Evaluation of the impact of the COVID-19 lockdown on the quality of life of patients monitored for cancer who practice an adapted physical activity: rugby for health

Abstract

Purpose: The benefits of regular physical exercise on the tolerability of cancer treatments, quality of life and survival rates post-diagnosis have been demonstrated but all supervised physical activities have been interrupted due to the global health crisis and the need for lockdown to halt the spread of SARS-CoV-2. To reintroduce activities post-lockdown, we wanted to assess the impact of the COVID-19 lockdown on the quality of life and the psychological status of patients who practice an adapted physical activity such as rugby for health.

Methods: The evaluation was conducted in two phases: an initial self-questionnaire comprised of 42 questions sent to all participants to assess the impact of lockdown and a second assessment phase in the presence of the participants. We assessed anthropometric data, functional fitness parameters, quality of life and the psychosocial status of the subjects. The data were compared to pre-lockdown data as part of a standardised follow-up procedure for patients enrolled in the programme.

Results: 105/120 (87.5%) individuals responded to the rapid post-lockdown survey analysis. In 20% of the cases, the patients reported anxiety, pain, a decline in fitness and a significant impact on the tolerability of cancer treatments. Twenty-seven patients agreed to participate in the individual analysis. Following lockdown, there was a significant decrease in the intensity of physical activity (p = 8.223e-05). No post-lockdown changes were noted in the assessments that focus on the quality of life and the level of psychological distress. Conversely, there was a significant correlation between the total of high energy expended during lockdown and the quality of life (p = 0.03; rho = 0.2248) and the level of psychological distress post-lockdown (p = 0.05; rho = - 0.3772).

Conclusion: Lockdown and reduced physical activity, particularly leisure activities, did not impact the overall health of the patients. However, there was a significant correlation with the level of physical activity since the higher the level of physical activity, the better the quality of life and the lower the level of psychological distress.

Keywords: Cancer; Physical activity; Psychological impact; Quality of life; Rugby for health.

Fig. 1

Flow-chart describing the participant recruitment and both procedures. *Interventional evaluation every 3 months, last evaluation before the first lockdown. **From 14 March to 11 May 2020. ***Resumption of 5-a-side rugby only in the Toulouse, Lavaur and Dijon centres

Fig. 2

a No significant difference in quality of life (ETORC QoL) between interventional evaluation before (baseline) and after lockdown (follow-up). b Evaluation of quality of life (ETORC score QoL) after lockdown (interventional evaluation follow-up) according to the amount of energy expended on a weekly basis (baseline). c Evaluation of quality of life (EORTC QoL) according to the amount of energy (MET min/week) expended on a weekly basis during leisure activities. d Evaluation of quality of life (ETORC QoL) according to the amount of time spent sitting or lying down during lockdown (h/day)

Fig. 3

a Kessler score correlated to the intensity of physical activity. Limited level physical activity at Baseline—low-level physical activity at Baseline. b Quality of life after lockdown (follow-up) correlated to psychological status prior to lockdown (baseline). c Emotional functioning score at follow-up (EF Q21a24) correlated to the mean overall activity at baseline (before lockdown). Medium level physical activity at Baseline—moderate-level physical activity at Baseline. d Cognitive functioning score at follow-up (CF Q20 25) correlated to mean overall activity at baseline. Medium level physical activity at Baseline—moderate-level physical activity at Baseline