• BMC research notes · Sep 2015

    Clinical Trial

    Implementing a home-based exercise program for patients with advanced, incurable diseases after discharge and their caregivers: lessons we have learned.

    • Waldemar Siemens, Anja Wehrle, Jan Gaertner, Michael Henke, Peter Deibert, and Gerhild Becker.
    • Department of Palliative Care, University Medical Center Freiburg, Robert-Koch-Straße 3, 79106, Freiburg, Germany. waldemar.siemens@uniklinik-freiburg.de.
    • BMC Res Notes. 2015 Sep 30; 8: 509.

    BackgroundPalliative care (PC) patients experience loss of physical function which usually impedes mobility, autonomy and quality of life. We aimed at examining the feasibility of a home-based exercise program for patients with advanced, incurable diseases after discharge.ResultsThis was a single-arm pilot study (WHO-ICTRP: DRKS00005048). The 12-week home-based program comprised strength, balance, flexibility and endurance components. Patients with a presumed life expectancy of 6-12 months were recruited during a 6-months period on a specialized PC and a radiation therapy ward. We chose the De Morton Mobility Index as primary outcome. Secondary outcomes were quality of life, 6-min walk test and others. A total of 145 patients were screened, 103 (98%) out of 105 patients on the specialized PC ward could not be included, mostly because of a low performance status [n = 94; 90%; Eastern Cooperative Oncology Group (ECOG) >2]. The only two eligible patients declined to participate. Eleven out of 40 patients (28%) were eligible on the radiation therapy ward. However, only one patient (9%) participated but dropped out 2 days later (upcoming surgery). Distance to the hospital (n = 3; 30%) and considering additional tasks as "too much" (n = 3; 30%) were most common reasons for non-participation.ConclusionsEstablishing a home-based exercise program for inpatients after discharge was not feasible mainly due to non-eligibility and lack of demand. For future trials, we suggest that choosing (1) outpatients with (2) an ECOG of ≤2 and (3) an estimated survival of ≥9 months could enhance participation in home-based exercise programs.

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