ABSTRACT
Objective: The purpose of this study was to clarify the characteristics of physical quality of life (QOL) and activities of daily living (ADL) in patients with advanced cancer undergoing home-visit rehabilitation. Method: In this prospective study, we included 35 patients with advanced cancer undergoing home-visit rehabilitation. Physical QOL was assessed using the Physical Functioning (PF) score on the QLQ-C15, and ADL was assessed using the Barthel Index (BI) and Functional Independence Measure (Motor FIM) scores. Changes in physical QOL and each ADL scores from the start of rehabilitation to 4 weeks later were investigated. Also, patients were divided into two groups according to the PF score and characteristics of physical QOL and ADL between the two groups were explored. Result: PF score was significantly improved after 4 weeks compared to baseline. In the PF score maintenance/improvement group, motor FIM score was significantly improved after 4 weeks compared to baseline. Conclusion: The physical QOL of patients with advanced cancer undergoing home-visit rehabilitation was maintained and improved 4 weeks after the start of rehabilitation. It was suggested that maintaining ADL may lead to maintenance and improvement of physical QOL.
ABSTRACT
Objectives: We developed the multimodal program Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC program). The aim of our study is to show algorithm of the home-based resistance training prescription and its compliance. Methods: We recruited 30 patients aged≥70 years scheduled to receive first-line chemotherapy for advanced pancreatic or non-small-cell lung cancer. Three educational sessions were planned in 8-week study period. Our resistance training consists of 3 or 5 of following 5 exercises components: (1) sit-to-stand, (2) calf raise, (3) knee extension, (4) knee raise, (5) side leg raise. Physiotherapist chose optimal prescription according to the modified Borg-scale. We assessed patient compliance, and safety. Results: Median proportion of days in which patients performed full or modified exercise program was 91%. Adverse events possibly related to the NEXTAC program were observed in 5 patients and included muscle pain (grade 1 in 2 patients), arthralgia (grade 1 in one patient), dyspnea on exertion (grade 1 in one patient), and plantar aponeurositis (grade 1 in one patient). Patient physical function and physical activity were maintained during the study period. Conclusion: Our resistance training showed excellent compliance and safety in elderly patients with newly diagnosed pancreatic and non-small-cell lung cancer receiving concurrent chemotherapy. Although this study was not designed to show the efficacy of the resistance training, our data indicate a potential protective effect on physical function and physical activity.