Symptoms, Biological Stress Response, And Physical Function After Exergaming Activities Among Advanced-stage Cancer Patients

PURPOSE: The purpose of the study was to preliminarily test changes in symptoms (fatigue & pain), stress response (hair cortisol), and physical function (preferred gait speed) after 6-week personalized Physical Activity intervention with fitness graded Motion Exergames (PAfitME™) among advanced-stage cancer patients. METHODS: Ten (10) advanced-stage cancer patients were recruited. They participated in the home-based 6-week telehealth PAfitME™. The Personalized exergame prescriptions in the PAfitME™ were developed to match participant’s fitness capacity, health belief, and symptoms. PAfitME™ was delivered through FaceTime calls and home visits. A within-group pre-/post-test design was implanted. Symptoms measurements included the Brief Fatigue Inventory and Brief Pain Inventory. Hair cortisol (pg/mg) was measured by the cortisol amount extracted from the hair sample (≥1 mg). Preferred gait speed (m/s) was measured by the time taken to complete the walk at a comfortable pace on a steady path (4 m). Non-parametric analyses were used to evaluate the pre- and post- difference. Cohen’s d was used to show the effect size for the difference. RESULTS: The recruitment rate, enrollment rate, and attrition rate were 17%, 50%, and 60%, respectively. Four (4) of the study subjects completed the study (40%). The mean age was 63.3 (±8.7) years old. There were one male (25%) and three females (75%) completing the study. Cancer types included breast cancer (25%), head and neck cancer (25%), rectal cancer (25%), and melanoma (25%). All participants had stage III cancer (100%). Participants engaged a mean of 70 minutes/week of exergame activities. The worst fatigue and worse pain scores decreased with medium effect sizes (d = 0.6-0.7). The reduction in hair cortisol had a medium effect size (d = 0.7), but the Improvement in preferred gait speed had a large effect size (d = 0.8). CONCLUSION: Exergame activities could reduce the worst fatigue, worst pain, and biological stress response but improve objective physical function. Positive results from an efficacy trial would support the use of PAfitME™ in the management of fatigue and pain in advanced-stage cancer patients.