Pub Date : 2021-01-01DOI: 10.1097/01.REO.0000000000000248
J. Blackwood, Kateri Rybicki
Background and Purpose: Executive function (EF) is associated with falls and impaired gait in older adults. Performance on a measure of EF, the Trail Making Test Part B (TMT-B), may be able to differentiate between physical mobility and balance in older cancer survivors. The purpose of this study was to describe the demographic, disease-associated, and mobility differences in 2 groups of older cancer survivors based on the ability to complete TMT-B. Methods: Physical mobility and cognition was assessed in 50 older (aged 65+ years) cancer survivors. Group assignment was by TMT-B completion status (completers/noncompleters). Between-groups comparisons were performed on measures of physical mobility, balance, gait, and self-efficacy using nonparametric statistics. Results: Sixteen (32%) older cancer survivors were unable to complete TMT-B. Significant differences were found (P < .05) on all Timed Up and Go (TUG) measures in noncompleters versus completers: TUG (12.10 seconds vs 9.28 seconds), TUG-manual (12.81 seconds vs 10.88 seconds), TUG-cognitive (14.35 seconds vs 10.98 seconds). Noncompleters had significantly worse (P < .05) scores on the Short Physical Performance Battery, Fullerton Advanced Balance Scale, 30-second timed chair rise, balance confidence, falls self-efficacy, and all gait speed (usual, fast, dual-task) measures. Discussion: Older cancer survivors unable to complete TMT-B had worse performance in mobility, balance, strength, and dual-task activities that involve the increased demand of cognitive function. Executive function should be screened as a part of the falls risk management in older cancer survivors. Conclusion: Physical mobility, balance, and function are significantly more impaired in older cancers survivors who are unable to complete the TMT-B cognitive measure.
背景和目的:执行功能(EF)与老年人跌倒和步态受损有关。EF测试的表现，即轨迹测试B部分(TMT-B)，可能能够区分老年癌症幸存者的身体活动能力和平衡能力。本研究的目的是根据完成TMT-B的能力，描述两组老年癌症幸存者的人口统计学、疾病相关和活动能力差异。方法:对50例老年(65岁以上)癌症幸存者的身体活动能力和认知能力进行评估。根据TMT-B完成状态(完成者/未完成者)进行分组分配。采用非参数统计方法对身体活动能力、平衡、步态和自我效能进行组间比较。结果:16例(32%)老年癌症幸存者无法完成TMT-B。未完成者和完成者在所有的拔高测试(Timed Up and Go, TUG)上均有显著差异(P < 0.05): TUG(12.10秒vs 9.28秒)、手动TUG(12.81秒vs 10.88秒)、认知TUG(14.35秒vs 10.98秒)。未完成者在短体能测试、富勒顿高级平衡量表、30秒定时椅子起身、平衡信心、跌倒自我效能和所有步态速度(通常、快速、双任务)测试上的得分明显较差(P < 0.05)。讨论:不能完成TMT-B的老年癌症幸存者在移动性、平衡性、力量和涉及认知功能需求增加的双任务活动方面表现较差。执行功能应该作为老年癌症幸存者跌倒风险管理的一部分进行筛查。结论:不能完成TMT-B认知测试的老年癌症幸存者的身体活动能力、平衡能力和功能明显受损更严重。
{"title":"Physical Mobility and Balance Performance Differs in Older Cancer Survivors With Impaired Executive Function","authors":"J. Blackwood, Kateri Rybicki","doi":"10.1097/01.REO.0000000000000248","DOIUrl":"https://doi.org/10.1097/01.REO.0000000000000248","url":null,"abstract":"Background and Purpose: Executive function (EF) is associated with falls and impaired gait in older adults. Performance on a measure of EF, the Trail Making Test Part B (TMT-B), may be able to differentiate between physical mobility and balance in older cancer survivors. The purpose of this study was to describe the demographic, disease-associated, and mobility differences in 2 groups of older cancer survivors based on the ability to complete TMT-B. Methods: Physical mobility and cognition was assessed in 50 older (aged 65+ years) cancer survivors. Group assignment was by TMT-B completion status (completers/noncompleters). Between-groups comparisons were performed on measures of physical mobility, balance, gait, and self-efficacy using nonparametric statistics. Results: Sixteen (32%) older cancer survivors were unable to complete TMT-B. Significant differences were found (P < .05) on all Timed Up and Go (TUG) measures in noncompleters versus completers: TUG (12.10 seconds vs 9.28 seconds), TUG-manual (12.81 seconds vs 10.88 seconds), TUG-cognitive (14.35 seconds vs 10.98 seconds). Noncompleters had significantly worse (P < .05) scores on the Short Physical Performance Battery, Fullerton Advanced Balance Scale, 30-second timed chair rise, balance confidence, falls self-efficacy, and all gait speed (usual, fast, dual-task) measures. Discussion: Older cancer survivors unable to complete TMT-B had worse performance in mobility, balance, strength, and dual-task activities that involve the increased demand of cognitive function. Executive function should be screened as a part of the falls risk management in older cancer survivors. Conclusion: Physical mobility, balance, and function are significantly more impaired in older cancers survivors who are unable to complete the TMT-B cognitive measure.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"43 1","pages":"31 - 37"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84895904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1097/01.reo.0000000000000251
Laura Sheridan
Book; however in the past time becomes a sacral thing to have by everybody. Many books from thin to the very thick pages are presented. But now, for the technology has developed advanced, we will serve you the book not in the printed ways. finding balance is one of the products of those books. This book model can be downloaded from the site link that we provide in this website. We offer you not only the best books from this country, but many from outsides.
{"title":"Finding Balance","authors":"Laura Sheridan","doi":"10.1097/01.reo.0000000000000251","DOIUrl":"https://doi.org/10.1097/01.reo.0000000000000251","url":null,"abstract":"Book; however in the past time becomes a sacral thing to have by everybody. Many books from thin to the very thick pages are presented. But now, for the technology has developed advanced, we will serve you the book not in the printed ways. finding balance is one of the products of those books. This book model can be downloaded from the site link that we provide in this website. We offer you not only the best books from this country, but many from outsides.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"459 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89024470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1097/01.REO.0000000000000243
Ryan J. Marker, R. Kakar, Jared J. Scorsone, J. Peters, W. Purcell
Background: Balance impairments are present in cancer survivors for many reasons and increase risk of falls, though specific investigation of these impairments, and assessments to identify them, is not widely reported. Objective: Describe the performance of a large diverse cancer survivor population on a single-leg stance (SLS) test and assess relationships between this test and clinical and patient characteristics, including recent falls. Methods: This was a retrospective cross-sectional study. Data were collected from baseline assessments of 412 cancer survivors joining a clinical exercise program. Measurements: The primary outcome was an SLS test, performed with eyes opened and closed. Clinical and patient characteristics included age, body mass index (BMI), gender, cancer diagnosis and treatment, quality of life (QOL), and a recent history of falls (within the past 6 weeks). Results: Approximately one-third of the population was unable to reach 30 seconds on at least one leg with eyes open. Age and BMI had a negative influence on SLS with eyes open, while only age had a negative influence with eyes closed, in participants impaired in these conditions (N = 137 and N = 254, respectively). QOL was not related to SLS. SLS identified participants with a recent history of falls (sensitivity = 0.83; specificity = 0.58). Limitations: This population was biased, determined by provider referral or participant choice to join. The population was diverse in cancer diagnoses and treatment, limiting subgroup observations. Conclusions: Cancer survivors demonstrate a wide range of performance on the SLS test, which may show promise as a screen for fall risk.
{"title":"Single-Leg Stance Times in a Diverse Group of Survivors of Cancer and the Relationship to History of Recent Falls","authors":"Ryan J. Marker, R. Kakar, Jared J. Scorsone, J. Peters, W. Purcell","doi":"10.1097/01.REO.0000000000000243","DOIUrl":"https://doi.org/10.1097/01.REO.0000000000000243","url":null,"abstract":"Background: Balance impairments are present in cancer survivors for many reasons and increase risk of falls, though specific investigation of these impairments, and assessments to identify them, is not widely reported. Objective: Describe the performance of a large diverse cancer survivor population on a single-leg stance (SLS) test and assess relationships between this test and clinical and patient characteristics, including recent falls. Methods: This was a retrospective cross-sectional study. Data were collected from baseline assessments of 412 cancer survivors joining a clinical exercise program. Measurements: The primary outcome was an SLS test, performed with eyes opened and closed. Clinical and patient characteristics included age, body mass index (BMI), gender, cancer diagnosis and treatment, quality of life (QOL), and a recent history of falls (within the past 6 weeks). Results: Approximately one-third of the population was unable to reach 30 seconds on at least one leg with eyes open. Age and BMI had a negative influence on SLS with eyes open, while only age had a negative influence with eyes closed, in participants impaired in these conditions (N = 137 and N = 254, respectively). QOL was not related to SLS. SLS identified participants with a recent history of falls (sensitivity = 0.83; specificity = 0.58). Limitations: This population was biased, determined by provider referral or participant choice to join. The population was diverse in cancer diagnoses and treatment, limiting subgroup observations. Conclusions: Cancer survivors demonstrate a wide range of performance on the SLS test, which may show promise as a screen for fall risk.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"15 1","pages":"23 - 30"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87535111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1097/01.REO.0000000000000217
K. Covington, K. Atler, J. Bailey, Katie Lucas, M. Pergolotti
Purpose/Objective: To understand activities and experiences of women with fear of falling during cancer survivorship. Design: Parallel, mixed-methods design. Setting: Academic research. Participants and Measurement: Women who had completed active treatment and reported fear of falling completed structured surveys, the Timed Up and Go (TUG) test, a time-use assessment(s) guided by individual interview, and a focus group. Descriptive statistics, independent-samples t test, and exploratory Pearson correlations were used to analyze quantitative variables. Qualitative themes were identified through inductive, descriptive analysis. Results: Three (38%) participants had fallen in the past 6 months and 4 (50%) were considered at risk for falling (ie, TUG >10.7 seconds). Most of participants' time was spent at home versus away from home (t = −1.2, P = .04) and in committed occupations (M = 5.5 ± 2.1 hours; 34.8% of time per day). TUG fall risk (>10.7 seconds) and global mental health (r = −0.83, P = .01), TUG time and Activities Balance Confidence (r = −0.71, P < .05), and fear of falling and global mental health (r = −0.76, P = .03) were significantly correlated. Fear of falling led to (1) identity challenges and (2) ongoing lifestyle adaptations during survivorship. Adaptations included increased awareness, avoidance, or making modifications to support (or diminish) participation in daily activities and roles while avoiding falls. Limitations: Small sample and lack of precancer data. Conclusions: Fear of falling is an important influence on women's activities and experiences during cancer survivorship. Fear of falling may negatively influence mental health and physical function. Women may experience identity challenges and the need to make ongoing adaptations to participate in important roles and activities during survivorship.
目的:了解女性在癌症生存期间害怕跌倒的活动和经历。设计:并行、混合方法设计。设置:学术研究。参与者和测量:完成积极治疗并报告害怕摔倒的女性完成了结构化调查、计时起身(TUG)测试、由个人访谈指导的时间使用评估和焦点小组。定量变量分析采用描述性统计、独立样本t检验和探索性Pearson相关性。定性主题通过归纳，描述性分析确定。结果:3名(38%)参与者在过去6个月内摔倒过，4名(50%)被认为有摔倒的风险(即TUG >10.7秒)。与离家相比，大多数参与者的时间花在家里(t = - 1.2, P = .04)和承诺职业(M = 5.5±2.1小时;每天34.8%的时间)。TUG摔倒风险(>10.7秒)与整体心理健康(r = - 0.83, P = 0.01)、TUG时间和活动平衡信心(r = - 0.71, P < 0.05)、害怕摔倒与整体心理健康(r = - 0.76, P = 0.03)显著相关。对跌倒的恐惧导致了(1)身份挑战和(2)生存期间持续的生活方式适应。适应包括提高意识，避免或作出修改，以支持(或减少)参与日常活动和角色，同时避免跌倒。局限性:样本量小，缺乏癌前数据。结论:对跌倒的恐惧对女性在癌症生存期间的活动和经历有重要影响。对跌倒的恐惧可能会对心理健康和身体机能产生负面影响。女性可能会遇到身份挑战，需要不断适应，以参与生存期间的重要角色和活动。
{"title":"“Life Isn't as Carefree as It Used to Be”: A Mixed-Methods Evaluation of the Experiences of Women With Fear of Falling During Cancer Survivorship","authors":"K. Covington, K. Atler, J. Bailey, Katie Lucas, M. Pergolotti","doi":"10.1097/01.REO.0000000000000217","DOIUrl":"https://doi.org/10.1097/01.REO.0000000000000217","url":null,"abstract":"Purpose/Objective: To understand activities and experiences of women with fear of falling during cancer survivorship. Design: Parallel, mixed-methods design. Setting: Academic research. Participants and Measurement: Women who had completed active treatment and reported fear of falling completed structured surveys, the Timed Up and Go (TUG) test, a time-use assessment(s) guided by individual interview, and a focus group. Descriptive statistics, independent-samples t test, and exploratory Pearson correlations were used to analyze quantitative variables. Qualitative themes were identified through inductive, descriptive analysis. Results: Three (38%) participants had fallen in the past 6 months and 4 (50%) were considered at risk for falling (ie, TUG >10.7 seconds). Most of participants' time was spent at home versus away from home (t = −1.2, P = .04) and in committed occupations (M = 5.5 ± 2.1 hours; 34.8% of time per day). TUG fall risk (>10.7 seconds) and global mental health (r = −0.83, P = .01), TUG time and Activities Balance Confidence (r = −0.71, P < .05), and fear of falling and global mental health (r = −0.76, P = .03) were significantly correlated. Fear of falling led to (1) identity challenges and (2) ongoing lifestyle adaptations during survivorship. Adaptations included increased awareness, avoidance, or making modifications to support (or diminish) participation in daily activities and roles while avoiding falls. Limitations: Small sample and lack of precancer data. Conclusions: Fear of falling is an important influence on women's activities and experiences during cancer survivorship. Fear of falling may negatively influence mental health and physical function. Women may experience identity challenges and the need to make ongoing adaptations to participate in important roles and activities during survivorship.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"69 1","pages":"38 - 47"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74892243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-21DOI: 10.1097/01.REO.0000000000000216
J. Blackwood, Kateri Rybicki, M. Huang
Background: Cancer and its treatment contribute to multiple sequelae affecting physical function, including difficulty in balance and walking. Although clinical tests should be used to assess fall risks in older cancer survivors, the literature describing the validity, reliability, measurement error, and minimal detectable change (MDC) of mobility measures is lacking. Objective: The purpose of this study was to describe the reliability, validity, standard error of the measurement (SEM), and minimal detectable change at 95% confidence (MDC95) of mobility measures in older cancer survivors. Methods: Fifty cancer survivors (breast, prostate, lung, or colorectal) aged 65+ years participated. Measures of gait speed (GS) (usual, fast, and dual-task) and mobility (Timed Up and Go [TUG], TUG-cognitive, and TUG-manual) were performed once and then repeated 2 weeks later. Test-retest reliability was assessed using intraclass correlation coefficient (ICC2,1). MDC95 and SEM were calculated. Construct validity was examined using Pearson's correlation coefficient with 6-item Activities-specific Balance Confidence scale and Short Physical Performance Battery performance. Results: Test-retest reliability was excellent for all mobility measures, with ICC values ranging from 0.89 to 0.94 for GS and 0.95 to 0.98 for TUG measures. Construct validity was present for TUG (r = −0.53 to −0.73) and GS (r = 0.29 to 0.5) measures. Low SEM values demonstrated excellent reproducibility. To be considered real change, usual GS should be 0.14 m/s or more and TUG 2.49 seconds or more. Conclusions: Measures of GS and TUG have excellent reliability and construct validity and should be considered for use in older cancer survivors. Further study is indicated to establish the psychometric values of mobility measures by cancer type.
{"title":"Mobility Measures in Older Cancer Survivors: An Examination of Reliability, Validity, and Minimal Detectable Change","authors":"J. Blackwood, Kateri Rybicki, M. Huang","doi":"10.1097/01.REO.0000000000000216","DOIUrl":"https://doi.org/10.1097/01.REO.0000000000000216","url":null,"abstract":"Background: Cancer and its treatment contribute to multiple sequelae affecting physical function, including difficulty in balance and walking. Although clinical tests should be used to assess fall risks in older cancer survivors, the literature describing the validity, reliability, measurement error, and minimal detectable change (MDC) of mobility measures is lacking. Objective: The purpose of this study was to describe the reliability, validity, standard error of the measurement (SEM), and minimal detectable change at 95% confidence (MDC95) of mobility measures in older cancer survivors. Methods: Fifty cancer survivors (breast, prostate, lung, or colorectal) aged 65+ years participated. Measures of gait speed (GS) (usual, fast, and dual-task) and mobility (Timed Up and Go [TUG], TUG-cognitive, and TUG-manual) were performed once and then repeated 2 weeks later. Test-retest reliability was assessed using intraclass correlation coefficient (ICC2,1). MDC95 and SEM were calculated. Construct validity was examined using Pearson's correlation coefficient with 6-item Activities-specific Balance Confidence scale and Short Physical Performance Battery performance. Results: Test-retest reliability was excellent for all mobility measures, with ICC values ranging from 0.89 to 0.94 for GS and 0.95 to 0.98 for TUG measures. Construct validity was present for TUG (r = −0.53 to −0.73) and GS (r = 0.29 to 0.5) measures. Low SEM values demonstrated excellent reproducibility. To be considered real change, usual GS should be 0.14 m/s or more and TUG 2.49 seconds or more. Conclusions: Measures of GS and TUG have excellent reliability and construct validity and should be considered for use in older cancer survivors. Further study is indicated to establish the psychometric values of mobility measures by cancer type.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"25 1","pages":"74 - 80"},"PeriodicalIF":0.9,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73910902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-18DOI: 10.1097/01.REO.0000000000000245
M. Pergolotti, K. Covington, A. Lightner, Jessica Bertram, M. Thess, J. Sharp, M. Spraker, G. Williams, Peter R. Manning
Background and Purpose/Objective: Evidence supporting the effect of community-based cancer-specific physical and occupational therapy (PT/OT) services on cancer-related disability is limited. We examined the effect of community-based outpatient cancer-specific PT/OT for performance-based and patient-reported outcomes (PROs) for adults with cancer. Methods: This retrospective, pre/posttreatment study included 185 adults seen for cancer rehabilitation (PT/OT). Demographic and clinical data were patient-reported. Patient-Reported Outcomes Measurement Information System (PROMIS) measures included global physical health (GPH) and global mental health (GMH) scale (10 item); physical function (PF; 4-item), and ability to participate in social roles and activities (SRA; 4-item). Performance-based measures included hand grip strength (HGS) and the Timed Up and Go (TUG) test. We used descriptive statistics to evaluate patient characteristics, paired-samples t test to compare scores pre- and post-PT/OT, and independent-samples t test to compare the mean change for all outcomes between patients in the active and posttreatment groups. Results: Patients were predominantly female (n = 137; 75%), were 41 to 65 years old (n = 99; 57%). The majority had been diagnosed with breast (n = 98; 53%) cancer. Most (n = 115; 62.2%) patients completed at least one follow-up evaluation over 6 ± 4.5 weeks. A significant effect (P < .05; Cohen d = 0.21-0.35) was observed for GPH, SRA, HGS, and TUG test. There was no difference in average effect between the active and posttreatment groups. Conclusions: Community-based cancer-specific PT/OT has a significant effect on the functioning and participation of adults with cancer. Implications for Cancer Survivors: Community-based cancer rehabilitation services may benefit cancer survivors' functioning and health-related quality of life across the cancer continuum.
{"title":"Association of Outpatient Cancer Rehabilitation With Patient-Reported Outcomes and Performance-Based Measures of Function","authors":"M. Pergolotti, K. Covington, A. Lightner, Jessica Bertram, M. Thess, J. Sharp, M. Spraker, G. Williams, Peter R. Manning","doi":"10.1097/01.REO.0000000000000245","DOIUrl":"https://doi.org/10.1097/01.REO.0000000000000245","url":null,"abstract":"Background and Purpose/Objective: Evidence supporting the effect of community-based cancer-specific physical and occupational therapy (PT/OT) services on cancer-related disability is limited. We examined the effect of community-based outpatient cancer-specific PT/OT for performance-based and patient-reported outcomes (PROs) for adults with cancer. Methods: This retrospective, pre/posttreatment study included 185 adults seen for cancer rehabilitation (PT/OT). Demographic and clinical data were patient-reported. Patient-Reported Outcomes Measurement Information System (PROMIS) measures included global physical health (GPH) and global mental health (GMH) scale (10 item); physical function (PF; 4-item), and ability to participate in social roles and activities (SRA; 4-item). Performance-based measures included hand grip strength (HGS) and the Timed Up and Go (TUG) test. We used descriptive statistics to evaluate patient characteristics, paired-samples t test to compare scores pre- and post-PT/OT, and independent-samples t test to compare the mean change for all outcomes between patients in the active and posttreatment groups. Results: Patients were predominantly female (n = 137; 75%), were 41 to 65 years old (n = 99; 57%). The majority had been diagnosed with breast (n = 98; 53%) cancer. Most (n = 115; 62.2%) patients completed at least one follow-up evaluation over 6 ± 4.5 weeks. A significant effect (P < .05; Cohen d = 0.21-0.35) was observed for GPH, SRA, HGS, and TUG test. There was no difference in average effect between the active and posttreatment groups. Conclusions: Community-based cancer-specific PT/OT has a significant effect on the functioning and participation of adults with cancer. Implications for Cancer Survivors: Community-based cancer rehabilitation services may benefit cancer survivors' functioning and health-related quality of life across the cancer continuum.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"29 1","pages":"137 - 142"},"PeriodicalIF":0.9,"publicationDate":"2020-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78619935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-16DOI: 10.1097/01.REO.0000000000000244
Christopher M. Wilson, Ann M. Lucado, D. Wendland, David W. M. Taylor, B. Black
Background: Cancer and its treatments cause a variety of symptoms and sequelae that can be impacted by patients' health behaviors. Objective/Purpose: To examine the perceptions of their role and the extent to which physical therapists (PTs) and physical therapist assistants (PTAs) include health promotion, wellness, and prevention (HPWP) in the care of patients with cancer. Design: Survey. Methods: A survey was developed to examine the perceptions, current practice, and barriers to HPWP practice in oncologic physical therapist practice. After reliability testing and survey refinement, the survey was administered electronically to PTs and PTAs who provide care for individuals with cancer. The responses of 69 PTs and 4 PTAs who completed the survey were analyzed. Results: Respondents reported their perceived role versus current practice in discussing the following behaviors with their patients: physical activity/exercise (99%/99%), stress management (93%/72%), sleep hygiene (92%/61%), tobacco use (83%/28%), healthy eating (82%/71%), alcohol/substance abuse (74%/7%), and vaping/e-cigarettes (73%/3%). Reported barriers to HPWP practice included economic limitations, lack of time, level of patient interest, inadequate skills, and lack of organizational support and resources. Conclusions: There was close alignment between respondents' perceived roles and HPWP practice for physical activity, healthy eating, and stress management but less agreement with the behaviors of sleep hygiene, alcohol/tobacco/substance use, and vaping. Limitations included a low response rate and limited psychometric testing of the survey. Because of the potential positive effect of healthy behaviors in those diagnosed with cancer, there is opportunity to better incorporate HPWP into oncologic physical therapist practice.
{"title":"Health Promotion, Wellness, and Prevention Practice in Oncologic Physical Therapy: A Survey Study","authors":"Christopher M. Wilson, Ann M. Lucado, D. Wendland, David W. M. Taylor, B. Black","doi":"10.1097/01.REO.0000000000000244","DOIUrl":"https://doi.org/10.1097/01.REO.0000000000000244","url":null,"abstract":"Background: Cancer and its treatments cause a variety of symptoms and sequelae that can be impacted by patients' health behaviors. Objective/Purpose: To examine the perceptions of their role and the extent to which physical therapists (PTs) and physical therapist assistants (PTAs) include health promotion, wellness, and prevention (HPWP) in the care of patients with cancer. Design: Survey. Methods: A survey was developed to examine the perceptions, current practice, and barriers to HPWP practice in oncologic physical therapist practice. After reliability testing and survey refinement, the survey was administered electronically to PTs and PTAs who provide care for individuals with cancer. The responses of 69 PTs and 4 PTAs who completed the survey were analyzed. Results: Respondents reported their perceived role versus current practice in discussing the following behaviors with their patients: physical activity/exercise (99%/99%), stress management (93%/72%), sleep hygiene (92%/61%), tobacco use (83%/28%), healthy eating (82%/71%), alcohol/substance abuse (74%/7%), and vaping/e-cigarettes (73%/3%). Reported barriers to HPWP practice included economic limitations, lack of time, level of patient interest, inadequate skills, and lack of organizational support and resources. Conclusions: There was close alignment between respondents' perceived roles and HPWP practice for physical activity, healthy eating, and stress management but less agreement with the behaviors of sleep hygiene, alcohol/tobacco/substance use, and vaping. Limitations included a low response rate and limited psychometric testing of the survey. Because of the potential positive effect of healthy behaviors in those diagnosed with cancer, there is opportunity to better incorporate HPWP into oncologic physical therapist practice.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"1 1","pages":"E51 - E57"},"PeriodicalIF":0.9,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88424999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-16DOI: 10.1097/01.REO.0000000000000241
Laura Tabacof, Andrew D. Delgado, Sophie Dewil, Fabiana Reis, Camila Molina Velar, Munique Egle Dona Corteline, R. Cecatto, D. Putrino, M. Imamura, L. Battistella, C. M. Moran de Brito
Background: Because of fear of skeletal complications, physicians often avoid referring patients with secondary bone cancer (SBC) to physical rehabilitation. However, there is little evidence on the risk of skeletal-related events (SREs) and pathological fracture (PF) during rehabilitation therapies. Objective: To determine the risk of PF following physical rehabilitation in people with SBC. Design: Single-group, single-centered interventional clinical trial. Setting: University-based outpatient rehabilitation clinic. Patients: Forty-eight patients with confirmed diagnosis of SBC were enrolled. Interventions: Participants were prescribed a multidisciplinary rehabilitation program. Participants and rehabilitation therapists were trained to detect and report symptoms that would indicate PF. Radiographs were used to confirm the presence of PF. Measurements: The primary outcomes were safety and feasibility of an outpatient rehabilitation program for patients with SBC. Safety was measured by the rate of SREs. Feasibility was measured by the ability to successfully complete the program. Secondary outcome measures included Short Form Health Survey (SF-36) and numeric rating scale (NRS) scores to assess pain intensity. Results: One PF was detected, which occurred outside of rehabilitation therapy. Two other SREs occurred, resulting in a total event rate of 11.8 for every 10 000 hours of exposure. There was a significant improvement in NRS (95% CI, 1.41-3.08, P < .001) and SF-36 measures (95% CI, 80.35-158.11, P < .001). Limitations: Twenty participants (42%) did not complete the rehabilitation program due to clinical complications or death. Conclusions: Rehabilitation interventions may not increase the risk of SREs or PF in patients with SBC. Further research is indicated to verify these findings.
背景:由于担心骨骼并发症，医生通常避免将继发性骨癌(SBC)患者转介到物理康复。然而，很少有证据表明在康复治疗过程中骨骼相关事件(SREs)和病理性骨折(PF)的风险。目的:确定SBC患者肢体康复后发生PF的风险。设计:单组、单中心介入临床试验。单位:校级康复门诊。患者:48例确诊为SBC的患者入组。干预措施:参与者被规定了一个多学科的康复计划。参与者和康复治疗师接受培训，以检测和报告可能表明PF的症状。x线片用于确认PF的存在。测量:主要结果是SBC患者门诊康复计划的安全性和可行性。安全性以SREs率衡量。可行性是通过成功完成项目的能力来衡量的。次要结果测量包括简短健康调查(SF-36)和评估疼痛强度的数字评定量表(NRS)评分。结果:1例PF发生在康复治疗外。另外还发生了两次SREs，导致每10,000小时暴露的总事件率为11.8。NRS (95% CI, 1.41-3.08, P < .001)和SF-36指标(95% CI, 80.35-158.11, P < .001)均有显著改善。局限性:20名参与者(42%)由于临床并发症或死亡而未完成康复计划。结论:康复干预可能不会增加SBC患者发生SREs或PF的风险。需要进一步的研究来验证这些发现。
{"title":"Safety and Feasibility of Outpatient Rehabilitation in Patients With Secondary Bone Cancer: A Preliminary Study","authors":"Laura Tabacof, Andrew D. Delgado, Sophie Dewil, Fabiana Reis, Camila Molina Velar, Munique Egle Dona Corteline, R. Cecatto, D. Putrino, M. Imamura, L. Battistella, C. M. Moran de Brito","doi":"10.1097/01.REO.0000000000000241","DOIUrl":"https://doi.org/10.1097/01.REO.0000000000000241","url":null,"abstract":"Background: Because of fear of skeletal complications, physicians often avoid referring patients with secondary bone cancer (SBC) to physical rehabilitation. However, there is little evidence on the risk of skeletal-related events (SREs) and pathological fracture (PF) during rehabilitation therapies. Objective: To determine the risk of PF following physical rehabilitation in people with SBC. Design: Single-group, single-centered interventional clinical trial. Setting: University-based outpatient rehabilitation clinic. Patients: Forty-eight patients with confirmed diagnosis of SBC were enrolled. Interventions: Participants were prescribed a multidisciplinary rehabilitation program. Participants and rehabilitation therapists were trained to detect and report symptoms that would indicate PF. Radiographs were used to confirm the presence of PF. Measurements: The primary outcomes were safety and feasibility of an outpatient rehabilitation program for patients with SBC. Safety was measured by the rate of SREs. Feasibility was measured by the ability to successfully complete the program. Secondary outcome measures included Short Form Health Survey (SF-36) and numeric rating scale (NRS) scores to assess pain intensity. Results: One PF was detected, which occurred outside of rehabilitation therapy. Two other SREs occurred, resulting in a total event rate of 11.8 for every 10 000 hours of exposure. There was a significant improvement in NRS (95% CI, 1.41-3.08, P < .001) and SF-36 measures (95% CI, 80.35-158.11, P < .001). Limitations: Twenty participants (42%) did not complete the rehabilitation program due to clinical complications or death. Conclusions: Rehabilitation interventions may not increase the risk of SREs or PF in patients with SBC. Further research is indicated to verify these findings.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"60 1","pages":"E42 - E50"},"PeriodicalIF":0.9,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85100378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-16DOI: 10.1097/01.REO.0000000000000247
Karsten Barbagelata, Jacqueline Eadi, M. McNamara, Melissa Sayles, James M. Smith
Background and Purpose: Pain and cancer-related fatigue (CRF) are impairments from breast cancer or the medical and surgical therapies for breast cancer. Aquatic therapy has been found to be effective for the problems of pain and CRF. The purpose of this systematic review was to determine whether aquatic therapy reduced pain and CRF among people with breast cancer and to identify any elements of aquatic therapy associated with those effects. Methods: The protocol for this systematic review was registered with PROSPERO, and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards were followed. Four databases were searched, and studies were selected on the basis of predetermined criteria. Data were extracted into a template for analysis and thematic synthesis. Measures of methodological quality (risk of bias) and level of evidence were applied. Results: Six studies involving 137 subjects who received treatment were included. Subjects received aquatic therapy (water-based exercise for rehabilitation) that was compared with various land-based interventions. Studies were evaluated with the Oxford Centre for Evidence-based Medicine—Levels of Evidence for Therapy/Prevention Studies Rating Scale, and all studies had a high or acceptable level of evidence. Studies were evaluated with the APTA Critical Appraisal Tool for Experimental Intervention Studies, and 5 studies had a high or acceptable quality. High-quality evidence supported the use of aquatic therapy for reducing CRF, and acceptable quality evidence supported the use of aquatic therapy for reducing pain. Adverse responses to aquatic therapy were minor symptoms that resolved within days and had no effect on attrition. Limitations: Searches were limited to publications in English. Analysis was confounded by heterogeneity of pain measures. Conclusions: Aquatic therapy is recommended as an intervention for the impairments of pain and CRF associated with breast cancer. Aquatic therapy is safe and feasible for this population.
{"title":"Aquatic Therapy Reduces Pain and Fatigue in Breast Cancer Survivors: A Systematic Review","authors":"Karsten Barbagelata, Jacqueline Eadi, M. McNamara, Melissa Sayles, James M. Smith","doi":"10.1097/01.REO.0000000000000247","DOIUrl":"https://doi.org/10.1097/01.REO.0000000000000247","url":null,"abstract":"Background and Purpose: Pain and cancer-related fatigue (CRF) are impairments from breast cancer or the medical and surgical therapies for breast cancer. Aquatic therapy has been found to be effective for the problems of pain and CRF. The purpose of this systematic review was to determine whether aquatic therapy reduced pain and CRF among people with breast cancer and to identify any elements of aquatic therapy associated with those effects. Methods: The protocol for this systematic review was registered with PROSPERO, and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards were followed. Four databases were searched, and studies were selected on the basis of predetermined criteria. Data were extracted into a template for analysis and thematic synthesis. Measures of methodological quality (risk of bias) and level of evidence were applied. Results: Six studies involving 137 subjects who received treatment were included. Subjects received aquatic therapy (water-based exercise for rehabilitation) that was compared with various land-based interventions. Studies were evaluated with the Oxford Centre for Evidence-based Medicine—Levels of Evidence for Therapy/Prevention Studies Rating Scale, and all studies had a high or acceptable level of evidence. Studies were evaluated with the APTA Critical Appraisal Tool for Experimental Intervention Studies, and 5 studies had a high or acceptable quality. High-quality evidence supported the use of aquatic therapy for reducing CRF, and acceptable quality evidence supported the use of aquatic therapy for reducing pain. Adverse responses to aquatic therapy were minor symptoms that resolved within days and had no effect on attrition. Limitations: Searches were limited to publications in English. Analysis was confounded by heterogeneity of pain measures. Conclusions: Aquatic therapy is recommended as an intervention for the impairments of pain and CRF associated with breast cancer. Aquatic therapy is safe and feasible for this population.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"33 1","pages":"E35 - E41"},"PeriodicalIF":0.9,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89841537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-01DOI: 10.1097/01.REO.0000000000000237
J. Binkley, Mallory Mark, Janae Finley, A. Brazelton, Marilyn M Pink
Background: COVID-19 presents a significant challenge to providing specialized rehabilitation and exercise for patients with breast cancer. Objective: The purpose of this report is to describe the implementation of telerehabilitation for one-on-one patient care and interactive, live, Web-based formats for group patient education, exercise, and support programs during the COVID-19 pandemic. Design: This report describes the concept, materials, and methods used in a community-based clinical setting to serve patients' needs during COVID-19. Results: Telerehabilitation and interactive Web-based strategies may be useful in meeting the physical and emotional needs of patients with breast cancer. Brief patient cases summarize the process of one-on-one telerehabilitation implementation and provide patient and family perspectives. Challenges and benefits of telerehabilitation are described. Interactive Web-based strategies substantially increased the numbers of patients reached with survivorship education and support groups during the first 2 months of COVID-19. Limitations: This report is descriptive and does not include group outcomes. Further research is needed to compare outcomes of telerehabilitation versus in-person delivery of breast cancer rehabilitation care. Conclusion: Telerehabilitation and interactive Web-based education formats provide an alternative to in-person breast cancer rehabilitation care during COVID-19 and have potential application for improving delivery of care to underserved populations and in other types of cancer.
{"title":"Meeting the Rehabilitation and Support Needs of Patients With Breast Cancer During COVID-19: Opening New Frontiers in Models of Care","authors":"J. Binkley, Mallory Mark, Janae Finley, A. Brazelton, Marilyn M Pink","doi":"10.1097/01.REO.0000000000000237","DOIUrl":"https://doi.org/10.1097/01.REO.0000000000000237","url":null,"abstract":"Background: COVID-19 presents a significant challenge to providing specialized rehabilitation and exercise for patients with breast cancer. Objective: The purpose of this report is to describe the implementation of telerehabilitation for one-on-one patient care and interactive, live, Web-based formats for group patient education, exercise, and support programs during the COVID-19 pandemic. Design: This report describes the concept, materials, and methods used in a community-based clinical setting to serve patients' needs during COVID-19. Results: Telerehabilitation and interactive Web-based strategies may be useful in meeting the physical and emotional needs of patients with breast cancer. Brief patient cases summarize the process of one-on-one telerehabilitation implementation and provide patient and family perspectives. Challenges and benefits of telerehabilitation are described. Interactive Web-based strategies substantially increased the numbers of patients reached with survivorship education and support groups during the first 2 months of COVID-19. Limitations: This report is descriptive and does not include group outcomes. Further research is needed to compare outcomes of telerehabilitation versus in-person delivery of breast cancer rehabilitation care. Conclusion: Telerehabilitation and interactive Web-based education formats provide an alternative to in-person breast cancer rehabilitation care during COVID-19 and have potential application for improving delivery of care to underserved populations and in other types of cancer.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"38 1","pages":"159 - 168"},"PeriodicalIF":0.9,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75137314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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