Utilization of Isometric Strength Training and Interval Training With a Patient With Cancer in the Acute Care Setting

Our plain-English summary of Utilization of Isometric Strength Training and Interval Training With a Patient With Cancer in the Acute Care Setting, by A. Chongaway (Curēus, 2021).

The study

• Author: A. Chongaway
• Journal: Curēus
• Published: 2021;13(6):e15570
• Type of article: Case report
• Read it: PubMed · Publisher · Free full text

Abstract

The onset of cancer and subsequent treatments often result in deficits in physical function and quality of life (QoL). Available research has demonstrated that an individualized exercise program has the ability to reduce fatigue, optimize physical function, and improve QoL. However, the exercise program is often lacking appropriate intensity and volume resulting in negligent improvement or even further reduction in function. Thus, the purpose of this case report is to demonstrate the application of isometric strength training (IST) and high-intensity interval training (HIIT) in the acute care setting with an individual with a history of malignant mesothelioma. The patient demonstrated improvement in functional mobility evidenced by improvement in Activity Measure for Post-Acute Care (AM-PAC) score through the hospitalization along with increased ambulation distance. No adverse events occurred during any physical therapy (PT) visits while utilizing HIIT or IST.

Copyright © 2021, Chongaway et al.

In plain English

This case report described physical therapy for one patient, an 80-year-old man hospitalized with fever, cough, shortness of breath, leg weakness and fatigue. Three years earlier he had been diagnosed with stage II epithelioid subtype malignant mesothelioma of the right lung, treated with chemotherapy and surgery. He denied any direct exposure to asbestos. He said his father had worked in the textile industry and that there may have been incidental exposure. Over four visits in seven days, the therapist used isometric strength training and high-intensity interval training, adjusted to his fatigue. No adverse events occurred. His mobility score (AM-PAC "6 clicks") rose from 19/24 (18/24 in one passage) to 23/24 at visit 4. At first he walked 49 m (160 ft) without an assistive device, with two losses of balance. At visit 4 he walked 27.5 m (90 ft) farther using a rolling walker, with none reported. The author noted the first AM-PAC score may have been lowered by how it was measured, and the timed up and go and Berg Balance Scale were not repeated. The author concluded that precise, challenging exercise prescription may reduce hospital-acquired deconditioning.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report of a single patient (physical therapy in the acute care hospital setting)
• Who was studied: One 80-year-old man admitted to an acute care community hospital. Three years before admission he had been diagnosed with stage II epithelioid subtype malignant mesothelioma of the right lung. No dates or hospital location are given.
• Exposure: The intervention studied was isometric strength training and high-intensity interval training. On asbestos, the patient denied direct exposure; his father worked in the textile industry and there may have been incidental exposure. No fiber type is named.
• Main results:
  • The patient was seen for four physical therapy visits over seven days.
  • The patient's AM-PAC '6 clicks' mobility score rose to 23/24 at visit 4. The Outcomes section gives the visit 1 score as 18/24, while the initial evaluation text and Table 3 give 19/24. AM-PAC was assessed at each visit.
  • At the initial evaluation the patient walked 49 m (160 ft) without an assistive device. He had two lateral losses of balance that needed moderate assistance to correct.
  • At visit 4 the patient walked an additional 27.5 m (90 ft) using a rolling walker, with no reported losses of balance. Table 3 lists 76 m (250 ft) with a rolling walker.
  • At the initial evaluation the patient's timed up and go took 25 and 23 seconds (average 24 seconds). The author interpreted this as increased fall risk. The test was not repeated later.
  • At visit 4 the patient scored 46/56 on the Berg Balance Scale, which the author interpreted as low fall risk.
  • No adverse events occurred during any of the visits.
• The authors' conclusion: The author concluded that precise, challenging exercise prescription may reduce the chance of hospital-acquired deconditioning and significant impairments, resulting in improved quality of life and a lower chance of readmission.
• Limitations the authors state:
  • At visit 1, stairs were not assessed and gait was tested without an assistive device. This may have lowered the first AM-PAC score and so enlarged the change between visits 1 and 4.
  • The timed up and go was done only at visit 1. The Berg Balance Scale was done only at visit 4, with no re-test because the patient was discharged.

Topics

Medical terms in this study, explained in our Lexicon: Quality of Life, Mesothelioma.

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