Rehabilitation Systems

Plan of Treatment or Exercise Prescription and Progression

Principle

In patients with Cancer, disability is primarily a result of anti-cancer treatment with progressive deconditioning. As the disease progresses, limited functional capacity makes exertion unpleasant and leads to an increasingly sedentary lifestyle. Shortness of breath (breathlessness) and exercise intolerance are the most incapacitating symptoms patients develop. A counter-measure to progressive functional decline in patients with cancer is exercise training.

To order Dr. Schwartz’s book, please click the following link:

http://books.simonandschuster.com/Cancer-Fitness/Anna-L-Schwartz/9780743...

To review Cancer Fitness, see Google Books:

http://books.google.com/books?id=Jl93sdxO4wUC&printsec=frontcover&dq=can...

Patient Education Outline from: Cancer Fitness: By Anna L. Schwartz, Ph.D., FNP, FAAN.

Eight (8) Chapter lessons are presented for patient education as outlined below. There will be (1) (20) minute lesson delivered each week during the eight week program for a total of eight (8) lessons. The synopses outline below will guide therapists to teach from Cancer Fitness - By Dr. Anna L. Schwartz, Ph.D., FNP, FAAN.

Lesson One(1): CH3 Managing You Side Effects.

Key Points:

Cancer is a class of diseases in which a group of cells display uncontrolled growth, invasion, and sometimes metastasis. These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, and do not invade or metastasize. Most cancers form a tumor, but some, like leukemia, do not. The branch of medicine concerned with the study, diagnosis, treatment, and prevention of cancer is oncology.

EXERCISE PHYSIOLOGY AND RELATED EXERCISE SCIENCE

1.1.1 Knowledge of physiologic outcomes that may be improved by exercise training among cancer survivors.
1.1.2 Knowledge of symptoms and psychological attributes that may be improved by exercise training among cancer survivors.
1.1.3 Knowledge of lymph, immunologic, cardiac, neurologic, and hematologic systems as they pertain to cancer specific exercise issues.
1.1.4 Knowledge of acute and chronic effects of exercise on temperature regulation and the adverse thermoregulatory/vasomotor symptoms
(e.g. hot flashes) experienced by many cancer survivors.
1.1.5 Knowledge of cancer diagnosis and treatment effects on physiological response to acute and chronic exercise, particularly with regard to
physical deconditioning, body composition changes, and range of motion.

HEALTH APPRAISAL, FITNESS AND CLINICAL EXERCISE TESTING

It is recommended by Oncology clinicians that one learn to manage cancer treatment side-effects before starting cancer rehabilitation. While knowing how to manage side –effects before rehabilitation may be optimal; it may not be the norm. At the beginning of cancer treatment there are numerous factors and conditions which typically overwhelm most patients. Thus, cancer rehabilitation may be the first focused learning opportunity patients have on managing side-effects.

Thus, knowing how to educate and treat the cancer patient population provides a significant intervention opportunity for Physical Therapy. It is through the delivery of information, care and skills that the Physical Therapist becomes a life long consultant to the cancer population.

Rehabilitation Program Development: 

By far, the On-Site Workshop is the most effective method of delivering customized rehabilitation programs for any rehabilitation organization. The settings which experience the greatest outcomes from specialized rehabilitation programs are skilled nursing, assisted living, physical therapy and rehabilitation, and home health care organizations. Specific rehabilitation programs are optimized in the following organizations:

• Cancer Rehabilitation offered by hospitals, outpatient rehabilitation clinics, and community fitness organizations (LAF/YMCA).
• Pulmonary Rehabilitation offered by hospitals, physician owned practices, skilled nursing, assisted living, outpatient rehabilitation clinics, and home health care organizations
• Heart Failure Rehabilitation offered by home health care organizations, skilled nursing, assisted living, and outpatient rehabilitation clinics.
• Diabetes Rehabilitation offered by home health care organizations, skilled nursing, assisted living, outpatient rehabilitation clinics, and community fitness organizations (YMCA).

Rehabilitation Systems Comments: Cancer treatments with increasing survivability rates have shifted cancer into the chronic disease category. This significant change is both a relief to one diagnosed with cancer and a challenge to the restorative professionals taking front and center positions to coach, support and motivate cancer survivors as they travel the restoration pathway to increased quality of life. Now is the time to leverage every caring hand in the quest for functional and social independence from cancer.

Cancer Rehabilitation: An Expanding Need

Deborah Julie Franklin, PhD,MD

Assistant Professor

Dept. of Rehabilitation Medicine Thomas Jefferson University