Therapeutic exercise during outpatient radiation therapy for advanced cancer: Feasibility and impact on physical well-being.
OBJECTIVE
To characterize the feasibility of delivering a structured physical therapy (PT) program as part of a multidisciplinary intervention to patients undergoing outpatient radiation therapy for advanced cancer.


METHODS
A single-blinded, randomized, controlled trial at a quaternary medical center outpatient clinic. One hundred three adults undergoing radiation therapy for advanced cancer with prognoses > or =6 mos and 5-yr survival estimates < or =50% were randomized to usual care or participation in eight 90-min, multidisciplinary interventional sessions with 30 mins of each session devoted to PT. PT consisted of truncal and limb isodynamic strengthening targeting major upper- and lower-limb muscle groups as well as education and provision with instructional materials. Physical well-being and fatigue were assessed with Linear Analog Scale of Assessment. The Profile of Mood States-Short form, including Fatigue-Inertia and Vigor-Activity subscales, was also administered.


RESULTS
PT session attendance was 89.3%. Relative to baseline, mean physical well-being Linear Analog Self Assessment scores at week 4 improved in the intervention group, 0.4 (SD, 23.6), and declined significantly in the control group, -10.0 (SD, 21.5) (P = 0.02). Fatigue and vigor were not significantly different between the groups. All intergroup differences had resolved at 8 and 27 wks. Baseline characteristics were not associated with the magnitude or direction of change in outcomes related to physical functioning.


CONCLUSIONS
Delivery of a standardized resistive exercise PT intervention is feasible during outpatient radiation therapy and is associated with preserved physical well-being. However, benefits were not sustained, and fatigue was not affected.
Cheville
Andrea L
AL
Departments of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA.
Girardi
Jean
J
Clark
Matthew M
MM
Rummans
Teresa A
TA
Pittelkow
Thomas
T
Brown
Paul
P
Hanson
Jean
J
Atherton
Pamela
P
Johnson
Mary E
ME
Sloan
Jeff A
JA
Gamble
Gail
G
D005221:Fatigue / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000532:radiotherapy*; D010044:Outpatient Clinics, Hospital; D026741:Physical Therapy Modalities; D011788:Quality of Life; D016037:Single-Blind Method