A home-based 12-week chair exercise intervention for older adults with advanced cancer receiving chemotherapy: a randomized pilot feasibility trial.

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.