An allied health rehabilitation program for patients following surgery for abdomino-pelvic cancer: a feasibility and pilot clinical study

An allied health rehabilitation program for patients following surgery for abdomino-pelvic cancer: a feasibility and pilot clinical study
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DOI:
10.1007/s00520-019-04931-w
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发表时间:
2020-03-01
影响因子:
3.1
通讯作者:
Denehy, Linda
Denehy, Linda
中科院分区:
医学2区
文献类型:
--
作者:
Frawley, Helena C.;Lin, Kuan-Yin;Denehy, Linda

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目的探讨对腹盆腔癌术后患者实施康复训练的可行性。方法采用非随机对照的治疗前后研究。招募了接受过I-III期腹盆腔癌(结直肠癌、妇科癌或前列腺癌)手术的患者。康复组(n = 84)接受为期8周,每两周一次的教育和锻炼计划,由物理治疗师,运动生理学家,健康心理学家和营养师进行,辅以运动日记和电话辅导。对照组(n = 104)只完成了邮寄问卷。在基线(时间1)、干预后即刻(时间2)和基线后6个月(时间3)测量可行性指标、功能性运动能力、肌肉力量、体力活动水平、盆底症状、焦虑和抑郁、健康相关生活质量(HRQoL)和自我效能,并在组内和组间进行比较。结果患者对康复计划的同意率为24%。81%的康复组参加了16次预定会议的85-100%。对该计划的总体满意度为96%。在第2时间点,康复组的功能性运动能力、男性的握力、肠道症状、体力活动水平、抑郁和HRQoL均显著改善(p < 0.05)。所有这些结局的改善在时间3时持续。与对照组相比,康复组在第2和第3次时的体力活动水平、抑郁和HRQoL显著改善(p < 0.05)。结论:肿瘤康复计划的招募比预期的要困难,然而,出勤率和患者满意度都很高。该计划对腹盆腔癌治疗后患者的几个重要临床结局产生了积极影响。
Purpose To investigate the feasibility of conducting a rehabilitation program for patients following surgery for abdomino-pelvic cancer. Methods A non-randomised controlled before-and-after study. Patients who had undergone surgery for stage I-III abdomino-pelvic cancer (colorectal, gynaecological or prostate cancer) were recruited. The rehabilitation group (n = 84) received an 8-week, bi-weekly education and exercise program conducted by a physiotherapist, exercise physiologist, health psychologist and dietician, supplemented by exercise diaries and telephone coaching sessions. The comparator group (n = 104) completed postal questionnaires only. Feasibility measures, functional exercise capacity, muscle strength, physical activity levels, pelvic floor symptoms, anxiety and depression, health-related quality of life (HRQoL) and self-efficacy were measured at baseline (time 1), immediately post-intervention (time 2) and at 6 months post-baseline (time 3) and compared within- and between-groups. Results The consent rate to the rehabilitation program was 24%. Eighty-one percent of the rehabilitation group attended 85-100% of 16 scheduled sessions. Overall satisfaction with the program was 96%. Functional exercise capacity, handgrip strength in males, bowel symptoms, physical activity levels, depression and HRQoL were significantly improved in the rehabilitation group (p < 0.05) at time 2. The improvements in all these outcomes were sustained at time 3. The rehabilitation group had significantly improved physical activity levels, depression and HRQoL compared with the comparator group at times 2 and 3 (p < 0.05). Conclusion Recruitment to this oncology rehabilitation program was more difficult than expected; however, attendance and patient satisfaction were high. This program had positive effects on several important clinical outcomes in patients following abdomino-pelvic cancer treatment.