Individualized Physiotherapy Improves Quality of Life and Symptom Burden in Advanced Cancer: A Quasi-Experimental Study.
Gonçalo Soares, Paulo Reis-Pina
Individualized physiotherapy over two weeks improved quality of life and reduced fatigue, pain, and breathlessness in hospitalized stage IV cancer patients, but the non-randomized, unblinded design means we cannot be certain the gains came from the therapy alone.
Key findings
1The primary outcome (overall quality of life on the EORTC QLQ-C30) improved in the physiotherapy group from 33.02 to 44.14 while the control group declined from 35.25 to 33.02, with a significant group-by-time interaction (F = 49.949, p < 0.001).
2Fatigue, pain, and breathlessness all improved significantly in the physiotherapy group (mean changes of −26.29, −24.44, and −14.44 respectively) while the control group showed no improvement or slight worsening in each domain.
3Social function did not change significantly in either group, and although cognitive function showed a small improvement in the physiotherapy group, the interaction effect was not significant, indicating these domains were less responsive to the intervention.
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What it does not show
Allocation was by clinical and organizational convenience, not randomization, so unmeasured differences between groups cannot be ruled out. Neither patients nor the therapist were blinded, and all outcomes were self-reported questionnaires, so expectancy and social-desirability effects may inflate the perceived benefit. Participants were identified and referred by their treating oncologist, which may have selected patients perceived as more likely to tolerate therapy. Single centre, single experienced physiotherapist, and a sample of 60 limit how far the results can be generalized. Follow-up ended at discharge; there is no data on whether the gains lasted beyond the hospital stay. The intervention was delivered over only about two weeks, so it is unclear whether longer or more intensive programmes would produce different results.
Declared interests
The authors declare no conflicts of interest and report no funding source.
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