Research News

Maintaining activities of daily living (ADLs) is of great importance for terminally ill cancer patients, and dependency is associated with psychological distress. However, evidence for rehabilitation remains scarce in this setting.

To address this, an Osaka Metropolitan University-led research team verified the effectiveness of a structured program developed for rehabilitation therapists that systematically organizes key recommended behaviors when providing care to cancer patients admitted to inpatient hospice and palliative care units.

They evaluated the efficacy of a structured rehabilitation program for maintaining ADLs among terminally ill cancer patients. This multi-center randomized controlled trial across 19 Japanese inpatient hospices/palliative care units (PCUs) enrolled terminally ill cancer patients with ECOG performance status (PS) 2–3, life expectancy ≥ three weeks, and no severe symptoms. Participants were randomly assigned (1:1, stratified by PS and site) to a 3-week structured rehabilitation program incorporating key elements of rehabilitation for terminally ill cancer patients, or usual unstructured rehabilitation. The primary outcome was change in total modified Barthel Index (mBI) from baseline to Day 22. Secondary outcomes included EORTC QLQ-C15-PAL and safety.

Between 8 July 2019 and 20 February 2024, 130 patients were randomized (59 intervention, 71 control; 56 [43.0%] female). The primary analysis included 77 participants with complete data. Mean change in total mBI was -1.31 in the intervention group and -15.51 in the control group. The between-group difference was 14.21, exceeding the minimally clinically important difference (9.25). Patient-reported physical functioning on EORTC QLQ-C15-PAL was also significantly higher in the intervention group than the control group. No serious harms occurred.

Structured rehabilitation better maintained ADLs than unstructured rehabilitation in terminally ill cancer patients, supporting its integration into routine care even in the last stage of cancer.

“The findings of this study provide evidence supporting the integration of rehabilitation into palliative care for patients with cancer in the final stage of life. By using this practical guide, therapists may be better supported in providing rehabilitation that reflects each patient’s condition and goals, while reducing variations in practice across institutions,” said Nanako Nishiyama, the first author of the study. “We also hope that this study will encourage healthcare professionals to recognize that support for daily living remains important even in the final stage of life.”

Paper information

Journal: Cancer
Title: Efficacy of a structured rehabilitation program for patients with terminal cancer: A multicenter randomized controlled trial
DOI: 10.1002/cncr.70485
Authors: Nanako Nishiyama, Yoshinobu Matsuda, Noriko Fujiwara, Keiichi Narita, Shunsuke Oyamada, Keisuke Ariyoshi, Yukiko Hosono, Kazuaki Kushi, Katsuaki Ichimaru, Ritsuko Yabuki, Keisuke Kaneishi, Kiriko Abe, Takahiro Fujihara, Yoshihito Kono, Kozue Suzuki, Tae Kinoshita, Takeshi Sasara, Masato Nakajima, Hironori Mawatari, Hiroki Sugawara, Kentaro Nobutani, Yuriko Shindoh, Koichiro Kobayashi, Takashi Yamaguchi, Ryuji Iwaki, Yosuke Kitazoe, Yoshiaki Kanai, Junya Ueno, Tesshin Fukumi, Ryouhei Ishii, and Nobuhisa Nakajima
Published: 16 June 2026
URL: https://doi.org/10.1002/cncr.70485

Contact

Nanako Nishiyama
Graduate School of Rehabilitation Science
Email: nnk.nishiyama[at]omu.ac.jp

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