1.Changes in Physical Function, Fatigue, and Psychiatric Symptoms in Patients with Hematological Malignancy Undergoing Chemotherapy and Low-intensity Exercise Training
Jiro Nakano ; Shun Ishii ; Takuya Fukushima ; Ayumi Natsuzako ; Koji Tanaka ; Kaori Hashizume ; Kazumi Ueno ; Emi Matsuura ; Yoko Kusuba
Palliative Care Research 2017;12(3):277-284
This study aimed to investigate the changes in physical function, fatigue, and psychiatric symptoms in patients with hematological malignancy undergoing chemotherapy and low-intensity exercise training. Sixty-two hospitalized patients with hematological malignancy undergoing chemotherapy and low-intensity exercise were recruited. At the time of exercise initiation and hospital discharge, grip strength, knee extension muscle strength, maximum walking speed, Eastern Cooperative Oncology Group (ECOG) performance status, a measure of functional independence, cancer fatigue pain, and hospital anxiety and depression were evaluated. When longitudinal data were analyzed in each group, changes in grip strength and knee extension muscle strength were unevenly distributed: some patients showed a decrease in knee extension strength. On the other hand, maximum walking speed, the measure of functional independence, and ECOG performance status were maintained or improved in more than 90% of the patients. Results of fatigue, anxiety, and depression tended to show an improvement in female patients, but not in male patients. In conclusion, physical function was maintained in nearly all patients with hematological malignancy undergoing chemotherapy and low-intensity exercise training. Sex differences were found in changes of fatigue, anxiety, and depression.
2.The Effect of a Behavior Change Intervention with Feedback on Motor Function and Physical Activity for Patients with Hematological Malignancies Undergoing Chemotherapy: A Historical Controlled Study
Shun ISHII ; Ayumi NATSUZAKO ; Takuya FUKUSHIMA ; Ryo KOZU ; Noriaki MIYATA ; Jiro NAKANO
Palliative Care Research 2021;16(2):123-131
Objective: This study aimed to investigate the effectiveness of an intervention that applied a behavioral change approach to the usual rehabilitation for patients with hematological malignancies undergoing chemotherapy. Methods: Patients with hematological malignancies undergoing chemotherapy were divided into two groups: patients who underwent conventional rehabilitation (control group, n=12) and a counterpart who received a behavioral change intervention with feedback on motor function and physical activity (feedback group, n=13). We analyzed the changes in motor function and physical activity between the two groups from the start of rehabilitation to discharge. Results: There were a significant difference in walking speed between baseline and discharge. Changes in weekly steps were significantly higher in the feedback group than those in the control group. Conclusion: A behavioral change intervention with feedback on motor function and physical activity may improve voluntary exercise in patients with hematological malignancies undergoing chemotherapy.
3.Factors Associated with Fatigue in Patients with Hematological Malignancies Undergoing Chemotherapy
Shun ISHII ; Ayumi NATSUZAKO ; Takuya FUKUSHIMA ; Ryo KOZU ; Noriaki MIYATA ; Jiro NAKANO
Palliative Care Research 2022;17(4):181-189
Objective: This study aimed to identify factors associated with fatigue in patients with hematological malignancies undergoing chemotherapy. Method: A total of 90 patients with hematological malignancies undergoing chemotherapy were enrolled in this study. Simple regression analysis was performed using total, physical, emotional, and cognitive fatigue as dependent variables. On the other hand, the patient’s sex, age, blood test findings, physical function, activities of daily living (ADL), performance status, presence or absence of anxiety or depression, physical symptoms, and nutritional status were used as independent variables. Multiple regression analysis was conducted with the items that showed significant differences in the simple regression analysis as independent variables. Results: Multiple regression analysis with total fatigue as the dependent variable identified depression as an associated factor. Additionally, physical fatigue was noted to be associated with pain and depression, while emotional fatigue was reported to be associated with ADL and depression. Conclusion: Our results suggest that patients with hematological malignancies who have symptoms of fatigue should be managed taking in consideration possible causes of their fatigue, such as depression, pain, and ADL.