Cheville, A.L., Kollasch, J., Vandenberg, J., Shen, T., Grothey, A., Gamble, G., & Basford, J.R. (2013). A home-based exercise program to improve function, fatigue, and sleep quality in patients with stage IV lung and colorectal cancer: A randomized controlled trial. Journal of Pain and Symptom Management, 45, 811–821.

To report the effects of a strength training and walking program in patients with stage IV lung and colorectal cancer.

Patients were given usual care or 1.5 hours of training by a physical therapist on rapid, easy, strength training exercises (REST) and pedometer-based walking using an instruction manual, resistance bands, an exertion rating scale, and a study log. They were then followed bimonthly by telephone for eight weeks.

• The study reported on a final sample of 56 patients.
• Mean patient age was 63.8 years in the intervention group and 65.5 years in the control group.
• The intervention group was 48.5% male and 51.5% female. The control group was 57.6% male and 42.4% female.
• Patients had stage IV lung or colorectal cancer.

• Single site 
• Outpatient setting
• Mayo Clinic

Patients were undergoing the end of life phase of care.

The study was a single-blinded, randomized, controlled trial.

• Activity Measure for Post-Acute Care Computerized Adaptive Testing (AM-PAC CAT)
• AM-PAC Mobility
• Functional Assessment of Cancer Therapy-General (FACT-G)
• FACT-Fatigue (FACT-F) subscale
• Numerical rating scale for pain and sleep quality
• Pedometer step-count logs
• REST logs
• Vital sign collection

Mobility, fatigue, and sleep measures were statistically significant between the intervention and control groups from baseline to week 8 (p = 0.002, p = 0.03, and p = 0.002, respectively), in favor of exercise. Other measures did not show significance. The number of REST sessions and weeks logged with step counts were associated with changes in the mobility score. Survival and withdrawals did not differ significantly between the groups.

A home-based intervention using walking and strength exercises may improve mobility, fatigue, and sleep quality in patients with stage IV colorectal or lung cancer.

• The study had a small sample size, with less than 100 participants.
• The study had risks of bias due to no blinding and no appropriate attentional control condition.

The teaching of walking exercises and strength routines may improve functioning in this patient population in terms of mobility, sleep quality, and fatigue. The one-time education session may be appealing to nurses looking for a timely intervention to help improve these symptoms.