A physical exercise programme for palliative care patients in a clinical setting: Observations and preliminary findings

Abstract

Introduction: Reduced physical function and increased dependency have a significant negative impact on the quality of life of people who are terminally ill. Previous research indicates that participation in physical exercise can reduce distressing symptoms and improve physical functioning and quality of life in palliative care patients with a diagnosis of cancer. We describe the preliminary evaluation of an outpatient rehabilitation and exercise programme implemented in a hospice setting specifically designed for patients with a palliative diagnosis, and aimed at improving and maintaining physical functioning. Methods: Eligible patients completed a programme of 10 gym-based exercise sessions including exercises to strengthen arms, legs, and core muscles, and to improve balance and cardiovascular fitness. This was further supported by a home-based exercise programme. Assessments of physical performance, fatigue, and quality of life were completed at baseline and immediately post-completion of the exercise programme. Results: Improvements were observed in physical performance, fatigue, and overall quality-of-life scores post-intervention. There were high levels of attrition and many patients were lost to follow-up. Discussion: While acknowledging the limitations of our design and small sample size, our findings contribute to the literature around the benefits of exercise for patients receiving palliative care. We recommend that exercise programmes implemented in clinical practice for palliative care patients should be individually tailored and supported by educational initiatives promoting the benefits of exercise to patients, families, and healthcare providers, and promoting early referral. Future work should explore the mechanisms by which such programmes might support improvements in quality of life, and how outcomes may differ for patients with different demographic and disease characteristics.