School of Allied Health, Human Services and Sport, La Trobe University and Allied Health Clinical Research Office, Eastern Health, Level 2, 5 Arnold St, Box Hill, VIC, Australia.
North Eastern Melbourne Cancer Services and Department of Cancer Services, Eastern Health, Box Hill, VIC, Australia.
Support Care Cancer. 2021 Nov;29(11):6701-6711. doi: 10.1007/s00520-021-06261-2. Epub 2021 May 8.
To establish the feasibility of embedding a flexible, exercise-based rehabilitation program into a cancer treatment unit to allow cancer survivors early exercise support.
A pre-post study was conducted using Bowen's Framework to describe key domains of feasibility: demand (referrals), acceptability (uptake, attendance, satisfaction), implementation (resources), practicality (adverse events, costs) and limited-efficacy (function, quality of life, self-efficacy). Participants were medically stable, adult cancer survivors receiving curative or palliative treatment for cancer at the health service. Participants completed an 8-week home or hospital-based exercise program. Data were analysed descriptively. Standardised mean differences (Hedge's g) and mean differences were calculated to determine effect size and clinical significance.
The exercise-based rehabilitation service received 155 referrals over 6 months. Of those eligible, 73/119 (61%) commenced. Participants opting for twice-weekly, hospital-based exercise attended 9/16 (56%) sessions. Participants reported high satisfaction and there were no major adverse events. The program utilised existing resources, with the predominant cost being staff. The average health service cost per participant was AUD $1,104. Participants made clinically significant gains in function (6-min walk distance; + 73 m, 95% confidence interval 49 to 96) and quality of life (EORTC QLQ-C30 Global quality of life; + 8 units, 95% confidence interval 3 to 13).
Implementation of exercise-based rehabilitation in a co-located cancer unit was safe and feasible. Access, patient and staff education and establishing funding streams are important implementation considerations. Implications for cancer survivors Access to exercise in a cancer unit provides opportunity for early intervention to optimise function during treatment.
将一个灵活的、基于运动的康复项目嵌入癌症治疗单元，为癌症幸存者提供早期运动支持。
采用鲍文框架（Bowen's Framework）对 8 周的家庭或医院为基础的运动项目进行预-后研究，以描述可行性的关键领域：需求（转介）、可接受性（参与率、出席率、满意度）、实施（资源）、实用性（不良事件、成本）和有限疗效（功能、生活质量、自我效能）。参与者为接受癌症治疗服务的、稳定的、成年癌症幸存者，治疗目的为治愈或姑息治疗。参与者完成了一个 8 周的家庭或医院为基础的运动项目。数据采用描述性分析。标准化均数差（Hedge's g）和均数差用于确定效果大小和临床意义。
基于运动的康复服务在 6 个月内收到了 155 次转介。在符合条件的患者中，73/119（61%）开始了运动项目。选择每周两次、在医院进行运动的患者参加了 9/16（56%）的课程。患者报告满意度高，没有出现重大不良事件。该项目利用了现有资源，主要成本是人员。每位参与者的平均医疗服务成本为 1104 澳元。参与者在功能（6 分钟步行距离；增加 73 米，95%置信区间 49 至 96）和生活质量（EORTC QLQ-C30 全球生活质量；增加 8 个单位，95%置信区间 3 至 13）方面均有显著改善。
在癌症联合治疗单元中实施基于运动的康复是安全且可行的。获得患者和工作人员的教育和建立资金来源是实施的重要考虑因素。对癌症幸存者的影响在癌症单元中进行运动可提供早期干预机会，以优化治疗期间的功能。
