Virtual reality bringing a new reality to postthoracotomy lung cancer patients via a home-based exercise intervention targeting fatigue while undergoing adjuvant treatment.
BACKGROUND
Little is known about rehabilitation for postthoracotomy non-small cell lung cancer (NSCLC) patients. This research uses a perceived self-efficacy-enhancing light-intensity exercise intervention targeting a priority symptom, cancer-related fatigue (CRF), for postthoracotomy NSCLC patients. This article reports on phase II of a 2-phase study. Phase I focused on initiation and tolerance of exercise during the 6 weeks immediately after thoracotomy, whereas phase II addressed maintenance of exercise for an additional 10 weeks including participants initiating and completing chemotherapy and/or radiation therapy.


OBJECTIVE
The objective of this study was to investigate the feasibility, acceptability, and preliminary efficacy of an exercise intervention for postthoracotomy NSCLC patients to include those initiating and completing adjuvant therapy.


METHODS
A single-arm design composed of 7 participants postthoracotomy for NSCLC performed light-intensity exercises using an efficacy-enhancing virtual-reality approach using the Nintendo Wii Fit Plus.


RESULTS
Despite most participants undergoing chemotherapy and/or radiation therapy, participants adhered to the intervention at a rate of 88% with no adverse events while giving the intervention high acceptability scores on conclusion. Likewise, participants' CRF scores improved from initiation through the conclusion of the intervention with perceived self-efficacy for walking at a light intensity continuously for 60 minutes, improving significantly upon conclusion over presurgery values.


CONCLUSIONS
Postthoracotomy NSCLC patients maintained exercise for an additional 10 weeks while undergoing adjuvant therapy showing rehabilitation potential because the exercise intervention was feasible, safe, well tolerated, and highly acceptable showing positive changes in CRF self-management.


CONCLUSIONS
A randomized controlled trial is needed to further investigate these relationships.
Author Affiliations: College of Nursing, Michigan State University, East Lansing (Dr Hoffman); Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, Michigan (Dr Brintnall); School of Nursing, University at Buffalo, State University of New York (Dr Brown); Psychology Department, Michigan State University, East Lansing (Dr von Eye); Duke Center for Cancer Survivorship, Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (Dr Jones); Frederik Meijer Honors College, Grand Valley State University, Grand Rapids, Michigan (Dr Alderink); Lemmen-Holton Cancer Pavilion, Spectrum Health, Grand Rapids (Ms Ritz-Holland and Mr Enter), Michigan; and Spectrum Health, Grand Rapids, Michigan, and College of Human Medicine, Michigan State University, East Lansing (Drs Patzelt and VanOtteren).
Amy J
AJ
Hoffman
Ruth Ann
RA
Brintnall
Jean K
JK
Brown
Alexander
A
von Eye
Lee W
LW
Jones
Gordon
G
Alderink
Deborah
D
Ritz-Holland
Mark
M
Enter
Lawrence H
LH
Patzelt
Glenn M
GM
VanOtteren
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000451:nursing / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000451:nursing; D005081:Exercise Therapy / Q000451:nursing*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000451:nursing / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011182:Postoperative Care / Q000451:nursing*; D018714:Radiotherapy, Adjuvant / Q000451:nursing; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D013908:Thoracotomy / Q000451:nursing; D016896:Treatment Outcome