Occupational Therapy and Horticulture for Cancer Survivors With Chronic Pain

Study Overview
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Brief Summary
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The purpose of this quasi-experimental study is to explore the impact of a therapeutic horticulture program as an occupation-based intervention to address chronic pain symptoms for cancer survivors. The main objectives are to assess participants' perceptions of pain, physical and psychosocial wellness, stress management, and quality of life at pre-, post-, and 3-month follow-up. Quantitative and qualitative data will be synthesized and analyzed to explore this phenomenon.

Official Title
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Exploring the Effect of Occupational Therapy and Horticulture for Cancer Survivors With Chronic Pain

Conditions
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Cancer Survivor, Chronic Pain

Intervention / Treatment
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* Behavioral: Horticultural activity


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 - 64 years of age History of cancer diagnosis Chronic pain longer than 3 months Have interest in therapeutic horticulture and exercise Able to participate in a moderate physical activity in sitting and/or standing for at least one hour twice a week Able to provide own transportation to the horticulture site or the supervised exercise program Able to comprehend, speak and write in English Exclusion Criteria: Uncontrolled seizure disorder Pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 64 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Therapeutic Horticulture Group<br>The therapeutic horticulture group will participate in a 6-week horticulture program meeting twice a week for an hour led by an occupational therapist incorporating plant-based activities and education on pain management techniques at a community farm. | Behavioral: Horticultural activity<br>* Therapeutic horticulture activities are plant-related activities that include but not limited to digging, watering, planting, weeding, trimming, fertilizing, mulching, harvesting, learning about organic farming, and exploring options to incorporate horticulture into daily activities<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Salivary Cortisol Test | Participant stress level will be determined by salivary cortisol levels. Participant's salivary cortisol level will be measured at awakening, 30 minutes following awakening and bedtime. Typically, there is Cortisol Awakening Response (CAR), which is a steep rise in cortisol output during the first 30 minutes following awakening, followed by a steady decline across the morning, afternoon, and evening hours, with the daily nadir typically occurring around midnight. Flattened diurnal cortisol slope relates to increased emotional and psychosocial stress and related to worse health outcomes. The typical Cortisol Awakening Response (CAR) is defined as an increase of at least 2.5 nmol/l from the cortisol level taken at awakening. Although there are no agreed norms for the absolute concentrations of free cortisol in saliva it typically ranges between 4.7-18.5 nmol/l for post-awakening, between 8.6-21.9 nmol/l for 30 minutes post-awakening, and 0.3-15.2 nmol/l for bedtime. | Change between baseline and three months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lower body strength | Chair Stand testing measures the strength of the lower body. Average scores for this testing are 15 reps for women and 16 reps for men. | Change between baseline and three months | 
| Upper body strength | Arm Curl testing measures the strength of the upper body. Average scores for this testing are 16 reps for women and 19 reps for men. | Change between baseline and three months | 
| Endurance | 2 Minutes Step testing measures the endurance or physical stamina. Average scores for this testing are 91 times for women and 101 times for men. | Change between baseline and three months | 
| Lower body flexibility | Chair Sit and Reach testing measures lower body flexibility, specifically your hamstring flexibility. Average scores for this testing are +2 inches for women and + 0.5 inches for men. | Change between baseline and three months | 
| Upper body flexibility | Back Scratch testing measures the flexibility of the upper body. Average scores for this testing are -0.5 inches for women and -3.5 inches for men. | Change between baseline and three months |