As population ages, geriatric patients with urinary tract cancer suffer from more complications and functional decline that alter treatment plan despite advance in cancer surgery. It was found that these urinary tract cancer survivors required a longer time to recover to the state before the treatment, and some may be even unable to recover to the state before the treatment. Exercise intervention has been found to be beneficial to improve functional capacity for cancer survivors, such as breast cancer. However, it is unclear whether exercise intervention could also improve functional recovery and mobility in patients with urinary tract cancer following curative surgery, especially in older adults. The purpose of this study is to investigate the effect of reconditioning exercise on morbidity, oncological outcomes, and functional recovery in older adults with urinary tract cancer following curative surgery. Patients aged over 65 years old and after having undergone curative surgery for confirmed urinary tract cancer will be recruited. The participants will be assigned into two groups using blocked randomization design. One group will receive reconditioning exercise training for five consecutive days, and the other group will receive exercise education. Structured questionnaire for comprehensive geriatric assessment and functional mobility, such as walking performance, will be used to assess the training effect. Outcome measures are assessed including major complication after surgeries, changes in functional status, tumor progression, and length of survival. Physical function measurement will include hand grip, muscle strength of lower extremities, and gait performance.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
32
Progressive resistance exercise and graded aerobic exercise will be provided for those in the experimental group.
Health education and gross joint range of motion exercise for bilateral upper and lower extremities will be provided for those in the control group.
National Cheng Kung University Hospital
Tainan, Taiwan
Muscle strength of the lower extremities
Muscle strength of bilateral hip flexor,knee extensor, ankle dorsiflexor, and ankle plantarflexor
Time frame: Before training
Muscle strength of the lower extremities
Muscle strength of bilateral hip flexor,knee extensor, ankle dorsiflexor, and ankle plantarflexor
Time frame: After five-day training
Muscle strength of the lower extremities
Muscle strength of bilateral hip flexor,knee extensor, ankle dorsiflexor, and ankle plantarflexor
Time frame: Follow up at one month after training
Timed up and go test
Subjects are asked to rise from a standard armchair, walk to a marker 3 m away, turn, walk back, and sit down again.
Time frame: Before training
Timed up and go test
Subjects are asked to rise from a standard armchair, walk to a marker 3 m away, turn, walk back, and sit down again.
Time frame: After five-day training
Timed up and go test
Subjects are asked to rise from a standard armchair, walk to a marker 3 m away, turn, walk back, and sit down again.
Time frame: Follow up at one month after training
Six minute walk test
Subjects are instructed to walk as far as possible for 6 minutes.
Time frame: Before training
Six minute walk test
Subjects are instructed to walk as far as possible for 6 minutes.
Time frame: After five-day training
Six minute walk test
Subjects are instructed to walk as far as possible for 6 minutes.
Time frame: Follow up at one month after training
Grip strength
Hand grip strength will be measured with a handheld dynamometer.
Time frame: Before training
Grip strength
Hand grip strength will be measured with a handheld dynamometer.
Time frame: After five-day training
Grip strength
Hand grip strength will be measured with a handheld dynamometer.
Time frame: Follow up at one month after training
Modified Katz Index of Independence in Activities of Daily Living
Measure independence in basic activities of daily living, including bathing, dressing, toileting, transfers, continence, and feeding. Full score is 32. The lower the score indicates lower dependence in performing daily activities.
Time frame: Before training
Modified Katz Index of Independence in Activities of Daily Living
Measure independence in basic activities of daily living, including bathing, dressing, toileting, transfers, continence, and feeding. Full score is 32. The lower the score indicates lower dependence in performing daily activities.
Time frame: After five-day training
Modified Katz Index of Independence in Activities of Daily Living
Measure independence in basic activities of daily living, including bathing, dressing, toileting, transfers, continence, and feeding. Full score is 32. The lower the score indicates lower dependence in performing daily activities.
Time frame: Follow up at one month after training
Lawton instrumental activities of daily living scale
To assess more complex activities that allow an individual to live independently in a community, such as shopping, cooking, and managing finances. Full score is 24. The higher the score indicates better function in performing instrumental daily activities.
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Time frame: Before training
Lawton instrumental activities of daily living scale
To assess more complex activities that allow an individual to live independently in a community, such as shopping, cooking, and managing finances. Full score is 24. The higher the score indicates better function in performing instrumental daily activities.
Time frame: After five-day training
Lawton instrumental activities of daily living scale
To assess more complex activities that allow an individual to live independently in a community, such as shopping, cooking, and managing finances. Full score is 24. The higher the score indicates better function in performing instrumental daily activities.
Time frame: Follow up at one month after training
The Short Portable Mental Status Questionnaire (SPMSQ)
To assess cognitive function, including tests of orientation, memory and recall the date, day of the week, place, telephone or address, birth date, current and etc.
Time frame: Before training
The Short Portable Mental Status Questionnaire (SPMSQ)
To assess cognitive function, including tests of orientation, memory and recall the date, day of the week, place, telephone or address, birth date, current and etc.
Time frame: After five-day training
The Short Portable Mental Status Questionnaire (SPMSQ)
To assess cognitive function, including tests of orientation, memory and recall the date, day of the week, place, telephone or address, birth date, current and etc.
Time frame: Follow up at one month after training
The Short-form Geriatric Depression Scale (GDS)
To measure depression. The scale consists of 15 questions with a full score of 15. Scores of 0-4 are considered normal; 5-8 indicate mild depression; 9-11 indicate moderate depression; and 12-15 indicate severe depression.
Time frame: Before training
The Short-form Geriatric Depression Scale (GDS)
To measure depression. The scale consists of 15 questions with a full score of 15. Scores of 0-4 are considered normal; 5-8 indicate mild depression; 9-11 indicate moderate depression; and 12-15 indicate severe depression.
Time frame: After five-day training
The Short-form Geriatric Depression Scale (GDS)
To measure depression. The scale consists of 15 questions with a full score of 15. Scores of 0-4 are considered normal; 5-8 indicate mild depression; 9-11 indicate moderate depression; and 12-15 indicate severe depression.
Time frame: Follow up at one month after training