A physical activity intervention to improve the quality of life of patients with a stoma: a feasibility study protocol

Background: We hypothesise that a physical activity (PA) intervention will improve the quality of life (QoL) of people with a stoma. A feasibility study of the intervention and trial parameters is necessary to inform a future main trial. Methods: Participants received a weekly PA consultation by telephone, video conferencing, or face-to-face for 12 weeks with a PA instructor who prescribed physical activities and supported participants by addressing stoma-related concerns and using behaviour change techniques. A feasibility study of the intervention and trial parameters was conducted in three UK sites using mixed methods. Results: The number of eligible patients consenting to the study was 30 out of 174 (17%). Most participants were female (73%); 73% had an ileostomy and 27% a colostomy; mean time since diagnosis was 6 months. A total of 18 (64%) participants completed pre-(baseline) and post-intervention (follow-up) measures. Results show an improvement on all scales measuring QoL and disease-specific fatigue. The median PA consultation rate per participant was eight sessions. Participants reported completing 75% or more of the prescribed PA each week. Eight stoma-related themes were identified from qualitative interviews: fear of hernia, bending down, fatigue, pain, prolapse, surgical wounds, stoma appliance, and stigma. The intervention appeared to address these issues. Conclusion: This feasibility study demonstrated that a novel manualised PA intervention for people with a stoma is safe, feasible, and acceptable, and shows promise for improving outcomes. However, difficulties with recruitment will need to be carefully considered to ensure the success of future studies in this area.

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“…A protocol of this study has been published [24]; hence, a brief summary of methods is provided here.…”

Section: Methodsmentioning

confidence: 99%

A physical activity intervention to improve the quality of life of patients with a stoma: a feasibility study

Hubbard

Taylor

Watson

et al. 2020

Pilot Feasibility Stud

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“…The research team have already developed a physical activity intervention for people with stoma [ 37 ] and produced an intervention manual for physical activity instructors supporting people with stoma to engage in physical activity [ 38 ]. In this study, the research team will develop new materials for people who have PSH, including videos to demonstrate exercises for re-engaging the body core and abdominal muscles and instructions on techniques and breathing for these exercises.…”

Section: Methodsmentioning

confidence: 99%

“…Stoma-related QoL will be measured using the Stoma-QoL [ 57 ], which was deemed acceptable for use by participants in our previous study [ 37 ]. It is a 21-item questionnaire; 19 items covering the 5 domains of work/social functioning, sexual/body image, stoma function, financial concerns, and skin irritation are scored using a 5-point Likert-type frequency scale, and 2 items measure overall life satisfaction and are scored from 0 to 100, with 0 being the worst possible score and 100 being the best score.…”

Section: Methodsmentioning

confidence: 99%

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HALT (Hernia Active Living Trial): protocol for a feasibility study of a randomised controlled trial of a physical activity intervention to improve quality of life in people with bowel stoma with a bulge/parastomal hernia

Hubbard

Beeken

Taylor

et al. 2020

Pilot Feasibility Stud

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Background Parastomal hernia (PSH) can be repaired surgically, but results to date have been disappointing, with reported recurrence rates of 30 to 76%. Other types of intervention are therefore needed to improve the quality of life of people with PSH. One potential intervention is physical activity. We hypothesise that the intervention will increase core activation and control across the abdominal wall at a site of potential weakness and thus reduce the risk of PSH progression. Increases in physical activity will improve body image and quality of life (QoL). Methods Subjects and sample There were approximately 20 adults with a bowel stoma and PSH. People with previous PSH repair will be excluded as well as people who already do core training. Study design This is a feasibility study of a randomised controlled trial with 2 months follow-up, in 2 sites using mixed methods. Stage 1 involves intervention development and in stage 2, intervention and trial parameters will be assessed. Intervention A theoretically informed physical activity intervention was done, targeting people with PSH. Main outcome of feasibility study The main outcome is the decision by an independent Study Steering Committee whether to proceed to a full randomised controlled trial of the intervention. Other outcomes We will evaluate 4 intervention parameters—fidelity, adherence, acceptability and safety and 3 trial parameters (eligible patients’ consent rate, acceptability of study design and data availability rates for following endpoints): Diagnosis and classification of PSH Muscle activation Body composition (BMI, waist circumference) Patient reported outcomes: QoL, body image and physical functioning Physical activity; Psychological determinants of physical activity Other data Included are other data such as interviews with all participants about the intervention and trial procedures. Data analysis and statistical power As this is a feasibility study, the quantitative data will be analysed using descriptive statistics. Audio-recorded qualitative data from interviews will be transcribed verbatim and analysed thematically. Discussion The feasibility and acceptability of key intervention and trial parameters will be used to decide whether to proceed to a full trial of the intervention, which aims to improve body image, quality of life and PSH progression. Trial registration ISRCTN15207595

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“…Recent studies have found that exercise interventions can help improve cancer-related fatigue and quality of life (QoL) in colon cancer survivors [ 6 , 7 ]. For these reasons, the American Cancer Society recommends that colon cancer survivors aim to engage in a minimum of 150 min of physical activity per week and include strength training at least 2 days per week [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Physical Fitness Levels among Colon Cancer Survivors with a Stoma: A Preliminary Study

2020

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Background and Objectives: Stoma surgery is linked to reduced physical activity in colon cancer survivors and leads to decreased physical fitness, activity of daily living dysfunction, and poorer quality of life. However, few studies have investigated the physical fitness levels of colon cancer survivors living with stomas. This study aimed to compare the physical fitness levels of colon cancer survivors with stomas and healthy adults, assessing them in a variety of dimensions (e.g., strength and flexibility) and in terms of physical fitness age (PFA), an integrated index of overall fitness. Materials and Methods: The study population consisted of 17 colon cancer survivors with (stoma group) and 20 healthy adults without (control group) a stoma. Physical fitness was assessed using a battery of five tests: repeated back-and-forth steps, 30-s chair stand, chair sit-and-reach, grip strength, and single-leg balance with eyes closed. Respective performance values were converted into PFA, which was compared between the stoma and control groups. Fitness indicators were compared between groups by analysis of covariance, and PFA and chronological age (CA) by paired t-tests. Results: The mean ages (±standard deviation) of the stoma and control groups were 74.1 ± 7.9 and 73.5 ± 7.1 years, respectively. Colon cancer survivors with stomas had poorer lower limb muscular strength, endurance, and flexibility than controls. In the stoma group, the marginal mean (±standard error) PFA was calculated to be 82.5 ± 3.7 years, significantly higher than the CA and PFA of the control group (69.6 ± 3.9 years). Conclusions: Colon cancer survivors with stomas have lower physical fitness levels than healthy adults, with apparent deficits in lower limb flexibility, muscular strength, and endurance. Our findings demonstrated the need for exercise interventions in this population, focusing on these dimensions of fitness. However, our results should be corroborated by means of a larger-scale comparison in future studies.

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A physical activity intervention to improve the quality of life of patients with a stoma: a feasibility study protocol

Cited by 13 publications

References 31 publications

A physical activity intervention to improve the quality of life of patients with a stoma: a feasibility study

A physical activity intervention to improve the quality of life of patients with a stoma: a feasibility study

HALT (Hernia Active Living Trial): protocol for a feasibility study of a randomised controlled trial of a physical activity intervention to improve quality of life in people with bowel stoma with a bulge/parastomal hernia

Physical Fitness Levels among Colon Cancer Survivors with a Stoma: A Preliminary Study

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