Improved Physical Function And Quality Of Life In People With Blood Cancer After An Exercise Intervention

Abstract

In blood cancer, aerobic physical activity may improve fatigue and depression, though its effect on quality of life and physical function is less clear. Assessment of Fit to Thrive (FTT), a community-based individualised, supervised exercise program for people with blood cancer, may assist with future recommendations. PURPOSE: To assess the effect of the FTT program on physical function and quality of life (QoL) in people with blood cancer. METHODS: The 12-week FTT program utilised progressive aerobic and resistance training, supervised by an Accredited Exercise Physiologist, in small groups (n=6), twice weekly, for 8 weeks, with associated psychosocial and peer support. Physical function was assessed via the six minute walk (6MW), functional forward reach (FFR) and 5 times-sit-to-stand (5TSTS) tests. QoL was measured using the 36-item Short Form Survey Instrument (SF-36) and the Functional Assessment of Cancer Therapy General (FACT-G). Minimally important differences (MID) involved a change of 2 points for the SF-36, 3 points for the FACT-G and +50m for 6MW. RESULTS: Participants (n=106) who attended the FTT program between 2014 and 2016 were included. Significant improvements in functional measures were observed for 6MW (+54.7m [95% CI 40.5, 69.0] p<0.001), 5TSTS (-1.9 sec [95% CI -2.5, -1.2] p<0.001) and FFR (+2.7cm [95% CI 1.5, 4.0] p<0.001), with the MID achieved by 56% for the 6MW. The SF-36 physical component summary (PCS) significantly increased (+4.99 [95% CI 3.29, 6.68] p<0.001) immediately following the intervention, with 68% (n=72) achieving the MID. The improvement in the SF-36 mental component summary (MCS) also achieved statistical significance (+2.81 [95% CI 0.54, 5.08] p=0.02), with 51% (n=54) achieving the MID. FACT-G scores improved significantly from pre- to post-intervention (+5.50 [95%CI 2.52, 8.47], p<;0.001) with 58% (n=62) meeting the MID. MID improvements in PCS and FACT-G were maintained in 77% (n=20/26) and 95% (n=19/20) of participants 3 months following completion of the program. CONCLUSION: The FTT program was effective in improving physical function and QoL, with some evidence for long-term effects. An individually-prescribed exercise program supervised by an Accredited Exercise Physiologist should be considered as part of standard care in people with stable blood cancer.