Pilot Feasibility Study of Physical Activity to Manage Bowel Dysfunction in Survivors of Rectal Cancer

Abstract

Background: Low anterior resection syndrome can disrupt health-related quality of life for survivors of rectal cancer.

Objective: To assess the feasibility, satisfaction with, and benefit of a pilot telehealth physical activity counseling intervention for survivors of rectal cancer with low anterior resection syndrome.

Design: Single site, single arm prospective pre-post pilot feasibility intervention.

Settings: This study was conducted at a single academic institution via telehealth.

Patients: Patients with stage I-III rectal or rectosigmoid cancer and low anterior resection syndrome who were 3 months to 5 years post-low anterior resection alone or with diverting loop ileostomy and subsequent reversal were included.

Interventionss: Twenty-four patients completed 12 weekly one-on-one physical activity counseling sessions with a health coach.

Main outcome measures: Feasibility, participant satisfaction, low anterior resection syndrome score, Memorial Sloan Kettering Cancer Center Bowel Function Instrument, International Physical Activity Questionnaire, City of Hope Quality of Life Survey - Colorectal Cancer, daily step counts.

Results: Twenty-seven patients enrolled in the study and 24 (89%) completed the intervention. Every intervention participant attended all telehealth coaching sessions. Through exit interviews, participants expressed satisfaction with the study, said it positively impacted their mental health, and helped them cope with their symptoms. At 12 weeks, 7.27% (p = 0.002) and 16.5% (p ≤ 0.0001) improvements in bowel function, as measured by the bowel function instrument and low anterior resection syndrome score, respectively were demonstrated. Quality of life improved by 9.8% at 12 weeks (p = 0.009), with the social domain having the greatest improvement (22%, p < 0.0001). These improvements persisted at twelve-week follow-up. Daily steps increased by 17.5% during the intervention (p = 0.035).

Limitations: Pre-post study design.

Conclusions: Delivering a telehealth counseling intervention is feasible and satisfactory for survivors of rectal cancer with LARS. This intervention has positive implications for bowel health and health-related quality of life. See Video Abstract.

Clinical trial registration: NCT06435975.