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© The Author(s)., [Background]: The increase in the survival of oncology patients include multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. An implementation of the conventional clinical practice, developed through multimodal physical exercise and functional rehabilitation program intervention, may be useful in controlling dyspnoea. This study aims to evaluate the effects of a multimodal exercise and functional rehabilitation program on fatigue, pain, functional capacity, and quality of life in cancer patients with cancer-related asthenia. [Methods]: This is a protocol for an experimental, prospective, randomised study using a parallel, fixed assignment scheme, with an experimental group and a control group in patients from the oncology hospitalisation unit at the Salamanca University Hospital Complex in Spain, using consecutive sampling to select 50 participants with oncological asthenia who are hospitalised at the time of inclusion. After the baseline evaluation, the participants will be randomised into two groups. Both groups will receive standard clinical practice care and the normal health education program at discharge, but in addition, the participants assigned to the experimental group will also complete a multimodal exercise and functional rehabilitation program lasting one month. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of asthenia (FACT-An scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the attention and executive functions (Trail-Making Test), fear/avoidance of movement (TAMPA scale), pain (VAS scale), and body composition (waist, hip, brachial, thigh, wrist, and ankle circumferences). [Discussion]: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with asthenia. The current study addresses to improve the conventional clinical practice by proposing a multimodal physical exercise and functional rehabilitation program intervention, which will be implemented by an interdisciplinary team, to try to improve the autonomy of cancer patients with cancer-related asthenia., This study was funded by the Regional Health Management of Castile and León, Spain, with project file number 2181/A/2020, and has undergone peer-review by the funding body.

© The Author(s)., [Background]: Survival in cancer patients has increased exponentially in recent years, with multiple side effects caused by treatments. Cancer-related asthenia and dyspnea are among them, which represent a serious health problem, with considerable limitations and reduced quality of life. An implementation of the conventional clinical practice, developed through physical exercise, may be useful in controlling dyspnoea. This study aims to compare the effects of a comprehensive rehabilitation implementing a programme of multimodal physical exercise with a specific autonomy recovery programme, versus an isolated intervention using the physical exercise programme alone, on the functionality, physical performance and respiratory parameters in oncologycal patients with dyspnea. [Methods]: This is a protocol por an experimental, prospective, randomized, parallel-controlled clinical trial, with two arms design of fixed assignment with an experimental and control groups. It will conduct in the Oncology Hospitalisation Unit at the University Hospital Complex of Salamanca, using consecutive sampling to select 50 participants with oncological dyspnoea who are hospitalised at the time of inclusion. After baseline assessment, participants will be randomised into the groups. Experimental group will complete Comprehensive Rehabilitation with the autonomy recovery and the multimodal exercise programmes, and in the control group, only the multimodal exercise programme will be carried out. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of dyspnoea (MRC scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the oxygen saturation in the blood using pulse oximetry, fear/avoidance of movement with the Tampa Scale of Kinesiophobia (TSK), and the quality of life of the oncology patient (ECOG performance scale). [Discussion]: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with dyspnoea. Increase in the survival of patients with cancer includes multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. The current study addresses to improve the conventional clinical practice by proposing an integral, rehabilitative approach, to implement education and training for oncology patients with dyspnea to increase their quality of life.

Resumen Justificación: La revisión de la literatura pone de manifiesto el impacto negativo que la astenia tumoral tiene sobre la calidad de vida y recomienda utilizar además del tratamiento farmacológico para controlar el síntoma, otras terapias centradas en aumentar la autonomía. Nuestro objetivo ha sido comprobar la eficacia del “Programa de entrenamiento en la realización de las actividades de la vida diaria”, en la mejora de la Calidad de Vida Relacionada con la Salud (CVRS) de los pacientes oncológicos con astenia. Metodología: Estudio experimental, prospectivo, longitudinal, aleatorizado mediante un esquema paralelo de asignación fija con grupo experimental y grupo control. El instrumento de evaluación para medir la variable dependiente fue el cuestionario SF-12 v2. El estudio se realizó con 180 sujetos reclutados entre diciembre de 2013 y septiembre de 2015. Resultados: Después de la intervención encontramos diferencias estadísticamente significativas (p< 0,01) en todos los ítems de calidad de vida en los pacientes incluidos en el grupo experimental, exceptuando el ítem “dolor corporal” (p> 0,05). Sin embargo no hemos encontrado relación entre la edad y la mejora de la calidad de vida. Conclusiones: La utilización sistemática y controlada del “Programa de entrenamiento en la realización de las actividades de la vida diaria” mejora todos los niveles de CVRS de los pacientes oncológicos por lo que después de estos resultados nuestro último objetivo será la implementación de este programa y su utilización en nuestra práctica clínica diaria. Abstract Background: The review of the literature show a negative impact of the fatigue on quality of life and recommend, in addition of the use of traditional drug treatment to control symptoms, other therapies focused into improve the autonomy. Our aim is to test the efficacy of improving the levels of quality of life related to health (HRQOL) of cancer patients using a” daily activity training program” to control fatigue reported by the oncological disease. Methods/design: experimental, prospective, longitudinal and randomized study using a parallel fixed allocation scheme with experimental and control group. We used the SF-12 v2 questionnaire to measure HRQL. The study was conducted in 180 subjects recruited between December 2013 and September 2015. Results: We found statistically significant differences after intervention (p < 0.001) in all items related to quality of life in the experimental group patients, except for the item “bodily pain”(p> 0, 05). However, we found no relationship between age and improving of the quality of life. In summary systematic and controlled use of our “daily activity training program” improve all levels of quality of life related to health (HRQOL) of cancer patients. Therefore after these results our ultimate goal will be the implementation of this program and its use in our daily practice.

Objetivo: Determinar la influencia de la alteración del sabor y olor de los alimentos, secundaria al tratamiento antineoplásico, sobre la malnutrición, una de las complicaciones más comunes del enfermo oncológico. Metodología: Mediante una entrevista y el método de Valoración Subjetiva Global Generada por el Paciente (VSG-GP), se determinó la sintomatología y estado nutricional de 62 pacientes en tratamiento quimioterápico en el Hospital Universitario de Salamanca. Resultados: La desnutrición es frecuente (67,8%), y está relacionada con la pérdida de apetito y disminución de ingesta. Estos factores están en cierta medida influenciados por la distorsión gustativa, la cual es frecuente (62,9%). Los resultados muestran que determinados hábitos higiénico-dietéticos podrían prevenir el desarrollo de distorsiones sensoriales. Conclusión: Las aversiones alimentarias debidas a alteraciones del gusto parecen actuar indirectamente sobre el estado de desnutrición del paciente oncológico al ocasionar pérdida de apetito y disminución de ingesta. Objective: To determine the influence of taste and smell disorders, a side effect of antineoplastic treatments, on nutrition of oncologic patients, amongst whom malnutrition is one of the most common complications. Methods: 62 patients from University Hospital of Salamanca, receiving treatment with chemotherapy, were included in our study. To investigate the nutritional state and secondary symptoms of the therapy, we did an interview and used the Patient-Generated Subjective Global Assessment (PG-SGA) method. Results: Malnutrition is frequent (67.8%), and is related to the loss of appetite and reduced intake. These are observed to be influenced by taste disorder, which is also frequent among patients (62.9%). The results show that hygiene-dietetic habits could prevent the development of sensorial disorders. Conclusions: Food aversions due to taste disorders seem to indirectly affect the malnutrition status of oncologic patients by causing loss of appetite and reduced intake.