Bertheussen, G.F., Kaasa, S., Hokstad, A., Sandmæl, J.A., Helbostad, J.L., Salvesen, Ø., & Oldervoll, L.M. (2012). Feasibility and changes in symptoms and functioning following inpatient cancer rehabilitation. Acta Oncologica, 51, 1070–1080. 

To assess feasibility and effects of an inpatient rehabilitation program on symptoms and physical function

Participants attended three weeks of inpatient rehabilitation and a follow-up five-day stay 8–12 weeks later. All attended group programs, which included physical training and education following cognitive behavioral approaches. Physical training was done twice a day for 60–120 minutes.

• N = 131
• AGE: 14% were 25–44 years old, 86% were greater than or equal to 45
• MALES: 23%, FEMALES: 77%
• KEY DISEASE CHARACTERISTICS: Participants had multiple tumor types, although breast and GI were most common.
• OTHER KEY SAMPLE CHARACTERISTICS: All had high school education, and 66% had some college education. Time since diagnosis was less than two years in 72%. Thirty percent were working full-time or part-time.

• SITE: Single site  
• SETTING TYPE: Inpatient  
• LOCATION: Norway

• PHASE OF CARE: Multiple phases of care

• Quasiexperimental

• EORTC Cancer Quality of Life Core 30 (EORTC–QLQ-C30) questionnaire
• Fatigue questionnaire
• Physical activity questionnaire
• Maximal oxygen consumption test (Vo₂ max test)
• Sit-to-Stand Test (SST)
• Maximum step length

Multiple symptoms showed decline. These were statistically significant; however, the degree of change seen from the end of the initial three weeks to the final measure was less than that which the authors identified as clinically relevant. Fatigue scores increased from baseline to postintervention measures (8.9–9.3 for physical fatigue and 4.9 for mental fatigue at both time points). All symptoms declined from baseline over time.

Findings suggest that a multicomponent rehabilitation program can improve multiple symptoms for patients with cancer.

• Risk of bias (no control group)
• Risk of bias (no blinding)
• Risk of bias (no random assignment)
• Risk of bias (sample characteristics)
• Subject withdrawals of 10% or greater 
• Dropouts tended to be those with lower education levels, and significantly more males dropped out.
• The sample was self-selected.
• Lack of a control group does not enable determination if changes seen were due only to time, as it is known that many symptoms decline over time. 
• Authors noted that the three-week program was very resource intensive.  

Findings showed improvement of multiple symptoms after a three-week inpatient rehabilitation program. This was resource intensive and had many dropouts, causing one to question the practicality and cost-effectiveness of this approach. This study is limited by its design, with lack of a control group.