Role of Physiotherapy in Cancer-Related Fatigue in Cancer Survivors - A Narrative Review (original) (raw)
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Integrative Nonpharmacologic Behavioral Interventions for the Management of Cancer-Related Fatigue
The Oncologist, 2007
sion. The etiological pathopsychophysiology underlying CRF is multifactorial and not well delineated. Mechanisms may include abnormal accumulation of muscle metabolites, dysregulation of the homeostatic status of cytokines, irregularities in neuromuscular function, abnormal gene expression, inadequate ATP synthesis, serotonin dysregulation, abnormal vagal afferent nerve activation, as well as an array of psychosocial mechanisms, including self-efficacy, causal attributions, expectancy, coping, and social support. An important first step in the management of CRF is the identification and treatment of associated comorbidities, such as anemia, hypothyroidism, pain, emotional distress, insomnia, malnutrition, and other comorbid conditions. However, even effective clinical management of these conditions will not necessarily alleviate CRF for a significant proportion of cancer survivors. For these individuals, intervention with additional therapeutic modalities may be required. The National Comprehensive Cancer Network guidelines recommend that integrative nonpharmacologic behavioral interventions be implemented for the effective management of CRF. These types of interventions may include exercise, psychosocial support, stress management, energy conservation, nutritional therapy, sleep therapy, and restorative therapy. A growing body of scientific evidence supports the use of exercise and psychosocial interventions for the management of CRF. Research on these interventions has yielded positive outcomes in cancer survivors with different diagnoses undergoing a variety of cancer treatments. The data from trials investigating the efficacy of other types of integrative nonpharmacologic behavioral therapies for the management of CRF, though limited, are also encouraging. This article provides an overview of current research on the relative merits of integrative nonpharmacologic behavioral interventions for the effective clinical management of CRF and makes recommendations for future research. The Oncologist 2007; 12(suppl 1):52-67
Examining the role of physical activity in reducing postcancer fatigue
Supportive Care in Cancer, 2012
Purpose Persistent fatigue is a long-term adverse effect experienced in about a quarter of patients cured of cancer. It was shown that cognitive behavior therapy (CBT) especially designed for postcancer fatigue is highly effective in reducing severe fatigue. However, it is unclear by what mechanism the fatigue reduction is reached. In many fatigue reduction programs, an increase in physical activity is assumed to reduce fatigue. The purpose of the present study is to determine whether the effect of CBT on fatigue is mediated by an increase in physical activity. Methods Data of a previous randomized controlled trial on the efficacy of CBT for postcancer fatigue were reanalyzed (CBT, n=41; waiting list condition, n=42). Actigraphy was used to assess the level of objective physical activity. Cancer survivors were assessed prior as well as after the CBT and waiting list period. The mediation hypothesis was tested according to guidelines of Baron and Kenny. A nonparametric bootstrap approach was used to test statistical significance of the mediation effect. Results Although CBT effectively reduced postcancer fatigue, no change in level of objective physical activity was found. The mean mediation effect was 1.4% of the total treatment effect. This effect was not significant. Conclusion The effect of CBT for postcancer fatigue is not mediated by a persistent increase in objective physical activity.
An Exercise Intervention for Cancer Fatigue
2018
Cancer related fatigue (CrF) is a debilitating side effect reported by cancer survivors, often lasting years following treatment. Although some evidence exists of a beneficial effect of exercise on CrF, there are critical shortcomings in the literature. Previous exercise rehabilitation studies did not specifically target fatigued cancer survivors. Most studies also lacked an appropriate control condition to isolate the effects of exercise per se. This thesis is comprised of three studies. The first study, an efficacy study, compared the effects of a 10-wk exercise intervention to a health education intervention on fatigue, fitness and psychological health outcomes in post-treatment cancer survivors with documented fatigue. The 37 post-treatment cancer survivors (33 females, 20 severe fatigue, 11 moderate fatigue, 30 breast cancer, aged 55±2 y, 2.3±0.3 y since treatment; mean±SEM) were allocated to an exercise group (EXG, n=19) or health education comparison group (HEG, n=18). The in...
Acta oncologica (Stockholm, Sweden), 2015
Background. Fatigue is a symptom that can occur during treatment as an acute side effect but can also result in persistent fatigue as a long-term side effect or late effect. Materials and methods. We undertook a narrative review of the current literature and discuss the current evidence of assessment of fatigue and we specifically focus on the role of promoting behavioural change and focused rehabilitation to minimise these long-term effects and update the literature relating to this area from 2012 to date. Results. We suggest there are behavioural change models that can be scaled up to enable patients to manage long-term fatigue using exercise. However, from this updated review there are limitations to the current infrastructure and evidence base that will impact on the ability to do this. Conclusion. We continually need to raise awareness amongst health professionals to continue to suggest modifications to impact on fatigue at all stages of cancer treatment and into survivorship a...
Impact of Physical Activity on Fatigue and Quality of Life of Cancer Patients
Revista Brasileira de Medicina do Esporte, 2020
Introduction: Physical exercise has been considered an important non-pharmacological treatment for reducing tiredness, pain, low self-esteem and increases in body mass in individuals diagnosed with cancer. Objective: To verify the relationship between fatigue, quality of life and levels of physical activity in cancer patients undergoing chemotherapy. Methods: Observational, cross-sectional study. The sample consisted of 85 adult patients undergoing cancer treatment at a university hospital. Physical activity was assessed by the IPAQ, and fatigue and quality of life by the PFS and EORTC QLQ-C30 questionnaires, respectively. Student's t and the Fisher's Exact tests were used to identify differences between active and physically inactive patients for the variables fatigue and quality. Additionally, covariance analysis (ANCOVA) was used, in which simple (outcome and exposure) and adjusted models (age, time of diagnosis and type of cancer) were tested. Results: The study included...
2021
Globally, breast cancer is considered one of the most common types of cancer among women. The National Institute of Health in collaboration with the National Coalition for Cancer Survivorship defines cancer survivors as an individual from the time of cancer diagnosis, through the balance of his or her life. Cancer-related Fatigue (CRF) is described as the distressing side effects of cancer and its treatment associated with physical, mental, and emotional manifestations including generalized weakness, diminished concentration, or attention, decreased motivation or interest to engage in normal activities and emotional lability. There are several validated tools for measuring cancer-related fatigue. The search for the relevant journal was carried out referring through many databases: PubMed, PubMed Central, Cochrane, and PEDro and mainly focuses on the RCTs, clinical trials, and systemic reviews. There are varieties of physical therapy interventions that play a beneficial role in reduc...