scholarly journals CaRE @ Home: Pilot Study of an Online Multidimensional Cancer Rehabilitation and Exercise Program for Cancer Survivors

2020 ◽  
Vol 9 (10) ◽  
pp. 3092 ◽  
Author(s):  
Anne Marie MacDonald ◽  
Aleksandra Chafranskaia ◽  
Christian J. Lopez ◽  
Manjula Maganti ◽  
Lori J. Bernstein ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cancer Survivors ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Care Home ◽  
Exercise Program ◽  
Rehabilitation Program ◽  
Cancer Rehabilitation ◽  
Post Intervention ◽  
Patient Reported

Background: Although facility-based cancer rehabilitation and exercise programs exist, patients are often unable to attend due to distance, cost, and other competing obligations. There is a need for scalable remote interventions that can reach and serve a larger population. Methods: We conducted a mixed methods pilot study to assess the feasibility, acceptability and impact of CaRE@Home: an 8-week online multidimensional cancer rehabilitation and exercise program. Feasibility and acceptability data were captured by attendance and adherence metrics and through qualitative interviews. Preliminary estimates of the effects of CaRE@Home on patient-reported and physically measured outcomes were calculated. Results: A total of n = 35 participated in the study. Recruitment (64%), retention (83%), and adherence (80%) rates, along with qualitative findings, support the feasibility of the CaRE@Home intervention. Acceptability was also high, and participants provided useful feedback for program improvements. Disability (WHODAS 2.0) scores significantly decreased from baseline (T1) to immediately post-intervention (T2) and three months post-intervention (T3) (p = 0.03 and p = 0.008). Physical activity (GSLTPAQ) levels significantly increased for both Total LSI (p = 0.007 and p = 0.0002) and moderate to strenuous LSI (p = 0.003 and p = 0.002) from baseline to T2 and T3. Work productivity (iPCQ) increased from T1 to T3 (p = 0.026). There was a significant increase in six minute walk distance from baseline to T2 and T3 (p < 0.001 and p = 0.010) and in grip strength from baseline to T2 and T3 (p = 0.003 and p < 0.001). Conclusions: Results indicate that the CaRE@Home program is a feasible and acceptable cancer rehabilitation program that may help cancer survivors regain functional ability and decrease disability. In order to confirm these findings, a controlled trial is required.

scholarly journals Addendum: MacDonald, A.M., et al. CaRE @ Home: Pilot Study of an Online Multidimensional Cancer Rehabilitation and Exercise Program for Cancer Survivors. J. Clin. Med. 2020, 9, 3092

2020 ◽  
Vol 9 (11) ◽  
pp. 3440
Author(s):  
Anne Marie MacDonald ◽  
Aleksandra Chafranskaia ◽  
Christian J. Lopez ◽  
Manjula Maganti ◽  
Lori J. Bernstein ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cancer Survivors ◽  
Care Home ◽  
Exercise Program ◽  
Cancer Rehabilitation

The authors wish to make the following corrections to this paper [...]

scholarly journals Yoga for Persistent Fatigue in Breast Cancer Survivors: Results of a Pilot Study

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Julienne E. Bower ◽  
Deborah Garet ◽  
Beth Sternlieb
Keyword(s):  
Breast Cancer ◽  
Pilot Study ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Controlled Trial ◽  
Post Intervention ◽  
Medical Problems ◽  
Beneficial Effects ◽  
Evidence Based Treatments ◽  
Persistent Fatigue

Approximately one-third of breast cancer survivors experiences persistent fatigue for months or years after successful treatment completion. There is a lack of evidence-based treatments for cancer-related fatigue, particularly among cancer survivors. This single-arm pilot study evaluated the feasibility and preliminary efficacy of a yoga intervention for fatigued breast cancer survivors based on the Iyengar tradition. Iyengar yoga prescribes specific poses for individuals with specific medical problems and conditions; this trial emphasized postures believed to be effective for reducing fatigue among breast cancer survivors, including inversions and backbends performed with the support of props. Twelve women were enrolled in the trial, and 11 completed the full 12-week course of treatment. There was a significant improvement in fatigue scores from pre- to post-intervention that was maintained at the 3-month post-intervention followup. Significant improvements were also observed in measures of physical function, depressed mood, and quality of life. These results support the acceptability of this intervention and suggest that it may have beneficial effects on persistent post-treatment fatigue. However, results require replication in a larger randomized controlled trial.

Supervised exercise for cancer survivors during and after active therapy.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 121-121
Author(s):  
Mark Allen O’Rourke ◽  
Regina A Franco ◽  
Dawn W. Blackhurst ◽  
Jennifer C. Trilk ◽  
Matthew F. Hudson ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Cancer Survivors ◽  
Exercise Capacity ◽  
Exercise Program ◽  
Rehabilitation Program ◽  
Physical Conditioning ◽  
Active Therapy ◽  
Fatigue Score ◽  
Supervised Exercise ◽  
Patient Reported

121 Background: Supervised exercise for cancer survivors can reduce symptoms and improve physical conditioning. This program evaluation reports the benefits of a nurse-supervised exercise program for cancer survivor participants both during and after active cancer therapy. Methods: The treating oncologist referred participants to the oncology rehabilitation program, called Moving On, either during or at the completion of active therapy. Participants enrolled in a 12-week program of supervised exercise for one hour, three days per week. Baseline and follow up evaluation included a patient reported fatigue score, on a scale from 1 to 10 (with higher scores indicating more fatigue), and the 6-minute walk test (6MWT), in feet. Results: In calendar 2011, 152 participants enrolled in the program and 91 completed all 12 weeks (completers). Participants were 71% female, 86% Caucasian, 14% African American, 68% enrolled on completion of active therapy, and 32% enrolled during active therapy. More than half were older than 60 years. More than half had cancer diagnoses other than breast cancer. A consistent decrease in fatigue and increase in exercise capacity was seen in subgroup analysis by gender, race, age, status on cancer therapy or after completion of therapy, and diagnosis. Conclusions: In this diverse group of cancer survivors, a program of 12 weeks of nurse-supervised exercise was feasible, substantially reduced fatigue, and increased exercise capacity. It is noteworthy that participants, both on active therapy and after, older and younger, and across diagnosis groups, experienced the benefits of the program. [Table: see text]

Comparison of exercise-based cancer rehabilitation delivered in-person or via telehealth (TeleCaRe): a randomised controlled trial protocol (Preprint)

2021 ◽  
Author(s):  
Amy M Dennett ◽  
Katherine E Harding ◽  
Casey L Peiris ◽  
Nora Shields ◽  
Christian Barton ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Exercise Program ◽  
Exercise Group ◽  
Cancer Rehabilitation ◽  
Home Exercise ◽  
Home Exercise Program ◽  
Randomised Controlled

BACKGROUND Access to rehabilitation to support cancer survivors to exercise is poor. Exercise-based rehabilitation may be delivered remotely but it is unknown how it compares to in-person cancer rehabilitation. OBJECTIVE To evaluate the effectiveness of an exercise-based cancer rehabilitation program delivered via telehealth compared to a traditional in-person model for improving quality of life of cancer survivors. METHODS A parallel, assessor-blinded, pragmatic, non-inferiority randomised controlled trial with embedded cost-effectiveness and qualitative analysis will be completed. One-hundred and twenty-four cancer survivors will be recruited from a metropolitan health network in Melbourne, Australia. The experimental group will attend an 8-week, twice weekly, 60-minute, exercise group supervised via videoconferencing supplemented by an online home exercise program and information portal. The comparison group will attend an 8-week, twice weekly, 60-minute, supervised exercise group in person, supplemented by a written home exercise program and information booklets. Assessments will be completed at week 0 (baseline), week 9 (post-intervention) and week 26 (follow-up). The primary outcome will be health related quality of life measured by the EORTC QLQ-C30 at week 9. Secondary measures include walking capacity (6-minute walk test), physical activity (activPAL accelerometer), self-efficacy (Health Action Process Approach Questionnaire) and recording of adverse events. Health service data including hospital length of stay, hospital readmissions, and emergency department presentations will be recorded. Semi-structured interviews will be completed and analysed using a framework approach to determine the impact of delivery mode on patient experience. The primary outcome will be analysed using linear mixed effects models. RESULTS Trial not yet recruiting. Anticipated commencement January 2022. CONCLUSIONS This trial will inform the future implementation of cancer rehabilitation by providing important data about safety, effectiveness, cost and patient experience. CLINICALTRIAL The TeleCaRe Trial has been approved by the Eastern Health Human Research Ethics Committee (E21-012-74698) and is funded by the Victorian Cancer Agency. This trial is prospectively registered with the Australian New Zealand Clinical Trials Registry ACTRN12621001417875. Registered 21st October, 2021.

A 10-hour time-restricted eating intervention to address cancer-related fatigue among cancer survivors.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12109-12109
Author(s):  
Amber Kleckner ◽  
Jennifer E Reschke ◽  
Brian James Altman ◽  
Elizabeth Belcher ◽  
Richard Francis Dunne ◽  
...  
Keyword(s):  
Adverse Events ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Treatment Time ◽  
Controlled Trial ◽  
Activity Patterns ◽  
Primary Treatment ◽  
Post Intervention ◽  
Cancer Related Fatigue ◽  
Patient Reported

12109 Background: Cancer-related fatigue is a common, debilitating condition that can persist for months or years after cancer treatment. Time-restricted eating has been shown to improve circadian rhythm and strengthen rest and activity patterns, and therefore could help reduce persistent fatigue. Herein, we evaluated the feasibility of recruiting cancer survivors to a two-week, single-arm, time-restricted eating intervention with a 10-h eating window, assessed safety of the intervention, monitored adherence, and obtained initial estimates of within-group change in patient-reported fatigue. Methods: We recruited adults 4-60 months post-cancer treatment who had a fatigue level ≥3 on a scale from 0-10 and who did not already consume food within a 10-h window. Participants were asked to consume all food and beverages within a self-selected 10-h eating window for 14 days; water was allowed at all times. Participants completed a daily diary indicating when they began and stopped eating each day. To assess fatigue, participants completed the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and the Brief Fatigue Inventory (BFI) at pre- and post-intervention. We report mean±standard deviation and used a t-test to assess differences in pre- vs. post-intervention scores. Results: A total of 21 participants consented (20 breast cancer, 1 prostate cancer; 20 female; age 57.7±11.4 years; 1.6±1.1 years post-primary treatment). The study was feasible: 19/21 (90.5%) completed pre- and post-intervention assessments and daily diaries. It was also safe: there were two mild adverse events—one unlikely (insomnia) and one possibly related to the intervention (acute headache) and no severe adverse events. Most of the participants adhered to the intervention; 14/19 (73.7%) ate all of their food within a 10-h window at least 80% of the days, and 16/19 (84.2%) reported an average eating window ≤10 h. Fatigue scores improved a clinically meaningful degree for FACIT-F total score, FACIT-F fatigue subscale, and the BFI total score from pre- to post-intervention per established cutoffs (Table). Conclusions: Cancer survivors were willing and able to adhere to a two-week time-restricted eating intervention, and the intervention was safe. Also, fatigue was reduced with moderate to large effect sizes after two weeks of time-restricted eating. Based on our results, a follow-up randomized controlled trial to investigate time-restricted eating to alleviate cancer-related fatigue among cancer survivors is indicated. Funding: NIH/NCI UG1CA189961, T32CA102618. Clinical trial information: NCT04243512. [Table: see text]

scholarly journals Cooking for Vitality: Pilot Study of an Innovative Culinary Nutrition Intervention for Cancer-Related Fatigue in Cancer Survivors

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2760
Author(s):  
Cheryl Pritlove ◽  
Geremy Capone ◽  
Helena Kita ◽  
Stephanie Gladman ◽  
Manjula Maganti ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Energy Levels ◽  
Nutrition Intervention ◽  
Management Skills ◽  
Cooking Skills ◽  
Patients With Cancer ◽  
Cancer Related Fatigue ◽  
Poor Nutritional Status

(1) Background: Cancer-related fatigue (CRF) is one of the most prevalent and distressing side effects experienced by patients with cancer during and after treatment, and this negatively impacts all aspects of quality of life. An increasing body of evidence supports the role of poor nutritional status in the etiology of CRF and of specific diets in mitigating CRF. We designed a group-based two session culinary nutrition intervention for CRF, Cooking for Vitality (C4V), aimed at increasing understanding of how food choices can impact energy levels and establishing basic food preparation and cooking skills as well as the application of culinary techniques that minimize the effort/energy required to prepare meals. The purpose of this pilot mixed-method study was to evaluate: Feasibility of the experimental methods and intervention; acceptability and perceived helpfulness of intervention; and to obtain a preliminary estimate of the effectiveness of the intervention on fatigue (primary outcome), energy, overall disability, and confidence to manage fatigue (secondary outcomes). (2) Methods: Prospective, single arm, embedded mixed-methods feasibility study of cancer survivors with cancer-related fatigue was conducted. Participants completed measures at baseline (T0), immediately following the intervention (T1), and three months after the last session (T2). Qualitative interviews were conducted at T2. (3) Results: Recruitment (70%) and retention (72%) rates along with qualitative findings support the feasibility of the C4V intervention for cancer survivors living with CRF (program length and frequency, ease of implementation, and program flexibility). Acceptability was also high and participants provided useful feedback for program improvements. Fatigue (FACT-F) scores significantly improved from T0–T1 and T0–T2 (p < 0.001). There was also a significant decrease in disability scores (WHO-DAS 2.0) from T0–T2 (p = 0.006) and an increase in POMS-Vigor (Profile of Mood States) from T0–T1 (p = 0.018) and T0–T2 (p = 0.013). Confidence in managing fatigue improved significantly from T0–T1 and T0–T2 (p < 0.001). (4) Conclusions: The results suggest that the C4V program was acceptable and helpful to patients and may be effective in improving fatigue levels and self-management skills. A randomized controlled trial is required to confirm these findings.

scholarly journals Evaluation of the General Practice Pharmacist (GPP) intervention to optimise prescribing in Irish primary care: a non-randomised pilot study

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e035087
Author(s):  
Karen Cardwell ◽  
Susan M Smith ◽  
Barbara Clyne ◽  
Laura McCullagh ◽  
Emma Wallace ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Pilot Study ◽  
Medication Review ◽  
Controlled Trial ◽  
Cost Savings ◽  
Practice Team ◽  
Patient Reported ◽  
General Practices ◽  
Medication Changes

ObjectiveLimited evidence suggests integration of pharmacists into the general practice team could improve medicines management for patients, particularly those with multimorbidity and polypharmacy. This study aimed to develop and assess the feasibility of an intervention involving pharmacists, working within general practices, to optimise prescribing in Ireland.DesignNon-randomised pilot study.SettingPrimary care in Ireland.ParticipantsFour general practices, purposively sampled and recruited to reflect a range of practice sizes and demographic profiles.InterventionA pharmacist joined the practice team for 6 months (10 hours/week) and undertook medication reviews (face to face or chart based) for adult patients, provided prescribing advice, supported clinical audits and facilitated practice-based education.Outcome measuresAnonymised practice-level medication (eg, medication changes) and cost data were collected. Patient-reported outcome measure (PROM) data were collected on a subset of older adults (aged ≥65 years) with polypharmacy using patient questionnaires, before and 6 weeks after medication review by the pharmacist.ResultsAcross four practices, 786 patients were identified as having 1521 prescribing issues by the pharmacists. Issues relating to deprescribing medications were addressed most often by the prescriber (59.8%), compared with cost-related issues (5.8%). Medication changes made during the study equated to approximately €57 000 in cost savings assuming they persisted for 12 months. Ninety-six patients aged ≥65 years with polypharmacy were recruited from the four practices for PROM data collection and 64 (66.7%) were followed up. There were no changes in patients’ treatment burden or attitudes to deprescribing following medication review, and there were conflicting changes in patients’ self-reported quality of life.ConclusionsThis non-randomised pilot study demonstrated that an intervention involving pharmacists, working within general practices is feasible to implement and has potential to improve prescribing quality. This study provides rationale to conduct a randomised controlled trial to evaluate the clinical and cost-effectiveness of this intervention.

scholarly journals The Surveillance After Extremity Tumor Surgery (SAFETY) trial: protocol for a pilot study to determine the feasibility of a multi-centre randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029054 ◽  
Author(s):  
Keyword(s):  
Pilot Study ◽  
Randomised Controlled Trial ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Systemic Disease ◽  
Chest Ct ◽  
Tumor Surgery ◽  
Free Survival ◽  
Patient Reported ◽  
Randomised Controlled

IntroductionFollowing the treatment of patients with soft tissue sarcomas (STS) that are not metastatic at presentation, the high risk for local and systemic disease recurrence necessitates post-treatment surveillance. Systemic recurrence is most often detected in the lungs. The most appropriate surveillance frequency and modality remain unknown and, as such, clinical practice is highly varied. We plan to assess the feasibility of conducting a multi-centre randomised controlled trial (RCT) that will evaluate the effect on overall 5-year survival of two different surveillance frequencies and imaging modalities in patients with STS who undergo surgical excision with curative intent.Methods and analysisThe Surveillance After Extremity Tumor Surgery trial will be a multi-centre 2×2 factorial RCT. Patients with non-metastatic primary Grade II or III STS treated with excision will be allocated to one of four treatment arms1: chest radiograph (CXR) every 3 months for 2 years2; CXR every 6 months for 2 years3; chest CT every 3 months for 2 years or4 chest CT every 6 months for 2 years. The primary outcome of the pilot study is the feasibility of a definitive RCT based on a combination of feasibility endpoints. Secondary outcomes for the pilot study include the primary outcome of the definitive trial (overall survival), patient-reported outcomes on anxiety, satisfaction and quality of life, local recurrence-free survival, metastasis-free survival, treatment-related complications and net healthcare costs related to surveillance.Ethics and disseminationThis trial received provisional ethics approval from the McMaster/Hamilton Health Sciences Research Ethics Board on 7 August 2019 (Project number 7562). Final ethics approval will be obtained prior to commencing patient recruitment. Once feasibility has been established and the definitive protocol is finalised, the study will transition to the definitive study.Trial registrationNCT03944798; Pre-results.

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