Cancer recovery and a personalised exercise service: A preliminary analysis

Purpose

Previously people with long term illnesses such as cancer were often advised by their clinical team to rest and reduce their physical activity. But recent research has shown that exercise is not only safe and possible during cancer treatment, it can also improve an individual's level of physical functioning, increase their strength and stamina, improve their quality of life and help them to return to work. Studies have also shown that exercise can reduce their mortality and the risk of recurrent types of cancer by approximately 50%. The aim of our evaluation study was to explore the efficacy of a physiotherapy led exercise programme for people living with and beyond cancer to improve their overall health and wellbeing and fitness levels.  

Approach

A case study methodology was used to explore the efficacy of a telephone based structured exercise programme for people living with and beyond cancer. Our data size of discharged patients was 166 patients. We limited the sample to 2016 data in order to carry out a selected case study audit. 16 patients were identified, 5 were not suitable for analysis (Consent not given to use data, limited input etc.). In the sample, 7 were female and 4 were male. The average age was 52 years. A range of interventions were used during the service, including personalised exercise programmes, sign posting to local services and walking programmes plus pedometers. Individual case reviews on 11 cases were carried out. EVS improvement was calculated, as were average number of sessions. Qualitative information and quantitative questionnaire data including data from patient satisfaction questionnaires, was pooled and analysed. Ethical approval was not necessary for this evaluation work. We sought patients´ consent to be able to use their data for research and evaluation purposes and that their data would remain confidential. 

Outcomes

Typical symptoms identified at assessment were fatigue, surgery site stiffness, pain, neuropathy, general deconditioning, mood. The average number of follow ups was 1.72 The most frequent cancer diagnosis was breast cancer. EVS scores showed a 176 point shift post service. Patients also reported improvements in fatigue, overall fitness and a reduction in symptoms. They also reported reaching their exercise targets. Patients described how they had been fearful of engaging in activity and were reassured that they were safe to move their bodies. Some even reported that they were fitter after their cancer diagnosis than before as a result of engaging in the exercise programme.

Implications

Patients reported that they were finding our service beneficial in their recovery from cancer and treatments. However, the data set was small and further quantitative evaluation is required to determine if similar outcomes are reported from a larger sample.

The data from the evaluation indicate that the service is beneficial and worthwhile to continue in its current format. It also supports the usefulness of continued qualitative and quantitative evaluation of the service to ensure that such outcomes continue to be achieved with the current service design and delivery.  

Top three learning points

  1. People are receptive to exercise support following cancer diagnosis and treatment
  2. Interventions do not have to be lengthy to have an impact
  3. Exercise is medicine.

Fund acknowledgements

This evaluation was carried out and funded by Working Towards Wellbeing as part of our internal audit and evaluation of services.

Additional notes

This evaluation was carried out and funded by Working Towards Wellbeing as part of our internal audit and evaluation of services.

This work was presented at Physiotherapy UK 2017.

For further information about this work contact Nicola Hunter at: Nicola.hunter@workingtowardswellbeing.com