Rehabilitation for the Terminal Cancer Patient

Yoshioka, Hideo

doi:10.1097/00002060-199406000-00009

Cited by 123 publications

(84 citation statements)

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“…Responses obtained from 169 families of deceased patients indicated that 88 percent of patients had previously indicated a desire for ambulation and wheelchair mobility, 78 percent were satisfied with rehabilitation in the terminal stage, and 63 percent considered the terminal rehabilitation to be effective. Yoshioka also found that almost all patients who underwent rehabilitation experienced some degree of pain relief [58]. Similarly, Sabers et al demonstrated significant functional gains in 189 cancer patients who received rehabilitation services on a consultation basis.…”

Section: Physical Medicine and Rehabilitation Approachesmentioning

confidence: 89%

“…Axelsson and Sjoden documented that physical strength, hours spent in bed, and the ability to do what one wants are ranked highly by cancer patients and their spouses with respect to overall quality of life [57]. Yoshioka found that 88 percent of his hospice patients who received rehabilitation expressed a strong desire for ambulation or wheelchair mobility [58].…”

Section: Physical Medicine and Rehabilitation Approachesmentioning

confidence: 99%

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Pain and palliative medicine

Chang

Sorger²,

Rosenfeld

et al. 2007

JRRD

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Abstract-Severe pain is highly prevalent, with rates of 40% to 70% in patients with advanced cancer, liver disease, heart failure, human immunodeficiency virus, and renal failure. Wide variations in pain assessment and reporting methods and the measurement of multiple symptoms should be addressed in future studies. Regarding psychological approaches, determining whether hypnotherapy or other individual psychotherapeutic interventions reduce pain and/or psychological distress in a palliative care population is difficult. Interest is increasing in the concept of demoralization syndromes and the role of posttraumatic stress disorder in modulating responses to pain at the end of life. We review evidence from multiple studies that the use of rehabilitative therapy improves functional status and pain control among patients with advanced cancer, and we raise the possibility that rehabilitation therapy will be helpful in patients with other advanced diseases. We summarize ongoing clinical trials of electronic order sets, clinical care pathways, and care management pathways to improve pain management in palliative care. Wagner's Chronic Illness Model provides a way of analyzing how healthcare systems can be changed to provide adequate and continuing pain management in palliative care. Much work remains to ensure that pain is recognized, treated, and monitored effectively.

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Section: Physical Medicine and Rehabilitation Approachesmentioning

confidence: 89%

Section: Physical Medicine and Rehabilitation Approachesmentioning

confidence: 99%

Pain and palliative medicine

Chang

Sorger²,

Rosenfeld

et al. 2007

JRRD

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“…Patients report treatment benefits such as symptom relief, psychological support, and improved function. 33 Utilization of physiotherapy was 26% in a Japanese unit in 1994 34 and 37% in an American unit in 2003. 35 In both facilities there was improved function in patients following physiotherapy, but neither used validated palliative scales.…”

mentioning

confidence: 99%

Physical Function in Hospice Patients and Physiotherapy Interventions: A Profile of Hospice Physiotherapy

Cobbe¹,

Kennedy

2012

Journal of Palliative Medicine

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Objective: There is a dearth of international research on hospice physiotherapy. This study aims to profile hospice physiotherapy in an Irish setting in order to inform practice internationally. Design: The study design consisted of a retrospective chart audit over 6 months. Setting: The study took place at a specialist palliative care inpatient unit (hospice) in Limerick, Ireland. Participants: All patients were discharged (through death or discharge onwards) from January to June 2010. Outcome measure: The Edmonton Functional Assessment Tool (EFAT-2) was used as an outcome measure. Results: Sixty-five percent were referred for physiotherapy; 58% (n = 144) were assessed and treated. A wide range of patients was referred (mean functional score 11, range 1-23, SD 5). Rehabilitation activities were widespread: 48% with more than one functional score recorded made improvements; 53% of physiotherapy patients were eventually discharged home; 47% of physiotherapy patients died, of whom 52% received physiotherapy in the last week of life. The median physiotherapy program lasted 11 days (range 1-186, SD 22) whereas the median number of treatments was four (range 1-99, SD 10). The most common interventions were gait re-education (67%), transfer training (58%), and exercises (53%). One third of treatment attempts were unsuccessful because of the unavailability/unsuitability of patients. Challenges for physiotherapists included frequent suspension of treatment and large functional fluctuations in patients. Conclusion: There was a high referral rate to physiotherapy in this hospice. Functional changes in hospice patients were mapped, showing that physiotherapy involved both rehabilitative and quality of life/supportive measures. The most common treatments were physical activity interventions.

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“…[15][16][17][18][19][20][21][22][23][24][25][26][27] A number of evaluation scales were applied in the studies; however, as the most common were Functional Independence Measure (FIM) and Barthel Index (BI) scales, only articles with complete FIM and/or BI data were selected for the meta-analysis. References of selected articles were used to identify further studies meeting the inclusion criteria.…”

Section: Search Methods For Meta-analysismentioning

confidence: 99%

“…Of these, 11 retrospective trials (9 with complete FIM data and 2 with complete BI data) met the aforementioned inclusion criteria. 15,[17][18][19][21][22][23][24][25][26][27] BI data of our patient cohort were also inserted in the BI meta-analysis (San Raffaele data). Table 3 summarizes results from the trials included.…”

Section: Meta-analysismentioning

confidence: 99%

Rehabilitation in Neuro-Oncology: A Meta-Analysis of Published Data and a Mono-Institutional Experience

Formica

Monte²,

Giacchetti

et al. 2010

Integr Cancer Ther

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Background. Rehabilitation for cancer patients with central nervous system (CNS) involvement is rarely considered and data on its use are limited. The purpose of the present study is to collect all available published data on neuro-oncology rehabilitation and perform a meta-analysis where results were presented in a comparable manner. Moreover, the authors report results on cancer patients with neurological disabilities undergoing rehabilitation at their unit. Study design. A PubMed search was performed to identify studies regarding cancer patients with CNS involvement undergoing inpatient physical rehabilitation. Studies with a complete functional evaluation at admission and discharge were selected. As the most common evaluation scales were Functional Independence Measure (FIM) and Barthel Index (BI), only articles with complete FIM and/or BI data were selected for the meta-analysis. Moreover, 23 cancer patients suffering from diverse neurological disabilities underwent standard rehabilitation program between April 2005 and December 2007 at the San Raffaele Pisana Rehabilitation Center. Patient demographics and relevant clinical data were collected. Motricity Index, Trunk Control Test score, and BI were monitored during rehabilitation to assess patient progresses. BI results of patients in this study were included in the meta-analysis. Results. The meta-analysis included results of a total of 994 patients. A statistically significant (P < .05) improvement of both BI and FIM scores was demonstrated after rehabilitation (standardized mean difference = 0.60 and 0.75, respectively). Functional status determined by either FIM or BI improved on average by 36%. Conclusion. Published data demonstrate that patients with brain tumors undergoing inpatient rehabilitation appear to make functional gains in line with those seen in similar patients with nonneoplastic conditions.

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Rehabilitation for the Terminal Cancer Patient

Cited by 123 publications

References 0 publications

Pain and palliative medicine

Pain and palliative medicine

Physical Function in Hospice Patients and Physiotherapy Interventions: A Profile of Hospice Physiotherapy

Rehabilitation in Neuro-Oncology: A Meta-Analysis of Published Data and a Mono-Institutional Experience

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