Effect of a Self-designed MET Exercise Intervention on Cancer-related Fatigue in Patients With Gastric Cancer
Condition: Neoplasm of Stomach
MeSH terms: Stomach Neoplasms
Study type: Interventional

Summary: 
      To investigate the effect of using Self-arranged Metabolic Equivalent Exercises on
      cancer-related fatigue in gastric cancer patients. Gastric cancer patients admitted to the
      oncology department of a tertiary hospital in Shanghai were selected as study subjects and
      randomly divided into observation group and control group. The experimental group used
      Metabolic Equivalent Exercises for intervention besides exercise education and implemented
      records. In the control group, conventional exercise catharsis was performed. The Piper
      Revised Fatigue Scale (RPFS) and QLQ-30 Quality of Life Scale were used to measure
      cancer-caused fatigue and quality of life in both groups at the first admission and after 3
      months.
    

Detailed description: 
      This study was a randomized controlled trial. The subjects were randomly assigned into a SMEE
      or a control group.

      For the SMEE group:

        1. The general information questionnaire, RPFS, and the Chinese version of the EORTC
           QLQ-C30 (V3.0) were used for the baseline assessment of patients, and intervention was
           performed for patients with an RPFS score greater than or equal to 1.

        2. Exercise plan: Each session of the SMEE program was divided into 8 components:
           Stretching exercises, chest expansion exercises, kicking exercises, lateral movement
           exercises, body rotation exercises, whole-body exercises, jumping exercises, and a
           cooldown. There were 4 sets and 8 repetitions per component, taking approximately 4
           minutes to complete and consuming approximately 18 calories. Patients were instructed to
           exercise once in the morning and once in the evening. For patients with moderate fatigue
           and with an RPFS score of 4 to 6 points, low-intensity exercises were recommended, i.e.,
           patients could choose 1 to 4 metabolic equivalent exercises and repeat them twice; for
           patients with mild fatigue and with an RPFS score of 1 to 3 points, moderate-intensity
           exercises were recommended, i.e., patients could choose to complete the entire set of
           metabolic equivalent exercises or 5 to 8 of the exercises and repeat them twice. The
           exercise frequency was 5 times per week. Nurses informed the participants of the
           precautions for exercises to ensure safe implementation.

           Metabolic equivalent intensity: The intensity of exercises was expressed as metabolic
           equivalents (METs). For this study, greater than or equal to 6 METs indicated high
           intensity, 3 to 5.9 METs moderate intensity, and less than 3 METs low intensity.

        3. Exercise training: Members of the Fatigue Management Team in the ward taught the
           patients to perform metabolic equivalent exercises using videos. Exercise guidance was
           provided after assessments of surgical, catheter, and incisional pain. Patients could
           follow the department's WeChat public account to watch complete videos pertaining to
           metabolic equivalent exercises and related exercise precautions. The Fatigue Management
           Team members confirmed that a patient could perform the exercise independently and
           correctly.

        4. Health education: The participants were provided with information related to CRF
           (causes, clinical manifestations, associated factors, the necessity and importance of
           fatigue prevention, and measures to reduce CRF, etc.) and exercises (intensity, time,
           frequency, precautions, etc.)

        5. Recording: Each participant completed a form after each exercise session.

        6. Follow-up: A nurse followed up with each patient by telephone every 2 weeks to determine
           if the patient completed his or her exercise sessions. Exercise completion rate
           (%)=(actual exercise time÷planned exercise time)×100%. Nurses supervised and provided
           reminders to patients with completion rates below 50%. In addition, each patient's
           exercise success rate was calculated: Exercise success rate (%)=(real-time heart rate
           after exercise÷target heart rate)×100% (>70% was considered to be up to standard).
           Target heart rate=(200-age)×100%; a heart rate of 70% to 80% of the target heart rate
           could improve cardiopulmonary function.

      For the control group:

      Participants received routine exercise health education that included information pertaining
      to CRF (causes, clinical manifestations, associated factors, the necessity and importance of
      fatigue prevention, and measures to reduce CRF, etc.) and exercises (3-5 times per week,
      regardless of the type of exercises). The patients were also informed of the precautions for
      exercise.

      After 3 months, the SMEE and the control groups were reassessed using the RPFS and the
      Chinese version of the EORTC QLQ-C30 (V3.0).
    

Intervention name(s): Met exercises
Intervention type(s): Behavioral
Intervention description(s): Exercise plan: Each session of the self-designed MET exercise program was divided into 8 components: stretching exercises, chest expansion exercises, kicking exercises, lateral movement exercises, body rotation exercises, whole-body exercises, jumping exercises, and a cool down. There are 4 sets and 8-repetitions per component, taking approximately 4 minutes to complete and consuming approximately 18 calories. Patients were instructed to exercise once in the morning and once in the evening. For patients with moderate fatigue and an RPFS score of 4 to 6 points, low-intensity exercise was recommended, i.e., patients could choose 1 to 4 metabolic equivalent exercises and repeat them twice; for patients with mild fatigue and an RPFS score of 1 to 3 points, moderate-intensity exercise was recommended, i.e., patients could choose to complete the entire set of metabolic equivalent exercises or 5 to 8 of the exercises and repeat them twice. The exercise frequency was 5 times per week.
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care