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

Pilot study

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.