Cancer Rehabilitation: Do Functional Gains Relate to 60 Percent Rule Classification or to the Presence of Metastasis?

Sliwa, James A.; Shahpar, Samman; Huang, Mark E.; Spill, Gayle R.; Semik, Patrick

doi:10.1016/j.pmrj.2015.06.440

Cited by 21 publications

(22 citation statements)

References 15 publications

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“…Although patients with advanced cancer may utilize inpatient rehabilitation more than those with controlled disease [38], Sliwa et al found that patients with metastases benefitted from inpatient rehabilitation similarly to patients without metastatic or advanced disease, regardless of the presence of common inpatient rehabilitation diagnoses such as spinal cord injury (SCI), stroke, or neuromuscular disease [39••]. Furthermore, patients with impairments such as SCI due to tumor compression have been shown to benefit from inpatient rehabilitation [40].…”

Section: Introductionmentioning

confidence: 99%

The Intersection of Oncology Prognosis and Cancer Rehabilitation

Smith

Zheng

2017

Curr Phys Med Rehabil Rep

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Purpose of reviewThis review examines the delivery of rehabilitation care to cancer patients with relation to disease prognosis. This includes the evaluation when patients are referred for rehabilitation services and the effectiveness of rehabilitation interventions across the cancer continuum.Recent findingsAlthough prognosticating life expectancy is difficult, referrals for rehabilitation interventions appear to be affected by physician attitudes towards patients with advanced disease, in part because of misconceptions about the nature of rehabilitation for oncology patients. Rehabilitation may also be underutilized in long-term survivors with no evidence of disease. Despite this, our review found that rehabilitation in advanced disease, end-of-life, geriatric cancer patients, and in long-term survivors can be beneficial. There is a relative dearth in studies on rehabilitation interventions specifically at the end-of-life.SummaryCancer rehabilitation can be helpful to patients along the spectrum of cancer prognoses. Examining more accurate ways to prognosticate life expectancy, improving communication and education between oncologists and rehabilitation team members, and modifying survivorship plans to include patient education on functional changes over time may improve the delivery of rehabilitation care.

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Section: Introductionmentioning

confidence: 99%

The Intersection of Oncology Prognosis and Cancer Rehabilitation

Smith

Zheng

2017

Curr Phys Med Rehabil Rep

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“…For example, Guo et al [8] was able to demonstrate that asthenic (a non‐60% rule compliant diagnosis) patients with cancer are able to make statistically significant functional improvements on inpatient rehabilitation. A study by Sliwa et al [9] revealed no significant differences in functional gains made by patients with cancer with diagnoses that were 60% rule compliant versus 60% rule noncompliant. However, institutions also must be aware of the ability to use the remaining 40% of admissions for “noncompliant” diagnoses.…”

Section: Regulatory Considerationsmentioning

confidence: 96%

“…Alam et al [61] reported a statistically significant difference of unplanned transfers back to the primary acute care service of 21% of patients with cancer in the IRF versus 9.7% of noncancer‐matched controls. Other studies have reported return to the primary acute care service rates of IRF patients with general cancers between 16.5% and 35% [9,20,21,66‐68]. In most cases, an uninterrupted acute inpatient rehabilitation course with discharge home is considered a successful IRF admission [69,70].…”

Section: Medical Fragilitymentioning

confidence: 99%

A Guide to Inpatient Cancer Rehabilitation: Focusing on Patient Selection and Evidence‐Based Outcomes

Raj

Guo

2017

PM&R

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Cancer inpatients commonly suffer from impairments that can prohibit safe discharge home from the acute care inpatient medical service and thus require transfer to a post-acute inpatient rehabilitation facility. It has been demonstrated in multiple studies that cancer rehabilitation inpatients are able to make statistically significant functional improvements and at a similar pace as their non-cancer counterparts. Medical fragility and reimbursement regulations are concerns that affect acceptance and triage of cancer rehabilitation inpatients. Strategies to rehabilitate these challenging patients include considering risk factors for medical complications, consult based inpatient rehabilitation and improved communication and coordination with oncology teams.

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“…Rehabilitation can be incredibly effective in improving cancer patients' function, even in the context of advanced disease . In fact, rehabilitation at the end of life has been shown to reduce the amount of unmet needs at death and lead to lower resource utilization among hospice patients .…”

Section: Futility In Cancer Rehabilitation In Patients With Terminal mentioning

confidence: 99%