Paper
Thursday, July 22, 2004
This presentation is part of : Physical Activity and Chronic Illness
Exercise to Relieve Cancer-Related Insomnia and Fatigue
Elizabeth Ann Coleman, PhD, RNP, AOCN1, Sharon K. Coon, PhD, RN, AOCN1, Kathy Richards, PhD, RN1, Carol B. Stewart, BS1, Elias J. Anaissie, MD2, David W. Gaylor, PhD1, and Jennifer L. Daniels Shaw, MPH1. (1) College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR, USA, (2) College of Medicine, Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
Learning Objective #1: Compare the effects of the home-based individualized exercise program that combines aerobic and strength resistance training (HBIEP with ASRT) with the effects of a usual care-control condition on nocturnal sleep and fatigue
Learning Objective #2: Examine the relationships among the HBIEP with ASRT, aerobic capacity, physical strength (muscle strength and lean body weight), daytime sleep, physical activity, nocturnal sleep and fatigue
Objectives: To compare the effects of the home-based individualized exercise program that combines aerobic and strength resistance training (HBIEP with ASRT) with the effects of a usual care-control condition on nocturnal sleep and fatigue and to examine the relationships among the HBIEP with ASRT, aerobic capacity, physical strength (muscle strength and lean body weight), daytime sleep, physical activity, nocturnal sleep and fatigue.

Design: Repeated measures experimental design with two groups: HBIEP with ASRT and usual care/control.

Sample and Setting: Patients receiving the same aggressive protocol for out-patient treatment of multiple myeloma at the Myeloma Institute for Research and Therapy with 23 randomly assigned to HBIEP with ASRT (mean age 52, SD 9.6) and 14 to usual care/control (mean age 59, SD 7.7).

Intervention and Outcome Variables: Exercise program consisted of stretching, strength resistance training and aerobic walking. Main outcomes were fatigue and nocturnal sleep.

Methods: Fifteen week experimental period with measurements (using Profile of Mood States and the Functional Assessment of Cancer Therapy – Fatigue, Actigraph, 6-minute walk test, dynamometer, bioelectrical impedance scale) at baseline before starting chemotherapy, just prior to chemotherapy for stem cell mobilization and at the end of stem cell collection. Comparison of group means and standard deviations provided pilot data.

Findings: Although both groups began the study with an average of 7.4 hours of nighttime sleep, the experimental group averaged 7.9 hours of nighttime sleep by the end of the study whereas the control group averaged 7.0 hours. Patients in both groups had an increase in fatigue with chemotherapy but the increase in fatigue came sooner for the control group.

Conclusions: The intervention will likely be effective in decreasing cancer-related insomnia and fatigue and the approach is feasible.

Implications: Cancer-related insomnia and fatigue are prevalent related problems and behavioral interventions are needed.

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