PS1514 PARTICIPATION IN A SPECIALISED EXERCISE INTERVENTION IMPROVED PHYSICAL FUNCTION AND HEALTH‐RELATED QUALITY OF LIFE IN PEOPLE WITH HAEMATOLOGICAL CANCERS
Authors: Nicol J. , Hill M. , Smith M. , Shevill M. , Pickersgill D. , Larsen D. , Donaghue A. , Pashley A. , Pollard C. , Skarparis M. , Leis M. , Skinner T. 
Published: June 2019

Background:

Exercise has been shown to improve quality of life and physical function in patients with solid tumours, such as colorectal, breast and prostate. In haematological cancers, there is some evidence that aerobic physical activity improves fatigue and depression, though its effect on quality of life and physical function is less clear. Assessment of programs, such as Fit to Thrive (FTT), a community‐based individualised, supervised exercise program offered to people with haematological cancers, may assist with future recommendations in this population.

Aims:

This study aimed to assess the effect of the FTT program on physical function and health‐related quality of life (HRQoL) in people with haematological cancers.

Methods:

The 12‐week FTT program utilised progressive aerobic and resistance training, supervised by an Accredited Exercise Physiologist, in small groups (n = 6), twice weekly, for 8 weeks, with an additional 4 weeks of associated psychosocial and peer support. Participants had stable disease and were off treatment or on maintenance therapy. Physical function was assessed at baseline and immediately after the intervention via the six minute walk (6MW), functional forward reach (FFR) and 5 times‐sit‐to‐stand (5TSTS) tests. HRQoL was measured using the 36‐item Short Form Survey Instrument (SF‐36) and the Functional Assessment of Cancer Therapy General (FACT‐G) at baseline, immediately post‐intervention and, for a subset of participants, at 3 months post‐intervention. Minimally important differences (MID) involved a change of 2 points for the SF‐36, 3 points for the FACT‐G and +50m for 6MW. A reach of ≤25 cm on the FFR predicted a moderate risk of falls.

Results:

Participants (n = 106; lymphoma 35%, myeloma 30%, leukaemia 26%, other 8%) who attended the FTT program between 2014 and 2016 were included in this analysis. Significant improvements in functional measures were observed for 6MW (+54.7m [95% CI 40.5, 69.0] p < 0.001), 5TSTS (‐1.9 sec [95% CI −2.5, −1.2] p < 0.001) and FFR (+2.7 cm [95% CI 1.5, 4.0] p < 0.001), with the MID achieved by 56% of participants for the 6MW. Of participants with a predicted moderate risk of falls on initial assessment (n = 6), 67% (n = 4) achieved >25 cm on the FFR after the intervention. The SF‐36 physical component summary (PCS) significantly increased (+4.99 [95% CI 3.29, 6.68] p < 0.001) immediately following the intervention, with 68% (n = 72) of participants achieving the MID. The improvement in the SF‐36 mental component summary (MCS) also achieved statistical significance (+2.81 [95% CI 0.54, 5.08] p = 0.02), with 51% (n = 54) achieving the MID. FACT‐G scores improved significantly from pre‐ to post‐intervention (+5.50 [95%CI 2.52, 8.47], p < 0.001) with 58% (n = 62) of participants meeting the MID. MID improvements in PCS and FACT‐G were maintained in 77% (n = 20/26) and 95% (n = 19/20) of participants 3 months following completion of the program.

Summary/Conclusion:

The FTT program was effective in improving and maintaining physical function and HRQoL, with some evidence for long‐term effects. An individually‐prescribed exercise program supervised by an Accredited Exercise Physiologist should be considered as part of standard care to improve function and HRQoL in patients with stable haematological cancer.