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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) Rehabilitation Oncology

Background: Understanding patient experience is key to optimize access and quality of outpatient cancer rehabilitation (physical or occupational therapy, PT/OT) services. Methods: We performed a retrospective mixed-method analysis of rehabilitation medical record data to better understand patient experience and aspects of care that influenced experience. From the medical record, we extracted case characteristics, patient experience data (Net Promoter Survey®, NPS) and patient-reported outcome (PRO) data. We categorized cases as ‘promoters’ (i.e., highly likely to recommend rehabilitation) or ‘detractors’, then calculated NPS score (−100 [worst] to 100 [best]). We identified key themes from NPS free-text comments using inductive content analysis, then used Pearson [r] or Spearman [ρ] correlation to explore relationships between NPS, characteristics, and PRO improvement. Results: Patients (N = 383) were 60.51 ± 12.02 years old, predominantly women with breast cancer (69.2%), and attended 14.23 ± 12.37 visits. Most were ‘promoters’ (92%); NPS score was 91.4. Patients described two experiences (themes) that influenced their likelihood to recommend rehabilitation: (1) feeling comfortable with the process and (2) observable improvement in health/functioning, and described attributes of clinic staff, environment and clinical care that influenced themes. Likelihood to recommend rehabilitation was associated with achieving the minimal clinical important difference on a PRO (ρ = 0.21, p < 0.001) and cancer type (ρ = 0.10, p < 0.001). Conclusion: Patients who received specialized cancer PT/OT were highly likely to recommend rehabilitation. Feeling comfortable with the rehabilitation process and making observable improvements in health and/or functioning influenced likelihood to recommend. Rehabilitation providers should leverage the findings of this study optimize access to and quality of cancer rehab services.

Date Presented 4/7/2016 What is the correlation between muscle strength of the upper extremity and hand function in older adults? Our study shows that arm-curl strength, rather than grip strength, is correlated with hand function. An arm-curl strength test may be used to predict hand function performance in older clients. Primary Author and Speaker: Chiung-ju Liu Additional Authors and Speakers: Aaron Frederick, Elaine Fess, Kristen Utley, Jessica Bertram, Deana Schuman

Background and Purpose: Malignant melanoma has a high propensity to metastasize, specifically to the brain. Research has shown that incorporating oncology rehabilitation as part of the interdisciplinary care team promotes independence in functional mobility that leads to an improvement in a patient's quality of life. Case Description: A 70-year-old man presented with recurrent melanoma to the brain 10 years after initial diagnosis. Multiple brain metastases led to left hemiparesis of the arm and leg. Left-sided weakness affected his ability to perform activities of daily living and exercise regularly. The confounding impairments in balance resulted in multiple falls at home. Interventions: Interventions included balance training on various surfaces, core and proximal lower extremity strengthening, aerobic conditioning, and implementation of a home exercise program. Outcomes: The patient attended outpatient cancer rehabilitation for 19 weeks and discharged from physical therapy with a reported 47.7% improvement in global physical health and 26.7% improvement in global mental health on the PROMIS tool. At discharge, performance on the Five Times Sit to Stand Test, Timed Up and Go Test, and Dynamic Gait Index was below cutoff scores, indicating the patient was no longer a high risk for falls at home. Discussion: Physical therapy specifically tailored for the oncology patient allows for a customized rehabilitation approach that incorporates oncologic medical history and treatment into the episode of care, with the ultimate goal of improving quality of life and function throughout the patient's cancer journey.