Authors (including presenting author) :
Ma W(1), Tsang G(2), Wong L(1), Kwan M(1), Yeung R(1), To K(1), Or C(1), Chan E(1), Kwong S(1), Ling YH(3), Chau PL(3), Leung WY(3), Ng M(3), Hui E(3)
Affiliation :
(1) Physiotherapy Department, Ruttonjee & Tang Shiu Kin Hospitals
(2) Physiotherapy Department, HKEC
(3) Department of Surgery, Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
Physiotherapy Wellness Program-Related fatigue (CRF) is the feeling of lethargic and lacking energy due to malignancy and cancer-related treatment. CRF affects 40% of patients upon diagnosis, and 80-100% during chemotherapy. More than 50% of Breast cancer (Ca Breast) survivors experienced CRF up to 10 years. Depression, anxiety, communication avoidance, sexual problems and relationship separations were prevalent. A Physiotherapy Wellness Program was initiated in July 2021 to address CRF in Ca Breast patients.
Objectives :
1. To minimize the symptoms of fatigue and assist patient in coping with CRF
2. To improve quality of life (QoL) and facilitate integration with community support
Methodology :
In collaboration with Ruttonjee Hospital Surgical Unit, breast cancer patients were recruited. Based on theory of Yoga, Pilates and breathing control, a 60-minute physiotherapy wellness class was constructed to promote lymphatic drainage, breathing relaxation, stretching and fascial gliding, postural awareness and core training. It also provided a venue for peers sharing and support. A video was produced with surgeon’s demonstration to support patients’ home exercise practice. Patients were also informed of community resources available. Six domains were evaluated with questionnaires, namely: stress after surgery, sleeping quality, sense of wellbeing, scar tightness or pain, tiredness or exhaustion, and social relationship.
Result & Outcome :
From July 2021 to December 2022, despite frequent adjustment of class sizes due to the pandemics, 46 female patients with mean age of 63(39-87) attended the class. The average attendance was 8.8. The time of recruitment was post-operative week 42. 31 patients completed the questionnaires. 97% of patients experienced reduction in stress after surgery and treatment process such as Chemotherapy and Radiation Therapy. 84% reported improved sleeping quality and 87% found it helpful in sense of wellbeing. The overall improvement in scar tightness and pain was 62%, improvement in tiredness and exhaustion was 63% and in social relationship with friends and family was 55%. 100% of patients were satisfied and would recommend others to join. Patients reported the exercises and breathing relaxation were helpful and could keep practising at home during chemotherapy, the period when they preferred staying home.
The PT wellness class was effective in minimizing CRF in Ca Breast patients, improving QoL with physiotherapists and peers support. The ongoing exercise habit is essential along the patient journey. Tele-care model with zoom class for patients during chemotherapy can be explored.
