Authors (including presenting author) :
Yu SW (1), Cheung YH (1), Fu TY (1), Chan KY (2), Au HY, Toni (2), Lam WK (2)
Affiliation :
(1) Physiotherapy Department, Grantham Hospital (2) Palliative Medical Unit, Grantham Hospital
Keyword 1: :
Physiotherapy
Keyword 2: :
Palliative Care
Keyword 4: :
Physical function
Keyword 5: :
Quality of life
Keyword 6: :
Symptoms management
Introduction :
Fatigue is a prevalent and distressing symptom reported by patients with advanced disease receiving palliative care (PC). However, research with a structured physiotherapy program remains limited. Moreover, the role of physiotherapy rehabilitation in palliative care fatigue management is fairly understood. Hence, a structured and individualized fatigue management program was implemented in Grantham Hospital’s Palliative Day-care setting.
Objectives :
(1) To evaluate the effectiveness of a structured physiotherapy fatigue management program in reducing fatigue level in PC patients. (2) To improve patient’s overall physical condition, functional status and quality of life. (3) To enhance and empower patient’s symptoms coping.
Methodology :
Between October 2023 and August 2024, patients under the Palliative Care Day Program in Grantham Hospital were recruited for an eight-week physiotherapy fatigue program with the following inclusion criteria: Advanced disease not limited to cancer diagnosis, Numerical Fatigue Rating Scale (NRS-F) scores ≥ 4 and Brief Fatigue Inventory (BFI) scores ≥ 4. Participants were invited to undergo 8-sessions of individualized physiotherapy fatigue program comprised of Five “E’’s: Exercise Training, Energy Conservation & Energy Restoration Management, Easing Stress, Empowerment and Education with educational pamphlets and educational video prepared by our department. Physical function was assessed using the following outcome measures tools: Modified Functional Ambulatory Classification (MFAC), Six-Minute Walk Test (6MWT), Timed Up and Go Test (TUG), Short Physical Performance Battery (SPPB), Single Leg Stance (SLS), and Grip Strength to evaluate the effectiveness of the program.
Result & Outcome :
A total of sixty patients enrolled in the program, with thirty patients completed the program. Significant improvements were observed in fatigue levels with a mean NRS-F scores decreased from 5.0 to 2.8 (p < 0.0001; 44% decrease) and mean BFI scores improved from 5.5 to 4.1 (p < 0.0001; 25.5% decrease). Exercise tolerance, functional performance, and muscle strength also showed significant improvements: mean 6MWT results increased from 178.7 to 197.2 meters (p = 0.04; 10.4% increase), mean TUG results decreased from 38.3 to 26.4 seconds (p = 0.01; 31.1% decrease), and grip strength improved significantly. Therefore, the structured 5 “E”s physiotherapy fatigue program effectively reduces fatigue levels and improves exercise tolerance, functional performance, and muscle strength in patients receiving palliative care in Grantham Hospital.
