Translating Research to Practice Using a Team-Based Approach to Cancer Rehabilitation: A Physical Therapy and Exercise-Based Cancer Rehabilitation Program Reduces Fatigue and Improves Aerobic Capacity

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Abstract

Background and Objective:

Intervention research has shown that exercise-based rehabilitation is safe and effective for reducing disease burden across the cancer continuum. However, the translation of this research to programs implemented in health care settings remains a challenge. This study describes the implementation of a physical therapy–based exercise program for patients who have been diagnosed with cancer and its effectiveness for reducing fatigue and improving aerobic capacity.

Methods:

Retrospective analysis of a single-group, pre/postprogram assessment for adult patients who have been diagnosed with cancer (N = 546). Six-Minute Walk Test (6MWT) measured aerobic capacity. Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-Fatigue) and Piper Fatigue Scale (PFS) measured fatigue. Paired-samples t tests examined changes in outcomes from pre- to postprogram assessments. Linear regression explored predictors of postprogram outcomes.

Results:

Participants were 63.7 ± 12.2 years old, diagnosed with breast (27.1%), hematological (15.4%), head and neck (12.6%), lung (12.3%), prostate (11%), colorectal (7.3%), or other (14.3%) cancers. For those who completed the postprogram measures (N = 169), FACIT-Fatigue scores improved (MΔ = +8.42 ± 9.2, t79 = −8.21, P = .000), PFS scores improved (MΔ = −2.1 ± 2.0, t81 = 9.5, P = .000), and 6MWT distance improved (MΔ = +42.9 ± 53.8 m, t160 = −10.1, P = .000). Age (P = .034) and time since completing chemotherapy (P = .000) or radiation therapy (P = .014) was inversely associated with the 6MWT. Greater exercise session attendance was associated with higher PFS scores (P = .020).

Limitations:

Only 31% of participants completed postprogram assessments, and limited information was available regarding reasons for dropout/withdrawal.

Conclusions:

This study provides a real-world example of a cancer rehabilitation program implemented in a health care setting, which was successful in reducing fatigue and improving aerobic capacity.

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