Nursing Researcher Uses Wii-Fit to Address Cancer-Related Fatigue
July 16, 2012
With the support of a $379,741 federal grant sponsored by the National Cancer Institute, MSU nursing researcher Amy Hoffman aims to help persons with lung cancer reduce fatigue and attain adequate exercise as they transition from the hospital to the home after surgery.
The most common type of lung cancer affecting 85% of those diagnosed is non-small cell lung cancer (NSCLC). Patients worldwide who suffer from NSCLC face significant, life-limiting health issues from the disease and its treatment. Likewise, patients with acute and chronic life-limiting illness, particularly cancer, report that self-management of symptoms are a common challenge.
“Nearly half of all Americans live with at least one chronic illness and nearly a quarter of Americans having multiple chronic illnesses,” Hoffman said. “The needs of the chronically ill are not being met and a common challenge noted by patients with cancer is self-management of symptoms.”
The Institute of Medicine notes that the healthcare system is not well designed to meet the needs of the chronically ill. This is not only a national concern in the United States, but extends globally as the World Health Organization advocates for symptom management interventions whereby the patient takes an active role in their symptom management plan to enhance their quality of life.
While surgery is the most prevalent treatment for earlier-stage NSCLC, no formal guidelines currently exist for routine rehabilitative support following lung cancer surgery. Research shows that designing services during the hospital to home transition provides healthcare continuity and avoids preventable poor outcomes.
Two of the most common NSCLC post-operative complications occurring within the first 30 days of surgery are collapse of a lung and pneumonia. This intervention aims to help protect the patient’s recovery by pre-empting post-operative complications.
“This is where my research team is making a difference - by transforming the current standard of care and providing an innovative, rehabilitative, home-based exercise intervention for post-surgical lung cancer patients,” said Hoffman.
Hoffman’s pilot rehabilitation program incorporates the use of the Nintendo Wii-Fit Plus as a way to promote light-intensity, self-paced walking and balance exercise to address cancer-related fatigue. The Wii-Fit program provides patients with a home-based exercise alternative without the barriers of travel or weather.
The exercise intervention is designed to build on successes, gradually increasing in duration, while incorporating self-efficacy enhancing methodologies where patients are involved in setting their exercise goals. This format helps patients focus on the fun in exercise while limiting the focus on the unpleasant symptoms typical of persons after undergoing surgery for lung cancer.
Hoffman stated that the pilot study successfully recruited and retained persons to participate. “The virtual exercise intervention was found to be safe, and highly acceptable - with patients stating they would recommend the program to others like themselves undergoing surgery for NSCLC.”
Results showed excellent improvement in cancer-related fatigue levels over time with fatigue decreasing from pre-surgery levels through 16 weeks of exercise after surgery while most patients were also undergoing chemotherapy and/or radiation therapy.
Since persons with NSCLC are among the most vulnerable patient populations, should this intervention prove to be effective in the clinical trial, it could be applicable across similar vulnerable populations with chronic illnesses that currently have few or no rehabilitation options.
The research team works together in a transdisciplinary approach by leveraging expertise in various fields of healthcare that understand the needs of this patient population. Hoffman leads a research team from: Michigan State University, Duke University Medical Center, Grand Valley State University, and Spectrum Health.
“Managing Fatigue Using Virtual Reality for Post-Operative Lung Cancer Patients,” is supported by the National Cancer Institute, National Institutes of Health. Grant #: R21CA164515.The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.