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Benefits of Physical Therapy Intervention: The Effects of an Individualized Home Exercise Program
(HEP) on Function and Quality of Life (QoL) in 7 Cancer Survivors
John Carr, SPT; Brittany Cochario, SPT; Sydney Folk, SPT, ATC, CSCS; Sara Nelson, SPT; Ellie Sterns, SPT;
Helene Strange, SPT; Abby Togliatti, SPT
Research Advisor: Jill Mayer, PT, DPT, NCS
ABSTRACT
Introduction: There are an estimated 14.5 million cancer survivors in the United States. Cancer survivors
endure a range of treatment side effects that lead to long-term secondary impairments, affecting
patients’ function and QoL. In a health interview survey, 58% of cancer survivors reported one or more
functional limitations. The purpose of this study was to determine the effects of an 8-week
individualized HEP for participants undergoing or recently post cancer treatment.
Methods: This was a case series of a heterogeneous sample of 8 participants with various types of
cancer in all phases of treatment (<75 days from treatment). At initial evaluation and following the 8
week program, participants completed the European Organization of Research and Treatment of Cancer
QoL Questionnaire-Cancer 30 (EORTC), 6 Minute Walk Test (6MWT), Fullerton Advanced Balance Scale
(FAB) and Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale. Participants were
provided with an individualized HEP and activity log designed by the PT and student PTs. HEPs included
strengthening exercises and aerobic activities as per American College of Sports Medicine (ACSM)
guidelines. Weekly phone calls were made and documented by the student PT to address concerns and
enhance compliance. Descriptive statistics and thematic analysis with participant review were used to
analyze data.
Results: Seven participants completed the study, with 1 drop out due to medical complications. Only 1
participant achieved ACSM guidelines. At least 4 participants improved on the following measures:
EORTC (all subscales), FACIT, FAB, 6 MWT. Thematic analysis was conducted to determine motivators
and barriers to exercise and considered a common theme when >50% of participants reported it.
Motivators included weekly phone calls, decreased fatigue, feeling better with exercise, self-motivation,
family/friend support and confidence. Barriers included fatigue, weather, lack of time, pain, medical
complications, social engagements, nausea and psychological well being.
Discussion: Although only 1 participant achieved the ACSM guidelines, all participants improved on at
least 5 outcome measures. Medical complications and side effects may make ACSM guidelines
unachievable for some; however, these results suggest that personalized exercises, with possibly
increasing activity levels, can influence recovery. A HEP mediated by regular communication with a PT
can show positive changes in QoL, physical functioning and exercise adherence. Motivators and barriers,
consistent among a heterogeneous sample, can be used to guide clinical decisions to improve quality of
care.
Conclusion: It is necessary that PTs are involved in the plan of care to address concerns in order to
manage the countless side effects and impairments faced by cancer survivors. Personalized HEPs with
regular communication may be adequate to manage and improve health status in this population. This
study can prompt future research focused on advocating for referrals to improve follow up care across
the survivorship continuum, with attention to activity guidelines and program adherence.