[Evaluation of the feasibility of a program of adapted physical activity in day hospital of digestive oncology: From the point of view of patients]

Feasibility and Impact of Adapted Physical Activity (APA) in Cancer Outpatients Beginning Medical Anti-Tumoral Treatment: The UMA-CHAPA Study

Simple Summary

Physical activity may reduce the risk of overall cancer incidence and improve survival in cancer patients. The beneficial effects of physical activity are also described in cancer survivors but remains poorly known during systemic cancer treatment. Therefore, we studied the feasibility of an adapted physical activity (APA) program in cancer outpatients beginning a medical anti-tumoral treatment for a digestive, lung, hematological, or dermatological cancer. We also studied the impact of APA on fatigue, anxiety, depression, and handgrip strength.

Abstract

Adapted physical activity (APA) improves quality of life and cancer outcomes. The aim of this study was to assess the feasibility of an APA program in outpatients beginning medical anticancer treatment. The secondary objective was to assess the impact of APA on fatigue, anxiety, depression, and handgrip strength (HGS). This prospective study was conducted between January and July 2017. Among 226 patients beginning treatment in the unit for a digestive, lung, hematological, or dermatological cancer, 163 were included. Adherence to the APA program was defined as more than or equal to one one-hour session per week for 3 months. The first evaluation was conducted at 3 months (M3), and the second evaluation at 6 months (M6). A total of 163 patients were included (mean age 62.5 ± 14.3); 139 (85.3%) agreed to follow the APA program. At M3, 106 of them were evaluated, of which 86 (81.1%) declared that they had followed the program. Improvement in anxiety was observed at M3 (−1.0 ± 3.2; p = 0.002) but there was no significant change in fatigue or depression. HGS decreased significantly (−1.2 ± 5.5; p = 0.04). The APA program was feasible in cancer outpatients beginning medical anticancer treatment. APA should be part of standard support care.

[Development of a grid for characterizing structures offering adapted physical activity programs for people who have had cancer]

As the benefits of physical activity (PA) in oncology field continue to be demonstrated, multiple structures (sports clubs, associations…) develop PA programs and activities to offer cancer patients survivors the opportunity to continue adapted physical activity. Promoted in the 2014-2019 cancer plan as complementary supportive care, the practice of physical activity is legitimized by the 2016 Health Act of the Ministry of Social Affairs and Health, including the amendment 'prescription health sport', by giving it a legislative framework. In this context of development of new PA offers for cancer patients, it seems necessary to determine and evaluate the structures on their capacities to supervise physical activities for this population with specific needs. This article presents the methodological development and validation process of a tool used to characterize the different structures offering physical activity programs for people who have had cancer, and seeks to define the quality criteria that a structure should meet in the current state of knowledge. Ten of these criteria were selected according to a qualitative methodology and the final tool therefore facilitates the identification of quality programs in post-cancer PA, and could be used systematically by both users and professionals as part of the post-cancer care pathway, as well as by the sport-health platforms themselves in the current dynamics of their deployment throughout the national territory.