Home-based exercise: promising rehabilitation for symptom relief, improved functional status and quality of life for post-surgical lung cancer patients

Abstract

Background: Post-thoracotomy non-small cell lung cancer (NSCLC) patients report cancer-related fatigue (CRF) as a severe symptom that may increase the occurrence and severity of other symptoms while decreasing functional status and quality of life (QOL). The aim of this pilot study was to describe the effects of a home-based rehabilitative exercise intervention on CRF, other symptoms, functional status, and QOL for post-surgical NSCLC patients starting within days after hospital discharge.

Methods: Seven post-thoracotomy NSCLC patients completed the Brief Fatigue Inventory (BFI) measuring CRF severity, and the M.D. Anderson Symptom Inventory measuring symptom severity at pre- and post-surgery, and at the end of each week of the six-week intervention. Additionally, the Medical Outcomes Short-Form-36 measuring physical and mental functional status; and the Quality of Life Index (QLI) measuring QOL were completed pre- and post-surgery, after week 3, and at the end of the intervention (week 6).

Results: Participants had a mean age of 65 years, a mean of 6 co-morbid conditions, and initiated the intervention within 4 days after hospital discharge. Participants' CRF severity scores were reduced to mild levels while the mean number of symptoms decreased from 10.4 post-surgery to 7.0 at week 6 with lower levels of severity and interference. Likewise, participants' post-intervention functional status and QOL improved to near or above pre-surgical levels.

Conclusions: The exercise intervention for post-surgical NSCLC patients showed promising preliminary efficacy in improving CRF, other symptom severity, functional status, and QOL. Further testing via a two-arm randomized controlled trial is being conducted.

Keywords: Lung cancer; cancer-related fatigue (CRF); exercise; functional status; quality of life (QOL); symptoms.

Figures

Figure 1

Number of symptoms. Symptom severity and interference (MDASI) with scores ranging from 0 to 10, with higher scores indicating greater severity and interference. Cancer-related fatigue severity (BFI) with scores ranging from 0 to 10, with higher scores indicating greater severity.

Figure 2

Functional status (SF-36) both physical and mental health component at pre-surgery, post-surgery, and 3 and 6 weeks after the start of the exercise intervention with scores from 0 to 100, with higher scores indicating better levels of functional status .

Figure 3

Quality of life index (QLI) at pre-surgery, post-surgery, and 3 and 6 weeks after the start of the exercise intervention with scores ranging from 0 to 30, with higher scores indicating better quality of life.