Specific autonomy recovery programme in a comprehensive rehabilitation on functionality and respiratory parameters in oncological patients with dyspnoea. Study protocol

Eduardo José Fernández-Rodríguez, Jesús González-Sánchez, Ana Silvia Puente-González, José Ignacio Recio-Rodríguez, Celia Sánchez-Gómez, Roberto Méndez-Sánchez, Juan Jesús Cruz-Hernández, María Isabel Rihuete-Galve, Eduardo José Fernández-Rodríguez, Jesús González-Sánchez, Ana Silvia Puente-González, José Ignacio Recio-Rodríguez, Celia Sánchez-Gómez, Roberto Méndez-Sánchez, Juan Jesús Cruz-Hernández, María Isabel Rihuete-Galve

Abstract

Background: Survival in cancer patients has increased exponentially in recent years, with multiple side effects caused by treatments. Cancer-related asthenia and dyspnea are among them, which represent a serious health problem, with considerable limitations and reduced quality of life. An implementation of the conventional clinical practice, developed through physical exercise, may be useful in controlling dyspnoea. This study aims to compare the effects of a comprehensive rehabilitation implementing a programme of multimodal physical exercise with a specific autonomy recovery programme, versus an isolated intervention using the physical exercise programme alone, on the functionality, physical performance and respiratory parameters in oncologycal patients with dyspnea.

Methods: This is a protocol por an experimental, prospective, randomized, parallel-controlled clinical trial, with two arms design of fixed assignment with an experimental and control groups. It will conduct in the Oncology Hospitalisation Unit at the University Hospital Complex of Salamanca, using consecutive sampling to select 50 participants with oncological dyspnoea who are hospitalised at the time of inclusion. After baseline assessment, participants will be randomised into the groups. Experimental group will complete Comprehensive Rehabilitation with the autonomy recovery and the multimodal exercise programmes, and in the control group, only the multimodal exercise programme will be carried out. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of dyspnoea (MRC scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the oxygen saturation in the blood using pulse oximetry, fear/avoidance of movement with the Tampa Scale of Kinesiophobia (TSK), and the quality of life of the oncology patient (ECOG performance scale).

Discussion: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with dyspnoea. Increase in the survival of patients with cancer includes multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. The current study addresses to improve the conventional clinical practice by proposing an integral, rehabilitative approach, to implement education and training for oncology patients with dyspnea to increase their quality of life.

Trial registration: ClinicalTrials.gov; ID: NCT04766593 . (February 23, 2021).

Keywords: Autonomy; Cancer; Comprehensive rehabilitation; Dyspnoea; Exercise; Functionality; Nursing; Oncology; Quality of live.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow Chart of the study. The enrolled participants are to be randomly assigned to one of the study conditions, with assessments to be taken at three pre-specified time points

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. doi: 10.3322/caac.21492.
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7–30. doi: 10.3322/caac.21590.
    1. Koelwyn GJ, Jones LW, Hornsby W, Eves ND. Exercise therapy in the management of dyspnea in patients with cancer. Curr Opin Support Palliat Care. 2012;6(2):129–137. doi: 10.1097/SPC.0b013e32835391dc.
    1. Nakano J, Hashizume K, Fukushima T, Ueno K, Matsuura E, Ikio Y, Ishii S, Morishita S, Tanaka K, Kusuba Y. Effects of aerobic and resistance exercises on physical symptoms in Cancer patients: a meta-analysis. Integr Cancer Ther. 2018;17(4):1048–1058. doi: 10.1177/1534735418807555.
    1. Ripamonti C. Management of dyspnea in advanced cancer patients. Support Care Cancer. 1999;7(4):233–243. doi: 10.1007/s005200050255.
    1. Cooper J. Occupational therapy in oncology and palliative care. London: Wiley; 2006.
    1. Migliore A. Improving dyspnea management in three adults with chronic obstructive pulmonary disease. Am J Occup Ther. 2004;58(6):639–646. doi: 10.5014/ajot.58.6.639.
    1. Velthuis MJ, Van den Bussche E, May AM, Gijsen BC, Nijs S, Vlaeyen JW. Fear of movement in cancer survivors: validation of the modified Tampa scale of kinesiophobia-fatigue. Psychooncology. 2012;21(7):762–770. doi: 10.1002/pon.1971.
    1. Nijs J, Roussel N, Van Oosterwijck J, De Kooning M, Ickmans K, Struyf F, Meeus M, Lundberg M. Fear of movement and avoidance behaviour toward physical activity in chronic-fatigue syndrome and fibromyalgia: state of the art and implications for clinical practice. Clin Rheumatol. 2013;32(8):1121–1129. doi: 10.1007/s10067-013-2277-4.
    1. Silver JK, Gilchrist LS. Cancer rehabilitation with a focus on evidence-based outpatient physical and occupational therapy interventions. Am J Phys Med Rehabil. 2011;90(5 Suppl 1):S5–15. doi: 10.1097/PHM.0b013e31820be4ae.
    1. Purcell A, Fleming J, Bennett S, Haines T. Development of an educational intervention for Cancer-related fatigue. Br J Occup Ther. 2010;73(7):327–333. doi: 10.4276/030802210X12759925544425.
    1. Henshall CL, Allin L, Aveyard H. A Systematic Review and Narrative Synthesis to Explore the Effectiveness of Exercise-Based Interventions in Improving Fatigue, Dyspnea, and Depression in Lung Cancer Survivors. Cancer Nurs. 2019;42(4):295–306. doi: 10.1097/NCC.0000000000000605.
    1. Cheng X. Effects of lung rehabilitation therapy in improving respiratory motor ability and alleviating dyspnea in patients with lung Cancer after lobectomy: a clinical study. Altern Ther Health Med 2020 AT6400.
    1. Schmitz KH, Campbell AM, Stuiver MM, Pinto BM, Schwartz AL, Morris GS, Ligibel JA, Cheville A, Galvão DA, Alfano CM, Patel AV, Hue T, Gerber LH, Sallis R, Gusani NJ, Stout NL, Chan L, Flowers F, Doyle C, Helmrich S, Bain W, Sokolof J, Winters-Stone KM, Campbell KL, Matthews CE. Exercise is medicine in oncology: engaging clinicians to help patients move through cancer. CA Cancer J Clin. 2019;69(6):468–484. doi: 10.3322/caac.21579.
    1. Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker DS, Matthews CE, Ligibel JA, Gerber LH, Morris GS, Patel AV, Hue TF, Perna FM, Schmitz KH. Exercise guidelines for Cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc. 2019;51(11):2375–2390. doi: 10.1249/MSS.0000000000002116.
    1. Hilfiker R, Meichtry A, Eicher M, Nilsson Balfe L, Knols RH, Verra ML, Taeymans J. Exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment: a systematic review incorporating an indirect-comparisons meta-analysis. Br J Sports Med. 2018;52(10):651–658. doi: 10.1136/bjsports-2016-096422.
    1. Fernández Rodríguez EJ, Rihuete Galve MI, Cruz Hernández JJ. Impact of a comprehensive functional rehabilitation programme on the quality of life of the oncological patient with dyspnoea. Med Clin (Barc). 2020:S0025–7753(20)30565–0. Advance online publication.
    1. Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61–65.
    1. Mahler DA, Wells CK. Evaluation of clinical methods for rating dyspnea. Chest. 1988;93(3):580–586. doi: 10.1378/chest.93.3.580.
    1. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85–M94. doi: 10.1093/geronj/49.2.M85.
    1. O'Driscoll BR, Howard LS, Davison AG. British Thoracic Society. BTS guideline for emergency oxygen use in adult patients. Thorax. 2008;63(Suppl 6):vi1–v68.
    1. Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP. Toxicity and response criteria of the eastern cooperative oncology group. Am J Clin Oncol. 1982;5(6):649–655. doi: 10.1097/00000421-198212000-00014.
    1. American College of Sports Medicine. Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, Salem GJ, Skinner JS, American College of Sports Medicine position stand Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;41(7):1510–1530. doi: 10.1249/MSS.0b013e3181a0c95c.
    1. Şahin S, Akel S, Zarif M. Occupational Therapy in Oncology and Palliative Care. In: Huri M, editor. In Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation. Turkey: IntechOpen; 2017. pp. 207–222.
    1. Gray CD, Kinnear PR. IBM SPSS statistics 19 made simple. Hove: Psychology Press; 2012.

Source: PubMed

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