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Measuring the impact of oesophagectomy on physical functioning and physical activity participation: a prospective study
Bennett, Annemarie; Reynolds, John; Guinan, Emer; Doyle, Suzanne; O'Neill, Linda; Elliott, Jessie; O'Sullivan, Jacintha; Hussey, Juliette
doi: Background: Oesophagectomy remains the only curative intervention for oesophageal cancer, with defined nutritional and health-related quality of life (HR-QOL) consequences. It follows therefore that there is a significant risk of decline in physical wellbeing with oesophagectomy however this has been inadequately quantified. This study prospectively examines change in physical functioning and habitual physical activity participation, from pre-surgery through 6-months post-oesophagectomy. Methods: Patients scheduled for oesophagectomy with curative intent were recruited. Key domains of physical functioning including exercise tolerance (six-minute walk test (6MWT)) and muscle strength (hand-grip strength), and habitual physical activity participation, including sedentary behaviour (accelerometry) were measured pre-surgery (T0) and repeated at 1-month (T1) and 6-months (T2) post-surgery. HR-QOL was measured using the EORTC-QOL C30. Results: Thirty-six participants were studied (mean age 62.4 (8.8) years,n= 26 male, n = 26 transthoracic oesophagectomy). Mean 6MWT distance decreased significantly from T0 to T1 (p= 0.006) and returned to T0 levels between T1 and T2 (p< 0.001). Percentage time spent sedentary increased throughout recovery (p< 0.001) and remained significantly higher at T2 in comparison to T0 (p= 0.003). In contrast, percentage time spent engaged in either light or moderate-to-vigorous intensity activity, all reduced significantly (p < 0.001 for both) and remained significantly lower at T2 in comparison to T0 (p= 0.009 andp= 0.01 respectively). Patients reported deficits in multiple domains of HR-QOL during recovery including global health status (p= 0.04), physical functioning (p <0.001) and role functioning (p < 0.001). Role functioning remained a clinically important 33-points lower than pre-operative values at T2. Conclusion: Habitual physical activity participation remains significantly impaired at 6-months post-oesophagectomy. Physical activity is a measurable and modifiable target for physical rehabilitation, which is closely aligned with patient-reported deficits in role functioning. Rehabilitation aimed at optimising physical health in oesophageal cancer survivorship is warranted.
Keyword(s): Physical functioning, Physical activity, Oesophageal cancer, Survivorship care, Health-related quality of life; Cancer; Cancer Survivorship; Health-related Quality of Life; OESOPHAGEAL CANCER; PHYSICAL ACTIVITY; Physical functioning; Health
Publication Date:
Type: Journal article
Peer-Reviewed: Yes
Language(s): English
Institution: Trinity College Dublin
Citation(s): Guinan, E.M., Bennett, A.E., Doyle, S.L., O'Neill, L., Gannon, J., Foley, G., Elliott, J.A., O'Sullivan, J., Reynolds, J.V., Hussey, J., Measuring the impact of oesophagectomy on physical functioning and physical activity participation: a prospective study, BMC Cancer, 2019, 19, 682
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First Indexed: 2019-08-29 06:13:52 Last Updated: 2019-08-29 06:13:52