Occupational Therapy and Horticulture for Cancer Survivors With Chronic Pain

Exploring the Effect of Occupational Therapy and Horticulture for Cancer Survivors With Chronic Pain

The purpose of this quasi-experimental study is to explore the impact of a therapeutic horticulture program as an occupation-based intervention to address chronic pain symptoms for cancer survivors. The main objectives are to assess participants' perceptions of pain, physical and psychosocial wellness, stress management, and quality of life at pre-, post-, and 3-month follow-up. Quantitative and qualitative data will be synthesized and analyzed to explore this phenomenon.

Study Overview

• Status: Completed
• Conditions: Chronic Pain; Cancer Survivor
• Intervention / Treatment: Behavioral: Horticultural activity

• Study Type: Interventional
• Enrollment (Actual): 9
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • California
    • Loma Linda, California, United States, 92350
      • Loma Linda University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 64 years (ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• 18 - 64 years of age
• History of cancer diagnosis
• Chronic pain longer than 3 months
• Have interest in therapeutic horticulture and exercise
• Able to participate in a moderate physical activity in sitting and/or standing for at least one hour twice a week
• Able to provide own transportation to the horticulture site or the supervised exercise program
• Able to comprehend, speak and write in English

Exclusion Criteria:

• Uncontrolled seizure disorder
• Pregnancy

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: NA
• Interventional Model: SINGLE_GROUP
• Masking: NONE

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Therapeutic Horticulture Group; The therapeutic horticulture group will participate in a 6-week horticulture program meeting twice a week for an hour led by an occupational therapist incorporating plant-based activities and education on pain management techniques at a community farm.	Behavioral: Horticultural activity; Therapeutic horticulture activities are plant-related activities that include but not limited to digging, watering, planting, weeding, trimming, fertilizing, mulching, harvesting, learning about organic farming, and exploring options to incorporate horticulture into daily activities

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Salivary Cortisol Test	Participant stress level will be determined by salivary cortisol levels. Participant's salivary cortisol level will be measured at awakening, 30 minutes following awakening and bedtime. Typically, there is Cortisol Awakening Response (CAR), which is a steep rise in cortisol output during the first 30 minutes following awakening, followed by a steady decline across the morning, afternoon, and evening hours, with the daily nadir typically occurring around midnight. Flattened diurnal cortisol slope relates to increased emotional and psychosocial stress and related to worse health outcomes. The typical Cortisol Awakening Response (CAR) is defined as an increase of at least 2.5 nmol/l from the cortisol level taken at awakening. Although there are no agreed norms for the absolute concentrations of free cortisol in saliva it typically ranges between 4.7-18.5 nmol/l for post-awakening, between 8.6-21.9 nmol/l for 30 minutes post-awakening, and 0.3-15.2 nmol/l for bedtime.	Change between baseline and three months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Lower body strength	Chair Stand testing measures the strength of the lower body. Average scores for this testing are 15 reps for women and 16 reps for men.	Change between baseline and three months
Upper body strength	Arm Curl testing measures the strength of the upper body. Average scores for this testing are 16 reps for women and 19 reps for men.	Change between baseline and three months
Endurance	2 Minutes Step testing measures the endurance or physical stamina. Average scores for this testing are 91 times for women and 101 times for men.	Change between baseline and three months
Lower body flexibility	Chair Sit and Reach testing measures lower body flexibility, specifically your hamstring flexibility. Average scores for this testing are +2 inches for women and + 0.5 inches for men.	Change between baseline and three months
Upper body flexibility	Back Scratch testing measures the flexibility of the upper body. Average scores for this testing are -0.5 inches for women and -3.5 inches for men.	Change between baseline and three months

Collaborators and Investigators

• Sponsor: Loma Linda University
• Investigators: Principal Investigator: Julie Kugel, OTD, Loma Linda University Health

Study record dates

Study Major Dates

• Study Start (ACTUAL): June 8, 2019
• Primary Completion (ACTUAL): November 23, 2019
• Study Completion (ACTUAL): February 10, 2020

Study Registration Dates

• First Submitted: April 16, 2019
• First Submitted That Met QC Criteria: May 14, 2019
• First Posted (ACTUAL): May 16, 2019

Study Record Updates

• Last Update Posted (ACTUAL): March 13, 2020
• Last Update Submitted That Met QC Criteria: March 12, 2020
• Last Verified: March 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Chronic Pain
• Other Study ID Numbers: 5180419

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No