Physiotherapy management of cancer-related fatigue: a survey of UK current practice.

PURPOSE: To establish physiotherapy management of cancer-related fatigue (CRF), in particular, to determine physiotherapy exercise management of CRF. METHODS: All physiotherapist members of the UK Association of Chartered Physiotherapists in Oncology and Palliative Care (ACPOPC) received a questionnaire. RESULTS: The response rate was 65% (223/341). Therapists had a mean of 6.8 years (+/-5.6) experience in oncology and/or palliative care. Seventy-eight percent of therapists recommend and/or use exercise as part of the management of CRF; 74% teach other strategies, most commonly energy-conservation techniques (79%). Therapists recommend and/or use exercise in similar frequencies with a range of cancer types, before (32%), during (53%) and following treatment (59%) and during advanced stages of the disease (68%). The most common barrier encountered by therapists in recommending and/or using exercise was related to the lack-of-exercise guidelines for patients with CRF (71%). CONCLUSION: Physiotherapists' management of CRF includes recommending and using exercise and teaching energy-conservation techniques. Therapists recommend and/or use exercise with a variety of cancer populations, across all stages of the disease trajectory, in particular during advanced stages of the disease. Findings show therapists feel their practice is affected by the lack of exercise guidance for the cancer population. CRF management and physiotherapy practice would benefit from further research testing the efficacy of exercise in understudied patient groups, in all stages of the disease trajectory.

Exercise Interventions to Manage Fatigue in Women With Gynecologic Cancer: A Systematic Review.

PROBLEM IDENTIFICATION: Fatigue has a negative impact on the quality of life of patients with cancer. The aim of this review is to evaluate studies on the effectiveness of exercise interventions in reducing fatigue in women with gynecologic cancer. LITERATURE SEARCH: The review was conducted according to the PRISMA guidelines using the CINAHL®, MEDLINE®, EMBASE, PsycINFO®, and Cochrane Library databases. The Critical Appraisal Skills Programme was used for quality assessment. DATA EVALUATION: Five studies met the inclusion criteria. SYNTHESIS: Evidence suggests that exercise interventions result in significant reductions in fatigue in women with gynecologic cancer. However, the current evidence is limited. Additional studies are required to address the dose-dependent outcomes of exercise interventions on fatigue in women with gynecologic cancer. IMPLICATIONS FOR NURSING: Findings support the positive effects of exercise interventions in reducing fatigue in women with gynecologic cancer, suggesting that healthcare professionals may consider including exercise programs into management plans for this population.

Biological markers as an outcome measure of exercise in cancer rehabilitation: A systematic review.

The number of people living with and beyond cancer is at an all time high. These survivors are not necessarily living well, as adverse side effects from cancer and its treatment can last up to 5 years and leave patients at a higher risk of developing secondary cancers and other chronic illnesses. Exercise has been proven to be a safe and effective method of intervention to decrease mortality and overall improve health outcomes. The biological mechanism through which this occurs is an area of research that is in its infancy and not well defined. A systematic search was conducted of four databases for relevant randomized controlled trials (RCTs) published between January 2004 and December 2014. Studies had to include any blood/urine biological markers as an outcome measure to a physical activity intervention for cancer survivors posttreatment. Fifteen relevant articles were identified (12 RCTs). It was shown that randomized controlled trials of exercise for cancer survivors posttreatment may results in changes to circulating levels of insulin, insulin related pathways (insulin like growth factor II [IGF II], IGF binding protein 3), high density lipoprotein, total cholesterol, leptin, and osteocalcin. Due to small sample sizes, the evidence is still preliminary and therefore more research is warranted in this area in the form of larger, statistically powered RCTs for cancer survivors.