A Behavioral Physical Activity Intervention to Manage Moderate and Severe Fatigue Among Head and Neck Cancer Patients—Pre-efficacy Study in the National Institutes of Health ORBIT Model

• Published in: Cancer nursing Vol. 42; no. 1; pp. E1 - E14
• Main Authors: Wang, Hsiao-Lan, McMillan, Susan C, Vijayakumar, Nisha, McDonald, Sally, Huang, Li-Ting, Gwede, Clement, Padhya, Tapan, Russell, Jeffery, Vondruska, Karen, Buck, Harleah G, Huang, Yangxin, Visovsky, Connie
• Format: Journal Article
• Language: English
• Published: United States Copyright Wolters Kluwer Health, Inc. All rights reserved 01-01-2019; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adult; Aged; Exercise; Exercise Therapy; Fatigue; Fatigue - prevention & control; Female; Head & neck cancer; Head and Neck Neoplasms - psychology; Head and Neck Neoplasms - therapy; Home Care Services; Humans; Male; Middle Aged; National Institutes of Health (U.S.); Nursing; Patients; Physical fitness; Severity of Illness Index; Survival analysis; Treatment Outcome; United States; United States
• ISSN: 0162-220X; 1538-9804
• DOI: 10.1097/NCC.0000000000000568

BACKGROUNDCancer-related fatigue (CRF) reduces head and neck cancer (HNC) survival rates and is the most common, severe, and distressing symptom negatively impacting activities of daily living (ADLs) dependence among HNC patients. These patients remain physically inactive after their cancer treatment, although there is consensus that physical activity mitigates CRF in cancer patients.
OBJECTIVEA home-based personalized behavioral physical activity intervention with fitness graded motion exergames (PAfitME) was evaluated for its intervention components, intervention delivery mode, and intervention contact time/duration with initial assessment of the feasibility, acceptability, safety, and outcomes.
METHODSThis study (N = 8) was a single-group, pre-post design to evaluate a 6-week PAfitME at the end of HNC treatment. Health outcomes were CRF, ADL dependence, and fitness performance. Behavioral outcomes were exergame adherence.
RESULTSPositive health and behavioral outcomes support the PAfitME protocol including intervention components, intervention delivery mode, and intervention contact times/duration. The PAfitME intervention is feasible and acceptable with promising adherence rates. No adverse events were reported. There was marked improvement in CRF, ADL dependence, cardiorespiratory fitness, balance, muscle strength, and shoulder forward flexion, with large to moderate effect sizes as a result of the PAfitME intervention.
CONCLUSIONThe PAfitME protocol is ready for additional testing in a randomized clinical trial.
IMPLICATIONS FOR PRACTICEThe PAfitME intervention is a nurse-led nonpharmacological intervention. It can be integrated into home care or telehealth care for HNC patients at the end of their cancer treatment once effectiveness is established.