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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

Leach, Heather J., PhD1,2; Covington, Kelley R., BS3; Pergolotti, Mackenzi, PhD, OTR/L4; Sharp, Julia, PhD5; Maynard, Brooke, BS6; Eagan, Jeffrey, PT6; Beasley, Joanne, PT, BSc6

doi: 10.1097/01.REO.0000000000000123
RESEARCH REPORTS

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, t 79 = −8.21, P = .000), PFS scores improved (MΔ = −2.1 ± 2.0, t 81 = 9.5, P = .000), and 6MWT distance improved (MΔ = +42.9 ± 53.8 m, t 160 = −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.

1Department of Health and Exercise Science, Colorado State University, Fort Collins, CO

2Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO

3Department of Occupational Therapy, Colorado State University, Fort Collins, CO

4Department of Occupational Therapy, Colorado State University, Fort Collins, CO

5Department of Statistics, Colorado State University, Fort Collins, CO

6Outpatient Rehabilitation Services, The Wellness Place, University of Colorado Health, Fort Collins, CO

Correspondence: Heather J. Leach, PhD, Department of Health and Exercise Science, Colorado State University, 1582 Campus Delivery, Fort Collins, CO 80523 (Heather.leach@colostate.edu).

All authors declare that they have no conflict of interest.

The authors have full control of all primary data and agree to allow the journal to review data if requested.

Copyright 2018 © Oncology Section, APTA
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