College of Nursing, Michigan State University, East Lansing, MI, USA.
Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, MI, USA.
Onco Targets Ther. 2014 Mar 10;7:415-23. doi: 10.2147/OTT.S57262. eCollection 2014.
The objective of this pilot study was to describe the effects of a 16-week home-based rehabilitative exercise program on cancer-related fatigue (CRF), other symptoms, functional status, and quality of life (QOL) for patients with non-small cell lung cancer (NSCLC) after thoracotomy starting within days after hospital discharge and continuing through the initiation and completion of chemotherapy.
Five patients with NSCLC completed the Brief Fatigue Inventory (measuring CRF severity) and the MD Anderson Symptom Inventory (measuring symptom severity) before and after thoractomy, and at the end of each week of the 16-week exercise program. Additionally, the Medical Outcomes Study Short Form-36 (measuring physical and mental functional status) and the Quality of Life Index (measuring QOL) were completed before and after thoracotomy, after weeks 3, 6, 12, and 16 (the end of the exercise program). Further, the 6-minute walk test (measuring functional capacity) was administered before thoracotomy, prior to the initiation of chemotherapy and/or radiation therapy, and at the end of the 16-week exercise program, after completion of chemotherapy.
Participants had a mean age of 63 years and a mean of five comorbid conditions; the exercise program was initiated within 4 days after hospital discharge. Participants' CRF severity scores were reduced to mild levels, while the mean number of symptoms decreased from 9 postthoracotomy to 6 after the exercise program, with mean levels of severity and interference decreasing to below prethoracotomy levels. Likewise, participants' functional status and QOL after completing the exercise program improved to near or above prethoracotomy levels.
The home-based, light-intensity exercise program for NSCLC patients receiving and completing adjuvant chemotherapy postthoracotomy showed promising trends in improving CRF severity, other symptom severity, functional status, and QOL. Further testing via a two-arm randomized controlled trial is being conducted.
本初步研究旨在描述在术后不久开始并持续至化疗启动和完成的 16 周家庭康复运动方案对非小细胞肺癌(NSCLC)患者术后癌因性疲乏(CRF)及其他症状、功能状态和生活质量(QOL)的影响。
5 例 NSCLC 患者在术后即刻、每周末和 16 周运动方案结束时分别完成简短疲劳量表(测量 CRF 严重程度)和 MD 安德森症状量表(测量症状严重程度)的测评。另外,患者还在术前和术后即刻、第 3、6、12 和 16 周(运动方案结束时)完成了医疗结局研究简表 36 项(测量生理和心理功能状态)和生活质量指数(测量 QOL)的测评。此外,在术前即刻、化疗和/或放疗开始前和 16 周运动方案结束时(化疗完成后)进行了 6 分钟步行测试(测量功能容量)。
参与者的平均年龄为 63 岁,平均合并 5 种合并症;运动方案在术后 4 天内启动。参与者的 CRF 严重程度评分降至轻度,而术后即刻的症状数从 9 项降至 6 项,严重程度和干扰的平均水平降至术前水平以下。同样,参与者在完成运动方案后功能状态和 QOL 得到改善,接近或超过术前水平。
接受辅助化疗的 NSCLC 患者术后家庭、低强度运动方案显示出改善 CRF 严重程度、其他症状严重程度、功能状态和 QOL 的有前景的趋势。目前正在进行一项双盲随机对照试验以进一步测试。