The effect of exercise counselling with feedback from a pedometer on fatigue in adult survivors of childhood cancer: a pilot study

Abstract

Objective: The aim of this study was to evaluate the results of home-based exercise counselling with feedback from a pedometer on fatigue in adult survivors of childhood cancer.

Patients: Adult survivors of childhood cancer were recruited from the long-term follow-up clinic of the University Medical Centre Groningen, The Netherlands. A score of 70 mm on a visual analogue scale (scale, 0-100 mm) for fatigue was used as an inclusion criterion. Controls were recruited by the survivors among their healthy siblings or peers.

Methods: During 10 weeks, the counselor encouraged the survivors to change their lifestyle and enhance daily physical activity such as walking, cycling, housekeeping and gardening. As a feedback to their physical activity, the daily number of steps of each survivor was measured by a pedometer and registered using an online step diary at the start of the programme and after 4 and 10 weeks. Fatigue was the primary outcome measure, assessed with the Checklist Individual Strength (CIS) at start (T0), 10 weeks (T10) and 36 weeks (T36). Thirty-three healthy age-matched control persons were asked to complete the CIS.

Results: Out of 486 cancer survivors, 453 were interested and were asked to complete the VAS to measure fatigue; 67 out of 254 respondents met the inclusion criteria, 21 refused, 46 were enrolled and eight dropped out during the study. The mean scores on the CIS in the survivors at T0 was 81.42 (SD +/- 20.14) and at T10 62.62 (SD +/- 20.68), which was a significant improvement (p < 0.0005). At T36, the end of the study, the mean CIS score was 63.67 (SD +/- 23.12); this was a significant improvement compared with the mean CIS at the start (p < 0.0005). There was no significant difference in the mean CIS scores of the controls during the follow-up period.

Conclusion: The stimulation of daily physical activity using exercise counselling and a pedometer over 10 weeks leads to a significant decrease in fatigue in adult survivors of childhood cancer, and this improvement lasts for at least 36 weeks.

Fig. 1

Study design. CIS Checklist Individual Strength

Fig. 2

Changes in CIS scores in survivors and controls during study period. CIS Checklist Individual Strength; lines connect mean CIS scores, vertical bars represent 95% CI. Mean CIS scores ± SD of participants (81.42 ± 20.14 at T1; 62.62 ± 20.86 at T10; 63.67 ± 23.12 at T 36) and controls (47.39 ± 19.06 at T1; 46.18 ± 17.70 at T10; 42.57 ± 17.40 at T36)

Fig. 3

Increase in number of steps of survivors during study period (lines connect means, error bars represent 95% CI). Mean steps ± SD of survivors(7.653 ± 3.272 at T0; 10.168 ± 3.483 at T3; 11.803 ± 3.695 at T10)