Pub Date : 2023-02-13DOI: 10.1097/01.REO.0000000000000332
Jacquelyn M Maciukiewicz, C. Dickerson
Background: Breast cancer is prevalent among Canadian women, but treatments may cause functional impairments among survivors. Despite a substantial number of survivors joining the population yearly, minimal research has approached the challenges faced by this population after primary treatment. The purpose of this study was to classify the different function of survivors of breast cancer and determine factors that differed across groups of survivors. Methods: Thirty-five survivors of breast cancer within 2 years since the conclusion of their treatment participated in this cross-sectional study. Participants completed quality-of-life questionnaires, followed by a full-body dual-energy x-ray absorptiometry scanning. The collection concluded with maximal force exertions at the shoulder and maximum shoulder range of motion. Results: This study determined, through feature reduction, that internal rotation force production, active extension range of motion, and 3 shoulder-related quality-of-life variables (energy/fatigue, social functioning, and pain) separated survivors within 2 years of treatment into 2 clusters (low- and high-score clusters [LSC/HSC], respectively). The LSC participants had higher self-reported disability, lower shoulder-related quality of life, force production, and flexion range of motion. Conclusion: Clustering survivors of breast cancer allows for a better understanding of deficits experienced by some individuals, as well as brings awareness to factors to monitor, and address in rehabilitation efforts.
{"title":"Improving Evidence-Based Methods of Characterizing Shoulder-Related Quality of Life for Survivors of Breast Cancer","authors":"Jacquelyn M Maciukiewicz, C. Dickerson","doi":"10.1097/01.REO.0000000000000332","DOIUrl":"https://doi.org/10.1097/01.REO.0000000000000332","url":null,"abstract":"Background: Breast cancer is prevalent among Canadian women, but treatments may cause functional impairments among survivors. Despite a substantial number of survivors joining the population yearly, minimal research has approached the challenges faced by this population after primary treatment. The purpose of this study was to classify the different function of survivors of breast cancer and determine factors that differed across groups of survivors. Methods: Thirty-five survivors of breast cancer within 2 years since the conclusion of their treatment participated in this cross-sectional study. Participants completed quality-of-life questionnaires, followed by a full-body dual-energy x-ray absorptiometry scanning. The collection concluded with maximal force exertions at the shoulder and maximum shoulder range of motion. Results: This study determined, through feature reduction, that internal rotation force production, active extension range of motion, and 3 shoulder-related quality-of-life variables (energy/fatigue, social functioning, and pain) separated survivors within 2 years of treatment into 2 clusters (low- and high-score clusters [LSC/HSC], respectively). The LSC participants had higher self-reported disability, lower shoulder-related quality of life, force production, and flexion range of motion. Conclusion: Clustering survivors of breast cancer allows for a better understanding of deficits experienced by some individuals, as well as brings awareness to factors to monitor, and address in rehabilitation efforts.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"55 1","pages":"149 - 156"},"PeriodicalIF":0.9,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86791629","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 : 2023-01-24DOI: 10.1097/01.REO.0000000000000331
D. Doubblestein, Bryan A. Spinelli, A. Goldberg, C. A. Larson, A. Yorke
Background: Various outcome measures (OMs) have been used with individuals with breast cancer–related lymphedema (BCRL). There have not been studies investigating the facilitators and barriers to the use of OMs by certified lymphedema therapists (CLTs) on BCRL. The purposes of this study was to (1) identify facilitators and barriers for use of OMs reported by CLTs and (2) investigate the association of personal and professional characteristics of CLTs and their knowledge or beliefs about OMs. Methods: Cross-sectional online survey research design. Electronic surveys were distributed to CLTs from various institutions. Data from 70 physical therapists and 41 occupational therapists were analyzed. Point-biserial correlations examined associations and logistic regression examined predictors to OMs facilitators and barriers. Results: Certified lymphedema therapists agreed that OMs help direct a plan of care (90.1%), improve quality of care (76.6%), and determine the efficacy of their intervention on BCRL (72.7%). Certified lymphedema therapists reported difficulty knowing the best OM to choose due to numerous options (67.3%). Barriers for OMs included lack of knowledge and time, availability in workplace, and personal preferences. Characteristics associated with barriers and facilitators were few and poorly correlated. Conclusion: Certified lymphedema therapists agree on the benefits of and to the use of OMs, however, physical therapist CLTs may value the use of OMs less than occupational therapists. Certified lymphedema therapists experience barriers to use of OMs related to lack of knowledge and implementation skills. Further guidance is needed in selecting OMs for breast cancer survivors with BCRL to reduce barriers to their use.
{"title":"Facilitators and Barriers to the Use of Outcome Measures by Certified Lymphedema Therapists","authors":"D. Doubblestein, Bryan A. Spinelli, A. Goldberg, C. A. Larson, A. Yorke","doi":"10.1097/01.REO.0000000000000331","DOIUrl":"https://doi.org/10.1097/01.REO.0000000000000331","url":null,"abstract":"Background: Various outcome measures (OMs) have been used with individuals with breast cancer–related lymphedema (BCRL). There have not been studies investigating the facilitators and barriers to the use of OMs by certified lymphedema therapists (CLTs) on BCRL. The purposes of this study was to (1) identify facilitators and barriers for use of OMs reported by CLTs and (2) investigate the association of personal and professional characteristics of CLTs and their knowledge or beliefs about OMs. Methods: Cross-sectional online survey research design. Electronic surveys were distributed to CLTs from various institutions. Data from 70 physical therapists and 41 occupational therapists were analyzed. Point-biserial correlations examined associations and logistic regression examined predictors to OMs facilitators and barriers. Results: Certified lymphedema therapists agreed that OMs help direct a plan of care (90.1%), improve quality of care (76.6%), and determine the efficacy of their intervention on BCRL (72.7%). Certified lymphedema therapists reported difficulty knowing the best OM to choose due to numerous options (67.3%). Barriers for OMs included lack of knowledge and time, availability in workplace, and personal preferences. Characteristics associated with barriers and facilitators were few and poorly correlated. Conclusion: Certified lymphedema therapists agree on the benefits of and to the use of OMs, however, physical therapist CLTs may value the use of OMs less than occupational therapists. Certified lymphedema therapists experience barriers to use of OMs related to lack of knowledge and implementation skills. Further guidance is needed in selecting OMs for breast cancer survivors with BCRL to reduce barriers to their use.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"28 1","pages":"121 - 128"},"PeriodicalIF":0.9,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89422323","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 : 2023-01-01DOI: 10.1097/01.reo.0000000000000329
M. Fisher
{"title":"Auld Lang Syne, My Friend","authors":"M. Fisher","doi":"10.1097/01.reo.0000000000000329","DOIUrl":"https://doi.org/10.1097/01.reo.0000000000000329","url":null,"abstract":"","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"20 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88546663","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 : 2022-12-20DOI: 10.1097/01.reo.0000000000000328
S. Weber, Athena A. Manzino, Christopher Wilson
{"title":"The Benefit of Nontraditional Rehabilitation Settings and Care Delivery Models for People Living With and Beyond Cancer","authors":"S. Weber, Athena A. Manzino, Christopher Wilson","doi":"10.1097/01.reo.0000000000000328","DOIUrl":"https://doi.org/10.1097/01.reo.0000000000000328","url":null,"abstract":"","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"39 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77703272","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 : 2022-12-20DOI: 10.1097/01.REO.0000000000000326
E. Helm, Brenda Crowley, Tara L Crowell, M. Galantino
Background: Individuals with breast cancer–related lymphedema (BCRL) require self-management strategies to reduce risk of infection, exacerbation, and/or progression of lymphedema. The coronavirus pandemic thrust the medical field into the world of telehealth; both patients and providers were forced to reduce in-person treatments and engage in this new platform of rehabilitation delivery. The role of telehealth in promotion of self-management for BCRL is unknown. Purpose: This study examines self-efficacy during cancer rehabilitation for in-clinic versus telehealth visits among individuals with BCRL during the pandemic quarantine April to November 2020. Methods: Forty women who recently completed oncology rehabilitation for BCRL were asked to complete demographics and 2 Likert surveys, including the Exercise Self-Efficacy Scale (ESES) and the Self-Care Self-Efficacy Scale (SCSE), to compare the efficacy of telehealth versus in-person treatment modalities. Results: Thirty-two participants completed the survey and indicated that the percentage of telehealth visits was less than face-to-face visits. Despite this, the participants indicated numerous positive moderately strong correlations between self-care self-efficacy and exercise self-efficacy for both types of visits (P < .05). Limitations: Self-report surveys by a convenience sample, multifactorial characteristics of rehabilitation treatment across modes, and varying severity of lymphedema may limit study findings. Conclusion: Telehealth provided safe and effective care to participants and bolstered confidence in self-care and self-management of BCRL. Data support that telehealth visits can be considered an essential part of comprehensive cancer rehabilitation care. Future research is needed to establish and optimize practice guidelines in both health delivery systems.
{"title":"Effect of Telerehabilitation Versus In-Clinic Rehabilitation Delivery on Self-Efficacy in Breast Cancer–Related Lymphedema","authors":"E. Helm, Brenda Crowley, Tara L Crowell, M. Galantino","doi":"10.1097/01.REO.0000000000000326","DOIUrl":"https://doi.org/10.1097/01.REO.0000000000000326","url":null,"abstract":"Background: Individuals with breast cancer–related lymphedema (BCRL) require self-management strategies to reduce risk of infection, exacerbation, and/or progression of lymphedema. The coronavirus pandemic thrust the medical field into the world of telehealth; both patients and providers were forced to reduce in-person treatments and engage in this new platform of rehabilitation delivery. The role of telehealth in promotion of self-management for BCRL is unknown. Purpose: This study examines self-efficacy during cancer rehabilitation for in-clinic versus telehealth visits among individuals with BCRL during the pandemic quarantine April to November 2020. Methods: Forty women who recently completed oncology rehabilitation for BCRL were asked to complete demographics and 2 Likert surveys, including the Exercise Self-Efficacy Scale (ESES) and the Self-Care Self-Efficacy Scale (SCSE), to compare the efficacy of telehealth versus in-person treatment modalities. Results: Thirty-two participants completed the survey and indicated that the percentage of telehealth visits was less than face-to-face visits. Despite this, the participants indicated numerous positive moderately strong correlations between self-care self-efficacy and exercise self-efficacy for both types of visits (P < .05). Limitations: Self-report surveys by a convenience sample, multifactorial characteristics of rehabilitation treatment across modes, and varying severity of lymphedema may limit study findings. Conclusion: Telehealth provided safe and effective care to participants and bolstered confidence in self-care and self-management of BCRL. Data support that telehealth visits can be considered an essential part of comprehensive cancer rehabilitation care. Future research is needed to establish and optimize practice guidelines in both health delivery systems.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"9 1","pages":"82 - 88"},"PeriodicalIF":0.9,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87626693","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 : 2022-12-20DOI: 10.1097/01.reo.0000000000000327
Athena A. Manzino, Stacy M. Weber, Christopher M. Wilson
{"title":"Significance and Plausibility of Providing Acute Care Physical Therapy Interventions to Patients With High Functional Status","authors":"Athena A. Manzino, Stacy M. Weber, Christopher M. Wilson","doi":"10.1097/01.reo.0000000000000327","DOIUrl":"https://doi.org/10.1097/01.reo.0000000000000327","url":null,"abstract":"","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"1995 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82435594","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 : 2022-10-19DOI: 10.1097/01.REO.0000000000000322
H. Mackie, B. Thompson, L. Koelmeyer, R. Blackwell, K. Gaitatzis, A. Heydon-White, J. Boyages, H. Suami
Background and Objectives: The contralateral inguinal pathway (CIP) to the inguinal nodal region of the contralateral limb has been described in lower-limb lymphedema (LLLE). This audit aimed to use indocyanine green (ICG) lymphography to determine characteristics of patients with CIP to inform conservative therapy. Methods: Patients with confirmed LLLE (n = 278) were categorized into secondary cancer-related (n = 82), secondary non–cancer-related (n = 86), or primary (n = 110). Patient characteristics, limb volume and bioimpedance spectroscopy (BIS) extracellular fluid ratio, and ICG lymphography of lymphatic pathways and dermal backflow areas were recorded. Results: Forty-seven patients (16.9%) had movement of ICG dye via CIP. Of these, 30 (63.8%) had secondary cancer-related, 8 (17.0%) had secondary non–cancer-related, and 9 (19.1%) had primary LLLE. Cancer-related LLE (P < .001) and unilateral LLLE (P = .017) were significant indicators of CIP, with 36.6% of patients with cancer-related LLLE demonstrating this pathway. CIP was significantly associated with dermal backflow in shin (P = .016), calf (P = .006), thigh (P < .001), inguinal (P < .001), pubic (P < .001), and abdominal regions (P = .001). Patients with CIP had significantly higher volume differences between limbs (P < .001), severity of lymphedema (P < .001), and BIS measurements (P < .001) than patients without CIP. Conclusion: A compensatory lymphatic drainage pathway from the affected limb to the contralateral inguinal lymph node region was evident in 16.9% of patients with LLLE. This pathway was most observed in unilateral cancer-related lymphedema, particularly where edema was present in proximal thigh, inguinal, pubic, and lower abdominal regions. Directing manual lymphatic drainage to the contralateral inguinal drainage region should be considered especially for patients with cancer-related LLLE.
{"title":"Clinical Characteristics and Implications of Indocyanine Green Lymphography-Identified Contralateral Inguinal Pathway of Lower-Limb Lymphedema","authors":"H. Mackie, B. Thompson, L. Koelmeyer, R. Blackwell, K. Gaitatzis, A. Heydon-White, J. Boyages, H. Suami","doi":"10.1097/01.REO.0000000000000322","DOIUrl":"https://doi.org/10.1097/01.REO.0000000000000322","url":null,"abstract":"Background and Objectives: The contralateral inguinal pathway (CIP) to the inguinal nodal region of the contralateral limb has been described in lower-limb lymphedema (LLLE). This audit aimed to use indocyanine green (ICG) lymphography to determine characteristics of patients with CIP to inform conservative therapy. Methods: Patients with confirmed LLLE (n = 278) were categorized into secondary cancer-related (n = 82), secondary non–cancer-related (n = 86), or primary (n = 110). Patient characteristics, limb volume and bioimpedance spectroscopy (BIS) extracellular fluid ratio, and ICG lymphography of lymphatic pathways and dermal backflow areas were recorded. Results: Forty-seven patients (16.9%) had movement of ICG dye via CIP. Of these, 30 (63.8%) had secondary cancer-related, 8 (17.0%) had secondary non–cancer-related, and 9 (19.1%) had primary LLLE. Cancer-related LLE (P < .001) and unilateral LLLE (P = .017) were significant indicators of CIP, with 36.6% of patients with cancer-related LLLE demonstrating this pathway. CIP was significantly associated with dermal backflow in shin (P = .016), calf (P = .006), thigh (P < .001), inguinal (P < .001), pubic (P < .001), and abdominal regions (P = .001). Patients with CIP had significantly higher volume differences between limbs (P < .001), severity of lymphedema (P < .001), and BIS measurements (P < .001) than patients without CIP. Conclusion: A compensatory lymphatic drainage pathway from the affected limb to the contralateral inguinal lymph node region was evident in 16.9% of patients with LLLE. This pathway was most observed in unilateral cancer-related lymphedema, particularly where edema was present in proximal thigh, inguinal, pubic, and lower abdominal regions. Directing manual lymphatic drainage to the contralateral inguinal drainage region should be considered especially for patients with cancer-related LLLE.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"66 1","pages":"47 - 54"},"PeriodicalIF":0.9,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90371146","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 : 2022-09-27DOI: 10.1097/01.REO.0000000000000321
J. Cohn, Shana E. Harrington, Jeannette Q. Lee, Daniel Malone, M. Fisher
Background: Cancer-related fatigue (CRF) prevalence is reported as high as 90%. Cancer-related fatigue is multidimensional and associated with lower health-related quality of life. Effective screening and assessment are dependent upon use of valid, reliable, and clinically feasible measures. This Executive Summary of the Screening and Assessment of Cancer-related Fatigue Clinical Practice Guideline provides recommendations for best measures to screen and assess for CRF based on the quality and level of evidence, psychometric strength of the tools, and clinical utility. Methods: After a systematic review of the literature, studies evaluating CRF measurement tools were assessed for quality; data extraction included psychometrics and clinical utility. Measurement tools were categorized as either screens or assessments. Results: Four screens are recommended: European Organization of Research and Treatment of Cancer Quality of Life Questionnaire, the MD Anderson Symptom Inventory, the Distress Thermometer, and the One-Item Fatigue Scale. Eight assessments are recommended: Functional Assessment of Chronic Illness Therapy—Fatigue, Piper Fatigue Scale—Revised, Brief Fatigue Inventory, Cancer Fatigue Scale, Fatigue Symptom Inventory, Patient-Reported Outcome Measurement Information System (PROMIS) Fatigue Short Form and CAT, and Multidimensional Fatigue Inventory-20. Discussion: This Executive Summary is a synopsis of and road map for implementation of the Clinical Practice Guideline for Screening and Assessment of CRF. Review of the full Clinical Practice Guideline is recommended [10.1093/ptj/pzac120]. Additional research focused on responsiveness of instruments is needed in order to consider them for use as outcome measures. Screening and assessing CRF will result in opportunities to improve the quality of life of individuals with cancer.
{"title":"Screening and Assessment of Cancer-Related Fatigue: An Executive Summary and Road Map for Clinical Implementation","authors":"J. Cohn, Shana E. Harrington, Jeannette Q. Lee, Daniel Malone, M. Fisher","doi":"10.1097/01.REO.0000000000000321","DOIUrl":"https://doi.org/10.1097/01.REO.0000000000000321","url":null,"abstract":"Background: Cancer-related fatigue (CRF) prevalence is reported as high as 90%. Cancer-related fatigue is multidimensional and associated with lower health-related quality of life. Effective screening and assessment are dependent upon use of valid, reliable, and clinically feasible measures. This Executive Summary of the Screening and Assessment of Cancer-related Fatigue Clinical Practice Guideline provides recommendations for best measures to screen and assess for CRF based on the quality and level of evidence, psychometric strength of the tools, and clinical utility. Methods: After a systematic review of the literature, studies evaluating CRF measurement tools were assessed for quality; data extraction included psychometrics and clinical utility. Measurement tools were categorized as either screens or assessments. Results: Four screens are recommended: European Organization of Research and Treatment of Cancer Quality of Life Questionnaire, the MD Anderson Symptom Inventory, the Distress Thermometer, and the One-Item Fatigue Scale. Eight assessments are recommended: Functional Assessment of Chronic Illness Therapy—Fatigue, Piper Fatigue Scale—Revised, Brief Fatigue Inventory, Cancer Fatigue Scale, Fatigue Symptom Inventory, Patient-Reported Outcome Measurement Information System (PROMIS) Fatigue Short Form and CAT, and Multidimensional Fatigue Inventory-20. Discussion: This Executive Summary is a synopsis of and road map for implementation of the Clinical Practice Guideline for Screening and Assessment of CRF. Review of the full Clinical Practice Guideline is recommended [10.1093/ptj/pzac120]. Additional research focused on responsiveness of instruments is needed in order to consider them for use as outcome measures. Screening and assessing CRF will result in opportunities to improve the quality of life of individuals with cancer.","PeriodicalId":54153,"journal":{"name":"Rehabilitation Oncology","volume":"19 1","pages":"148 - 161"},"PeriodicalIF":0.9,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75347649","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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