Hoffman, A. J., Brintnall, R. A., Brown, J. K., von Eye, A., Jones, L. W., Alderink, G., . . . Vanotteren, G. M. (2014). Virtual reality bringing a new reality to postthoracotomy lung cancer patients via a home-based exercise intervention targeting fatigue while undergoing adjuvant treatment. Cancer Nursing, 37, 23–33.
To explore the efficacy of a virtual reality home-based exercise program for managing fatigue during adjuvant therapy in patients with postthoracotomy lung cancer.
Patients were initially provided self-management education for fatigue and a Nintendo Wii system for walking and balance exercise in the home. Nurses initiated the program in a home visit, performed follow-up at two weeks, and contacted patients via telephone for reinforcement at three and six weeks in the initial study. This report involved extension of the initial study for an additional 10 weeks while patients were receiving adjuvant therapy. Patients wore a pedometer to record the number of steps per day and were to use the program five days per week.
Patients were undergoing the active antitumor treatment phase of care.
This was a prospective trial.
Adherence to the exercise protocol declined slightly from the previous six-week study to an overall adherence of 87.6% (range 59%–100%). All patients reported unmanaged symptoms unrelated to the exercise at some point in the 10 weeks. Fatigue scores increased slightly from weeks 6 to 14 and then declined further. Self-efficacy for walking and self-management were relatively stable. There was high variability in the average walking steps per day from the pedometers.
Results suggested continued feasibility and overall efficacy of the virtual reality home-based exercise and balance program tested. Findings showed that, over longer periods of time, program adherence declined and was more variable. Some of this variability in exercise adherence and fatigue scores may be associated with periods of adjuvant chemotherapy and radiation therapy.
The use of a home virtual reality–based approach to facilitate exercise among patients with cancer is a promising approach for self-management of fatigue. Larger well-designed research using this approach is warranted.