistically improved, however the 30STS (p=.010), COPM satisfaction (p

Conclusions: Use of a personalized PT and OT intervention aimed at improving function in those with CRF resulted in improvement in physical function measured by the 30STS and COPM. Use of eHealth appears to be an effective method to deliver exercise and personalized problem-solving intervention in this population. Limitations include a small sample size in this ongoing study as well as variability of cancer diagnoses, making broad generalization difficult.

Clinical Relevance: eHealth interventions of personalized exercise and goal setting can be effective to improve function among individuals with CRF.

Publication Date

5-2024

Disciplines

Oncology | Physical Therapy | Rehabilitation and Therapy

eHealth Cancer-Related Fatigue Intervention Single Arm Study

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