Functional Training

Eduardo J Fernandez-Rodriguez et al. (2023) · International journal of environmental research and public health

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.

Filip Gedin et al. (2025) · BMC musculoskeletal disorders

This Swedish trial asked whether a chiropractor, a physiotherapist, or advice to stay active works best for low back pain lasting months — and the honest answer is that it could not tell the three apart. Eighty-eight people at ten primary care clinics around Stockholm were randomly assigned to one of four things: advice only, physiotherapy, chiropractic care, or both together. Six months later, everyone was better. Disability scores dropped in every group — most in the chiropractic group, least in the physiotherapy group — but the gaps between groups were well within what chance alone would produce. Pain scores and quality of life told the same story: improvement everywhere, no clear winner. Where the groups did differ was cost. The advice-only group ended up costing the health system about three times more than the others — around SEK 11,000 per person versus roughly SEK 3,000 — mostly because those patients went on to see doctors more, and one of them had spine surgery. Getting hands-on treatment early appeared to head off more expensive care later, though with numbers this small a single surgery moves the whole average. Combining chiropractic care with physiotherapy came out best on the economics: slightly more quality-adjusted life years for slightly less money. But "slightly" is doing a lot of work — the difference across all four groups was eight thousandths of a QALY, which is roughly three days of perfect health. The researchers are unusually candid about the limits. They wanted far more participants than they got, nearly half the people dropped out before six months, and the four groups were not well matched at the start. They present this as a lesson for whoever runs the definitive trial next, not as a result to act on. What it does support, gently: for chronic low back pain, staying active matters, and both chiropractic care and physiotherapy are reasonable, comparably effective options — with some signal that getting treatment rather than advice alone may save money downstream.