Hoffman, A.J., Brintnall, R.A., von Eye, A., Jones, L.W., Alderink, G., Patzelt, L.H., & Brown, J.K. (2014). Home-based exercise: Promising rehabilitation for symptom relief, improved functional status and quality of life for post-surgical lung cancer patients. Journal of Thoracic Disease, 6, 632–640.
DOI Link
Study Purpose
To describe the effects of a postsurgical home exercise intervention implemented immediately after hospital discharge on cancer-related fatigue (CRF), other symptoms, functional status, and quality of life (QOL) in individuals with non-small cell lung cancer (NSCLC)
Intervention Characteristics/Basic Study Process
Patient education in a hospital regarding exercise was followed by a home visit from a nurse educated on warm-up exercises, light intensity exercise such as walking, and balance exercises with a Wii. Patients were instructed to increase walking to goal of 30 minutes a day in week 6.
Sample Characteristics
- N = 7
- MEAN AGE = 64.6 years (range = 53–73 years)
- MALES: 29%, FEMALES: 71%
- KEY DISEASE CHARACTERISTICS: All received lobectomy for NSCLC; average of 5.9 comorbidities
- OTHER KEY SAMPLE CHARACTERISTICS: Five of seven patients started chemotherapy in week 5.
Setting
- SITE: Single site
- SETTING TYPE: Home
- LOCATION: University teaching hospital in Michigan
Phase of Care and Clinical Applications
- PHASE OF CARE: Active antitumor treatment
Study Design
Measurement Instruments/Methods
- Brief Fatigue Inventory (BFI)
- MD Anderson Symptom Inventory (MDASI) core and lung module (symptom severity)
- Medical Outcomes Short Form-36 (MO SF-36 v.2) acute recall (function)
- Ferrans and Powers Quality of Life Index (FP QLI) (QOL)
Results
- Fatigue: Presurgery = 3.5, postsurgery = 4.8, and week 6 = 2.8
- Overall physical function: Presurgery = 49.8, postsurgery = 31.5, and week 6 = 45.9
- QOL: Presurgery = 23.5, postsurgery = 22.4, and week 6 = 23.8
Conclusions
Cancer-related fatigue decreased below presurgery levels after six weeks of exercise intervention.
Limitations
- Small sample (< 30)
- Risk of bias (no control group)
- Risk of bias (no blinding)
- Risk of bias (no random assignment)
- Risk of bias (no appropriate attentional control condition)
Nursing Implications
Home-based exercise may reduce cancer-related fatigue in patients with NSCLC postsurgery.