Efficacy of a structured rehabilitation program for terminally ill cancer patients
Maintaining activities of daily living (ADLs) is important for terminally ill cancer patients, and dependency is associated with psychological distress. However, evidence for rehabilitation remains scarce in this setting.
Maintaining daily activities is crucial for cancer patients facing a terminal diagnosis, and a lack of independence can lead to significant psychological distress. However, research on the effectiveness of rehabilitation programs in this setting has been limited. A team from Osaka Metropolitan University conducted a study to assess the impact of a structured rehabilitation program on the activities of daily living (ADLs) of terminally ill cancer patients.
The multicenter randomized controlled trial took place in 19 Japanese inpatient hospice and palliative care units and included 130 patients with Eastern Cooperative Oncology Group performance status between 2 and 3, a life expectancy of at least three weeks, and no severe symptoms. Participants were randomly assigned to either a three-week structured rehabilitation program or usual unstructured rehabilitation.
The primary outcome measured was the change in total modified Barthel Index from baseline to day 22, while secondary outcomes included EORTC QLQ-C15-PAL scores and safety. Of the 130 participants, 77 had complete data for the primary analysis. The results showed that the intervention group had a mean change in total mBI of -1.31, while the control group had a mean change of -15.51.
This resulted in a 14.21-point difference between the groups, which exceeded the minimally clinically important difference of 9.25. Additionally, patient-reported physical functioning on EORTC QLQ-C15-PAL was significantly higher in the intervention group compared to the control group. Importantly, no serious harms were reported during the study.
The findings support the integration of structured rehabilitation into routine care for terminally ill cancer patients, providing evidence that it can help maintain ADLs and improve overall functioning. Nanako Nishiyama, the lead author of the study, emphasized that this practical guide could help therapists better tailor rehabilitation to each patient's condition and goals, reducing variations in practice across institutions and ensuring that support for daily living remains important even in the final stage of life.
Written by urgent.news from Medical Xpress's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
