Physiotherapist can relieve chronic cancer-related fatigue online

A large proportion of patients who have undergone cancer treatment go on to suffer from chronic fatigue. A new online intervention, which uses an activity tracker and a standard smartphone, has brought significant improvement in 66% of cases, while 21% of patients report a complete recovery. Marije Wolvers of Roessingh Research and Development will receive her doctorate for her research from the University of Twente on 3 March.

Fatigue is a very common complaint among cancer patients. If someone continues to experience problems three months after the final treatment session, it is refered to as 'Chronic Cancer-Related Fatigue'. The condition is rarely self-limiting and can have a very serious impact on the quality of life. Between 20% and 40% of patients experience this problem.

Online intervention

As part of the 'Fitter after cancer' project, Marije Wolvers and a team at Roessingh Research and Development (RRD) have refined and tested an existing online intervention. Patients were equipped with an activity tracker, worn on a belt, together with a smartphone. Data from the tracker was processed by an app which automatically sent information about physical behaviour to the physiotherapist involved. A baseline measurement was taken over the course of the first week. The patient and therapist then devised a step-by-step plan, setting targets for an increase in the patient's level of activity.

Less fatigue

A total of 62 participants used the system several days a week for nine weeks. They received feedback and tips on how to meet their individual targets through the smartphone. The patients and therapists never actually met face to face; with the exception of the initial phone call, the entire programme was run online. After six months, a significant decrease in chronic fatigue was observed in 66% of the participants, while in 21% of cases there was a complete recovery.

Marije Wolvers believes that the results show online interventions to be a useful weapon in the battle against chronic cancer-related fatigue. The fact that treatment takes place in the home setting is a significant advantage, she adds, since it is here that long-term behavioural change must take place. "Travelling to a hospital for physiotherapy sessions may demand too much energy, something that these patients just don't have." Focussing on additional exercise is not always the best solution, she suggests. "For some patients, it is preferable to spread activity out over the course of the day. It is therefore important to have a personalized activity plan rather than relying on a 'one-size-fits-all' approach."