Buss, T., de Walden-Gałuszko, K., Modlińska, A., Osowicka, M., Lichodziejewska-Niemierko, M., & Janiszewska, J. (2010). Kinesitherapy alleviates fatigue in terminal hospice cancer patients-an experimental, controlled study. Supportive Care in Cancer, 18, 743–749.

To evaluate the effect of physical exercise on terminally ill patients with cancer.

Patients in the exercise group exercised three times a week for 20 to 30 minutes for a three- to four-week period. The schedule of exercises was individually planned by a physiotherapist. Study outcome measures were obtained at baseline, weekly, and at the end of the study. No information was provided regarding the control group procedures.

• The sample was comprised of 49 patients. 
• No age, gender, or diagnosis information was provided. 
• All patients were in hospice either at home or in an inpatient hospice setting.

• Multisite
• Inpatient and outpatient
• Poland

Patients were undergoing end of life care/end of life and palliative care phase of care.

This was a two-group comparative trial – no information was provided on whether patients were randomly assigned.

• Fatigue visual analog scale (VAS) (0-10)
• Rotterdam symptom checklist
• Brief Fatigue Inventory (BFI)

There were no apparent effects on outcomes during the first two weeks. By week 3, mean VAS intensity of fatigue declined in the exercise group from 6.5 to 5.5. In the control group, fatigue increased from 6.5 to 7.5 (ANOVA; p < 0.001). Physical symptoms tended to decline slightly in the exercise group and increase slightly in the control group, with changes ranging from 0.1 to .05 (p < 0.05). There were no observable effects on quality of life scores from the symptom checklist data.

Results suggested that individualized exercise can be beneficial for fatigue in terminal patients with cancer.

• The study had a small sample size, with less than 100 participants.
• It was not clear how patients were assigned to study groups.
• No demographic or disease-related information was reported, so any relevant differences between groups that might affect findings cannot be determined.
• BFI results were not reported, and only a VAS fatigue measure analysis was given.
• Use of the symptom checklist for the single quality of life measure is questionable.
• Statistically significant outcome changes seen here were very small.
• The types of exercise provided were not described.

The study did not provide strong evidence for the effectiveness of exercise due to multiple issues in this report and the small measured changes seen. Findings suggested that exercise may be beneficial in terminally ill patients and showed that there were no apparent adverse effects from the activity provided to these patients.