Outpatient cancer rehabilitation to improve patient reported and objective measures of function.

Abstract

e19325 Background: Adults with cancer often struggle with persistent symptoms that negatively impact quality of life (QoL), physical and social function. Cancer rehabilitation delivered by a trained physical and/or occupational therapist (PT/OT) is recommended. However, evidence is lacking regarding the impact of community-based PT/OT on patients' functioning. Methods: We assessed adults (≥ 18 years) who completed cancer-specific visits in routine care at two outpatient rehabilitation clinics. Demographic and clinical data was patient-reported. Patient-Reported Outcomes Measurement Information System (PROMIS) measures included: Global Physical Health (GPH) and Mental Health (GMH) scale (10 item); Physical Function (PF; 4-item), and Ability to Participate in Social Roles and Activities (SRA; 4-item). Hand grip strength (HGS) and the Timed Up and Go (TUG) were administered by PT/OT. We compared outcomes collected during the first and final therapy evaluations using paired samples t-test and calculated effect size using Cohen’s d. We used independent t-test to compare mean pre-post change between patients on active treatment versus post-treatment. Results: Patients (N= 185) were predominantly female (75%), 41-64 years old (57%), and majority receiving cancer treatment (58%). Most (N =115, 62%) completed at least one follow-up evaluation over 6 weeks. From pre to post therapy, a significant (p<.05; d = 0 .35-.21) effect was observed for GPH, SRA, HGS, and TUG. There was no difference in the average improvement between active and post-treatment groups. Conclusions: Community-based cancer-specific PT/OT has a significant impact on the well-being and functioning of adults with cancer. Evidence supports the utilization of community-based, cancer-specific PT/OT throughout the cancer-care continuum. [Table: see text]

In-Clinic versus Hybrid Cancer Rehabilitation Service Delivery during the COVID-19 Pandemic: An Outcome Comparison Study

“…Previous authors have suggested that hybrid models may enhance a cancer survivor's ability to maintain appointments by reducing barriers to rehabilitation, including transportation restrictions, inclement weather, illness, anxiety, and depression, and time constrictions due to work or other responsibilities [28,45,46]. In our study, the survivors in the hybrid group attended more visits over a longer period, suggesting that having the option of telerehabilitation may have enhanced the accessibility of services by minimizing the barriers.…”

“…The limited ability to control for all the potential confounding variables is another important limitation of this study. We included the available covariates in the main effects analyses, although additional variables could be investigated in future studies, including diagnosis stage and treatment type and status [46], patient digital literacy and confidence [19,20], and the therapist's experience with telerehabilitation [16,26]. We recommend future studies to capture these additional covariates to better understand how they may, or may not, influence the effectiveness of rehabilitation interventions.…”