TY - JOUR
T1 - Physical Therapist–Led Exercise Assessment and Counseling in Integrative Cancer Care
T2 - Effects on Patient Self-reported Symptoms and Quality of Life
AU - Lopez, Gabriel
AU - Eddy, Carol
AU - Liu, Wenli
AU - Li, Yisheng
AU - Chen, Minxing
AU - Bruera, Eduardo
AU - Cohen, Lorenzo
N1 - Publisher Copyright:
© The Author(s) 2019.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Background. Exercise - contributes to improved treatment-related outcomes. We reviewed characteristics of cancer patients referred for physical therapist–led exercise counseling at a comprehensive cancer center and its effects on self-reported symptoms and quality of life. Methods. Patients presenting for outpatient exercise counseling from February 2016 to May 2017 completed the Edmonton Symptom Assessment Scale (ESAS; 0-10 scale, 10 most severe) pre-encounter/post-encounter and Patient-Reported Outcomes Measurement Information System (PROMIS10) global health assessment pre-encounter. Counseling included assessment and education. ESAS individual items and subscales of physical distress (PHS), psychological distress, and global distress (GDS) were analyzed. We used paired t-tests to compare (1) ESAS symptoms pre-encounter/post-encounter and (2) ESAS and PROMIS10 scores at baseline (pre-encounter) and first follow-up. Results. Of 350 participants, most were female (77.7%), Caucasian (66.3%), and had breast cancer (43%). Baseline (pre-encounter) symptom scores (frequency; mean) included poor sleep (68.2%; 3.5), poor well-being (67.4%; 3.2), and fatigue (64.7%; 3.1). Comparing pre-encounter/postencounter ESAS outcomes, we observed statistically and clinically significant reduction in GDS (−3.32; SD = 6.52; P <.001). On follow-up, statistically and clinically significant improvements were observed for fatigue (−1.22; P =.01), GDS (−4.81; P =.01), PHS (−3.1; P =.03) and PROMIS10 global health, mental health, and physical health scores (all P <.05). Conclusion. Patients presenting for exercise counseling had a low to moderate symptom burden and experienced significant improvement in GDS. Longitudinal evaluation revealed improvement in global health and fatigue. Additional research is needed to learn more about patient selection and timing of exercise counseling.
AB - Background. Exercise - contributes to improved treatment-related outcomes. We reviewed characteristics of cancer patients referred for physical therapist–led exercise counseling at a comprehensive cancer center and its effects on self-reported symptoms and quality of life. Methods. Patients presenting for outpatient exercise counseling from February 2016 to May 2017 completed the Edmonton Symptom Assessment Scale (ESAS; 0-10 scale, 10 most severe) pre-encounter/post-encounter and Patient-Reported Outcomes Measurement Information System (PROMIS10) global health assessment pre-encounter. Counseling included assessment and education. ESAS individual items and subscales of physical distress (PHS), psychological distress, and global distress (GDS) were analyzed. We used paired t-tests to compare (1) ESAS symptoms pre-encounter/post-encounter and (2) ESAS and PROMIS10 scores at baseline (pre-encounter) and first follow-up. Results. Of 350 participants, most were female (77.7%), Caucasian (66.3%), and had breast cancer (43%). Baseline (pre-encounter) symptom scores (frequency; mean) included poor sleep (68.2%; 3.5), poor well-being (67.4%; 3.2), and fatigue (64.7%; 3.1). Comparing pre-encounter/postencounter ESAS outcomes, we observed statistically and clinically significant reduction in GDS (−3.32; SD = 6.52; P <.001). On follow-up, statistically and clinically significant improvements were observed for fatigue (−1.22; P =.01), GDS (−4.81; P =.01), PHS (−3.1; P =.03) and PROMIS10 global health, mental health, and physical health scores (all P <.05). Conclusion. Patients presenting for exercise counseling had a low to moderate symptom burden and experienced significant improvement in GDS. Longitudinal evaluation revealed improvement in global health and fatigue. Additional research is needed to learn more about patient selection and timing of exercise counseling.
KW - cancer
KW - complementary health approaches
KW - exercise counseling
KW - integrative oncology
KW - patient reported outcomes
KW - physical therapy
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U2 - 10.1177/1534735419832360
DO - 10.1177/1534735419832360
M3 - Article
C2 - 30862209
AN - SCOPUS:85062876864
SN - 1534-7354
VL - 18
JO - Integrative cancer therapies
JF - Integrative cancer therapies
ER -