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

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-postintervention pilot feasibility study. SETTINGS: This study was conducted at a single academic institution via telehealth. PATIENTS: Patients with stage I to 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. INTERVENTIONS(S): Twenty-four patients completed 12 weekly one-to-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, and 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 said it helped them cope with their symptoms. At 12 weeks, bowel function improved by 7.27% (p = 0.002) and 16.5% (p ≤ 0.0001) as measured by the bowel function instrument and low anterior resection syndrome score, respectively. 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 a 12-week follow-up. Daily steps increased by 17.5% during the intervention (p = 0.035). LIMITATIONS: Pre-postintervention study design. CONCLUSIONS: Delivering a telehealth counseling intervention is feasible and satisfactory for survivors of rectal cancer with low anterior resection syndrome. This intervention has positive implications for bowel health and health-related quality of life.