Packel, L., Fang, C.Y., Handorf, E., & Rodoletz, M. (2017). A 12-week exercise and stress management pilot program from theory through implementation and assessment. Rehabilitation Oncology, 35, 172–180.

DOI Link

Study Purpose

The purpose of the study was to assess the response of an exercise, education, and stress management program (12 weeks) on fatigue levels of community-dwelling cancer survivors.

Intervention Characteristics/Basic Study Process

12-week program that consisted of 10 weeks of supervised moderate-intensity aerobic and strength training combined with 2 unsupervised weeks of home exercise. Supervised weeks included 1 in-person and 2 at-home sessions. Participants also received education on nutrition, stress management (mindfulness), and sleep.

Sample Characteristics

  • N = 16   
  • MEAN AGE: 68.5 years
  • MALES: 38%
  • FEMALES: 62%
  • CURRENT TREATMENT: Not applicable
  • KEY DISEASE CHARACTERISTICS: Some patients were receiving active treatment and some were in survivorship
  • OTHER KEY SAMPLE CHARACTERISTICS: 24% of patients had breast cancer

Setting

  • SITE: Single site   
  • SETTING TYPE: Outpatient    
  • LOCATION: Philadelphia area

Phase of Care and Clinical Applications

PHASE OF CARE: Late effects and survivorship

Study Design

Single arm, pre-/post-test design

Measurement Instruments/Methods

FACT-Fatigue, HADS, NCCN Distress Thermometer, 6-Minute Walk Test, and Sit-to-Stand Test

Results

Significant improvements were noted in fatigue (p = 0.008), physical well-being (p = 0.004), and in the anxiety subscale scores of the HADS (p = 0.047). Increases in 6MWT distance (p = 0.002) and Sit-to-Stand Test score (p = 0.018) were also observed. Significant reductions in psychological distress were found (p = 0.003); however, no significant changes were observed in emotional well-being (p = 0.855), social well-being (p = 0.327), or depression (p = 0.221).

Conclusions

The program had some barriers to recruitment and retention but was able to identify a statistically significant improvement in fatigue, physical well-being, and anxiety as well as increased in the 6MWT distance and Sit-to-Stand Test score.

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

Exercise, stress management, and behavior change are moderately feasible and may have an impact on cancer-related fatigue and anxiety. Larger studies are needed to confirm these results.