The effectiveness of circuit training on physical ability in palliative care patients

Background
Structure exercise groups within palliative care are becoming a more common feature of standard hospice provision, supported by increasing evidence of the benefits for patients on both their physical and emotional function. This small audit reviews the circuit group running at the Wisdom Hospice over a 2 year period, analysing the outcomes for all patients completing the 6 week programme.

Methods
All patients joining the circuit group are assessed using 3 physical measures and 1 quality of life measure, prior to starting. These measures are then repeated every 6 weeks while the patient is attending. The number of patients attending the group between 2017 and 2018 were recorded and from those the data of patients who had completed at least 6 weeks and had 6 week outcome measure data were analysed for the audit. There were 28 patients who had attended the group for between 1 and 5 sessions in the same time period.

Outcomes
There were 7 patients who completed at least 6 weeks of circuit training between January 2017 and November 2018. All of these patients showed improvements in their physical outcome measures and all showed maintenance or improvement of their quality of life measure. The physical improvements showed an average of 33% in the Timed Up and Go Test; 68% in the 2 min timed walk test; and 29% in the functional reach test. The quality of life measure EORTC-QLQ-PAL showed an average improvement of 1 point in both the sections. A large number of patients who attended for less than 5 sessions all dropped out due to becoming less well.

Conclusions
This audit further supports the evidence that palliative care patients can undertake cardiovascular, strength and balance training with significant improvements in physical function. It also highlights the need for early referral into such programmes.