Multimodal Physical Exercise and Functional Rehabilitation Program in Oncological Patients with Cancer-Related Fatigue-A Randomized Clinical Trial.

The short version

This randomized clinical trial with 48 cancer patients explored whether a one-month, home-based program combining supervised exercise with functional rehabilitation could reduce cancer-related fatigue and help patients regain independence after being discharged from an oncology hospital stay. Cancer-related fatigue, also called asthenia (tiredness without a clear physical cause), affects most cancer patients yet is often dismissed by care teams as an unavoidable side effect rather than something that can be actively treated with structured therapy. Conducted in Salamanca, Spain, the trial split 48 recently hospitalized patients (average age about 63, with lung, digestive, prostate and breast cancers) into two equal groups. Both received standard cancer care, but one group also completed daily home exercise sessions (short aerobic-and-strength workouts, twice a day) plus hands-on retraining in daily activities like dressing and moving safely, energy-saving strategies, and sleep coaching. Independence, fatigue, quality of life, physical performance and fear of movement were measured before treatment, at 15 days, and at 1 month by evaluators who did not know which group each patient was in. Patients in the exercise-and-rehabilitation group showed significantly better independence, less cancer-related fatigue, and stronger physical performance than the control group at both check-ins (p<0.001 for the final comparisons on all three), while the control group's scores stayed flat or worsened over the same month. Fear of movement related to fatigue also improved more in the treatment group by the one-month mark. Pain levels did not differ meaningfully between groups. Quality-of-life results were more mixed: one specific overall-wellbeing rating improved more with treatment, but the broader quality-of-life questionnaire actually improved slightly more in the control group, a puzzling result the researchers think may reflect that instrument's limits for this population. These results suggest a structured, home-based exercise and rehabilitation program can meaningfully help newly discharged cancer patients regain daily independence and feel less fatigued. However, patients could not be kept unaware of which group they were in, the study ran for only one month so longer-term benefits are unknown, it took place at a single hospital, and adherence relied on patients' own reports. Larger, longer trials with cancer-specific quality-of-life tools are needed to confirm and extend these findings.

Key findings

• In this 48-patient randomized trial, cancer patients who did a month of home-based multimodal exercise plus occupational-therapy-led functional rehabilitation after hospital discharge showed significantly less cancer-related fatigue and greater independence than those receiving standard care alone.
• Physical performance (balance, gait speed, strength) also improved significantly more in the exercise-and-rehabilitation group, with benefits still growing between the 15-day and 1-month assessments.
• Fear of movement related to fatigue (kinesiophobia) improved significantly in the treatment group by the one-month mark, suggesting patients became more confident being physically active.
• Quality-of-life results were mixed: a general wellbeing rating favored the treatment group, but a broader quality-of-life questionnaire unexpectedly favored the control group, which the researchers attribute to that instrument's limitations for this population rather than a true decline in treatment benefit.
• Because participants could not be blinded to their group, the trial ran only one month, and it took place at a single hospital, larger and longer studies are needed to confirm how durable these benefits are.

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