A Focused Review of Safety Considerations in Cancer Rehabilitation

Abstract

Cancer and its treatments introduce various adverse effects that may impact survivors’ physical, cognitive and psychological functioning. Frequently both tolerance to activity and exercise are affected as well. Rehabilitation providers should have substantive knowledge about the effect of cancer progression and common side effects associated with anti-neoplastic treatment to safely integrate rehabilitation interventions. Rehabilitation may mitigate loss of function and disability; however, these patients are among the most medically complex that providers treat. This report provides a focused review that synthesizes the current evidence regarding disease progression and oncology-directed treatment side effects within the context of safety considerations for rehabilitation interventions throughout the continuum of cancer care. Descriptive information regarding the evidence for precautions and contraindications is provided so that rehabilitation providers can promote a safe plan of rehabilitation care. It is incumbent upon but also challenging for rehabilitation providers to stay up to date on the many advances in cancer treatment, and there are many gaps in the literature regarding safety issues. Although further research is needed to inform care, this review provides clinicians with a framework to assess patients with the goal of safely initiating rehabilitation interventions.

Functional, physiological and subjective responses to concurrent neuromuscular electrical stimulation (NMES) exercise in adult cancer survivors: a controlled prospective study

“…Session compliance was monitored during weekly phone calls which were in addition to collecting information to help progress the NMES prescription, were used to maximise the compliance with the intervention, encourage continued increase in stimulation intensity where possible, and to identify and solve problems. In addition, due to the cognitive issues which can be experienced by individuals undergoing treatment such as memory loss 32 written instruction manuals were provided with NMES units.…”

Integrating Rehabilitation Into the Cancer Care Continuum

“…In 2015, a group of physiatrists from a variety of institutions across the US developed a modern definition for cancer rehabilitation aimed at clarifying some of the confusion: “Cancer rehabilitation is medical care that should be integrated throughout the oncology care continuum and delivered by trained rehabilitation professionals who have it within their scope of practice to diagnose and treat patients' physical, psychological and cognitive impairments in an effort to maintain or restore function, reduce symptom burden, maximize independence and improve quality of life in this medically complex population” [31]. Cancer rehabilitation physiatrists and other rehabilitation specialists have continued to educate colleagues about the role of the physiatrist [32], safety concerns in these complicated patients [33,34], and employment and disability issues in these patients [35,36].…”

Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization: A single-center retrospective study

“…Both physical and psychological impairments contribute to decreased quality of life which may result in disability. Recently, many researchers have demonstrated that cancer rehabilitation improves physical impairments at every stage along the treatment course for a variety of cancer types [2][3][4][5].…”