In blood cancer, aerobic physical activity may improve fatigue and depression, though its effect on quality of life and physical function is less clear. Assessment of Fit to Thrive (FTT), a community-based individualised, supervised exercise program for people with blood cancer, may assist with future recommendations.
Purpose: To assess the effect of the FTT program on physical function and quality of life (QoL) in people with blood cancer.
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 associated psychosocial and peer support. Physical function was assessed via the six minute walk (6MW), functional forward reach (FFR) and 5 times-sit-to-stand (5TSTS) tests. QoL was measured using the 36-item Short Form Survey Instrument (SF-36) and the Functional Assessment of Cancer Therapy General (FACT-G). Minimally important differences (MID) involved a change of 2 points for the SF-36, 3 points for the FACT-G and +50m for 6MW.
Results:
Participants (n=106) who attended the FTT program between 2014 and 2016 were included. 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 (+2.7cm [95% CI 1.5, 4.0] p<0.001), with the MID achieved by 56% for the 6MW. 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) 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) 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.
Conclusion:
The FTT program was effective in improving physical function and QoL, 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 in people with stable blood cancer.