Mattick Lindsey J, Lin Po-Ju, Gada Umang, Loman Blake, Chakrabarti Alisha, Mustian Karen M, Hopkins Judith O
Division of Supportive Care in Cancer, Department of Surgery, School of Medicine and Dentistry, University of Rochester, Rochester, NY, 14621, USA.
Southeast Clinical Oncology Research Consortium (SCOR), Winston-Salem, NC, 27104, USA.
Support Care Cancer. 2025 Jun 2;33(6):526. doi: 10.1007/s00520-025-09584-6.
Older adults with advanced cancer are at risk for toxicities and declines in physical function, which can impact their ability to perform instrumental activities of daily living (IADLs, e.g., preparing meals, managing medications, and cleaning). This decline is a key predictor of treatment outcomes and survival in this population. To address this, we conducted a two-arm, randomized trial to evaluate the feasibility of a home-based chair exercise intervention (ChairEx), delivered in-clinic by oncology staff.
Older adults (n = 27; mean age: 74 years; 62% female; 67% White) with advanced cancer receiving chemotherapy were recruited from community oncology clinics and randomized to ChairEx (5 days/week, rate of perceived exertion [RPE] of 3-5 light-moderate intensity, 30 min/day, seated strengthening and stretching exercises), or usual care (UC). Adherence was tracked with exercise diaries. IADLs were assessed via OARS-IADL.
Among 34 screened, 27 (79%) were eligible, consented, and randomized. Seventy-eight percent (21/27) completed all study visits. ChairEx participants exercised a median of 5 days/week for 22 min/day at an RPE of 3.3, with no adverse events. Oncology staff found ChairEx minimally disruptive to clinic workflow. All ChairEx participants recommended the intervention. ChairEx participants reported improvements in IADLs (Cohen's d = 0.52), compared to UC (p = 0.026). Non-significant improvements in physical function, fatigue, and depression were observed.
ChairEx was safe, feasible, and well received by older patients with advanced cancer receiving chemotherapy. Results suggest that ChairEx may improve IADLs, physical function, fatigue, and depression. Phase II randomized clinical trials are warranted to confirm these findings.
患有晚期癌症的老年人面临毒性反应和身体功能下降的风险，这可能会影响他们进行日常生活工具性活动（如准备饭菜、管理药物和打扫卫生）的能力。这种身体功能下降是该人群治疗结果和生存的关键预测指标。为解决这一问题，我们开展了一项双臂随机试验，以评估由肿瘤学工作人员在诊所内实施的居家椅子运动干预（ChairEx）的可行性。
从社区肿瘤诊所招募正在接受化疗的患有晚期癌症的老年人（n = 27；平均年龄：74岁；62%为女性；67%为白人），并将其随机分为ChairEx组（每周5天，自感用力度[RPE]为3 - 5的轻度至中度强度，每天30分钟，坐姿强化和伸展运动）或常规护理（UC）组。通过运动日记跟踪依从性。通过OARS - IADL评估日常生活工具性活动。
在34名筛查对象中，27名（79%）符合条件、同意并被随机分组。78%（21/27）的参与者完成了所有研究访视。ChairEx组参与者每周平均运动5天，每天22分钟，RPE为3.3，未出现不良事件。肿瘤学工作人员发现ChairEx对诊所工作流程的干扰最小。所有ChairEx组参与者都推荐该干预措施。与UC组相比，ChairEx组参与者报告其日常生活工具性活动有所改善（科恩d值 = 0.52，p = 0.026）。观察到身体功能、疲劳和抑郁方面有不显著的改善。
ChairEx对接受化疗的晚期癌症老年患者来说是安全、可行且广受好评的。结果表明，ChairEx可能会改善日常生活工具性活动、身体功能、疲劳和抑郁状况。有必要开展II期随机临床试验来证实这些发现。
