The effectiveness of circuit training on physical ability in palliative care.

Purpose

Exercise and physical activity is increasingly being encouraged with palliative care patients due to emerging evidence suggesting the physical and psychosocial benefits to patients. This small, local audit analyses the changes in physical outcome measures of a group of patients undertaking a weekly circuit exercise group.

Improvements ranged from 17-58%
in the Timed up and Go...
...and from 12 to 222%
in their 2 minute walk test.
The results for Functional Reach
ranged from maintenance of original score to a 80% improvement.

Approach

Data from all patients who had completed at least 6 weeks of the circuit group between January 2017 and December 2018 were collated. Over 30 patients attended the circuit group during this time but most did not complete 6 sessions.

The outcome measures used for all patients prior to beginning circuits and at every 6 week review were: 2 minute walk test, Functional Reach and Timed up and Go. All patients also completed the EORTC-QLQ-Pal as the quality of life outcome measure.

The circuit group consists of a 1 hour session including a group warm up then individualised aerobic and resistance training, both weight bearing and non weight bearing. All patients risk factors are taken into consideration. The group is usually supervised by two experienced therapy assistants. Patients are provided with a home exercise programme and encouraged to complete daily between circuit group sessions.

Outcomes

Seven patients completed at least 6 weeks of the circuit group and their demographics are shown below. There were 4 female and 3 male participants. Four out of the 7 participants had metastatic disease.

All patients made improvements in their physical measures which were Timed up and Go and the 2 minute walk test. Improvements ranged from 17-58% in the Timed up and Go and from 12 to 222% in their 2 minute walk test. The results for Functional Reach ranged from maintenance of original score to a 80% improvement.

These results demonstrate that patients under palliative care services can achieve meaningful improvements in their physical function by taking part in a weekly, gym based circuit group. All participants also indicated either maintenance or improvement in their quality of life scores.

It is important that patients are referred early to these services in order for them to have the opportunity to gain the maximum benefit.

Implications

Patients with advanced cancer can participate and make physical and functional gains through group exercise but it is imperative that patients are referred early so that they have the time to gain these benefits and to complete the programme.

Fund acknowledgements

There was no funding required for this audit.

Additional notes

This work was presented at Physiotherapy UK 2019 and as a poster presentation at the Association of Palliative Medicine conference 2019.