Introduction
Cancer-rated fatigue is the most commonly reported treatment-related side effect from chemotherapy. Such symptom can be very distressing and frustrating that affect mentally, physically, emotionally and spiritually, leading to reduced physical activity, social engagement and quality of life in cancer patients. Physiotherapy plays a crucial role in the management of fatigue symptoms. Exercises in correct dosage of intensity and method enable cancer patients to increase their physical activity, reduce fatigue and improve the functional status. However, majority of the cancer patients did not notice the causal relationship between exercise and fatigue and prone to remain physically inactive and exercise less.
Objectives
To evaluate the effectiveness of Physiotherapy Fatigue Management Program on (1) promoting knowledge of cancer-related fatigue, (2) enhancing exercise habit and physical activity, and (3) improving symptom of fatigue and quality of life in cancer patients receiving chemotherapy.
Methodology
Patients who were diagnosed of cancer and underwent chemotherapy that joined the Physiotherapy Fatigue Management Program from 1 April to 30 September 2018 were analyzed. The Program included both educational and exercise components. All patients were educated on knowledge and self-management tips about cancer-related fatigue and supplemented by an educational booklet with photos illustration on home exercise program and exercise log book. The exercise component included a multidimensional program that comprised of relaxation exercise, active limb mobilization exercise, aerobic exercise, strengthening exercise and acu-point massage. Participants were advised to exercise daily and record down their compliance in the exercise log book. Outcome measures included (1) questionnaire on fatigue knowledge, (2) Brief Fatigue Index (BFI-T) to measure severity and impact of fatigue, (4) Functional Assessment of Cancer Therapy – Fatigue (FACT-F) to measure quality of life. Evaluations were done at baseline and immediately upon completion of chemotherapy. Telephone follow-ups were conducted at 1-week and 2-month post-chemotherapy to check for exercise compliance and positive reinforcement was provided if participants come across any barriers.
Results & Outcome
Twenty patients, aged ranged from 45 to 76 years old, were analyzed. Majority of them suffered from cancer in colorectal (60%), lung (15%), cervix (10%), lymphoma (10%), and small bowel (5%). Improvements were shown for all the outcome measures. At baseline, only 5% of the participants knew what was cancer-related fatigue and the related non-pharmacological management approach. On completion of education training, all participants (100%) showed understanding on the causal relationship between exercise and fatigue. At 1-week follow-up, 75% of the participants reported exercise of at least 150 hours per week. At 2-month follow-up, both the BFI-T score and FACT-F scores were significantly improved and higher (p< 0.05) in this group of participants as compared with those exercise less than 150 hours per week. Physiotherapy Fatigue Management Program was effective on promoting knowledge, enhancing physical activity and exercise habit, and reducing cancer-related fatigue and improving quality of life in cancer patients receiving chemotherapy.
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