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Home-based exercise program after rectal cancer surgery: changes in bowel habits, quality of life, and depression
Mehmet Ali Melik1, Deniz Kocamaz2, Murşide Özpineci3, Elif Dökünlü Dinler2, Mustafa Yıldırım41Department Of General Surgery, Sanko University Hospital, Gaziantep, Türkiye2Department Of Physiotherapy And Rehabilitation, Faculty Of Health Sciences, Hasan Kalyoncu University, Gaziantep, Türkiye
3Department Of Oncological Physical Therapy, Sanko University Hospital, Gaziantep, Türkiye
4Department Of Medical Oncology, Sanko University Hospital, Gaziantep, Türkiye
INTRODUCTION: Surgery for rectal cancer can be followed by persistent bowel symptoms, impaired quality of life, and psychological distress. This study explored short-term changes in patient-reported bowel symptom burden, health-related quality of life, and depressive symptoms after a home-based exercise program.
METHODS: This prospective single-arm pre–post study included 74 adult rectal cancer survivors who had undergone low anterior resection, completed temporary stoma closure, and were at least 24 months post-surgery. A physical therapist provided individualized in-hospital exercise instruction, followed by a 4-week home-based pelvic floor and core exercise program. Weekly telephone follow-up was used to support continuity and address exercise-related problems. Patient-reported outcomes were measured at baseline and at the end of the program using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), the EORTC Quality of Life Questionnaire Colorectal Cancer Module 29 (EORTC QLQ-CR29), and the Beck Depression Inventory (BDI).
RESULTS: Seventy-four participants completed baseline and follow-up assessments. Patient-reported symptom burden decreased significantly after the 4-week program. The QLQ-C30 symptom-burden composite decreased from 61.32±5.25 to 57.04±4.62, and the QLQ-CR29 bowel symptom-burden composite decreased from 63.73±4.33 to 57.78±5.39. BDI total score also decreased from 28.66±4.62 to 22.42±4.81. All pre–post comparisons were statistically significant (p<0.001).
DISCUSSION AND CONCLUSION: A 4-week home-based pelvic floor and core exercise program was associated with lower bowel symptom burden and depressive symptom scores in rectal cancer survivors. Because this was a single-arm study with short-term follow-up, the findings should be considered preliminary. Controlled studies with longer follow-up are needed.
Keywords: Rectal cancer, Low anterior resection syndrome, Pelvic floor exercise, Core exercise, Exercise therapy, Quality of life, Depression, Survivorship
Manuscript Language: English