China
Africa
Explore chapters and articles related to this topic
Cancer Rehabilitation
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
Susan Maltser, B. Allyn Behling-Rosa
Cancer rehabilitation is a discipline of physical medicine and rehabilitation that aims to achieve the highest level of function and quality of life for patients throughout the continuum of cancer care, including treatment and survivorship. The need for comprehensive rehabilitation services has been well studied. A landmark study by Lehman et al.1 revealed that 50% of cancer patients have a need for rehabilitation due to deficits in ambulation and activities of daily living (ADL). They also noted that cancer patients will likely develop psychological dysfunction that will require support; comprehensive rehabilitation facilitates early identification of these impediments, allowing patients to make functional gains. This is especially true in the geriatric cancer patient who is more likely to already present with functional decline. The geriatric cancer population also has an increased need for rehabilitation services due to underlying comorbidities associated with aging such as osteoporosis, osteoarthritis, cognitive deficits, and polypharmacy. One study notes that 75% of these patients may require help with at least one ADL.2 Rehabilitation of elderly patients with cancer has also been demonstrated to improve physical and psychological well-being; as such, rehabilitation services are a critical part of supportive care for a cancer patient.3 Thus, a complete physiatric assessment of an elderly cancer patient should include identification and assessment of comorbid disease and psychosocial status to predict potential impairments the patient may develop from cancer and cancer treatment.
Design considerations for the development of neuromuscular electrical stimulation (NMES) exercise in cancer rehabilitation
Published in Disability and Rehabilitation, 2021
Dominic O’Connor, Olive Lennon, Conor Minogue, Brian Caulfield
Recently, the optimal frequency for HF-NMES applications has been revisited. Mettler et al. [53] compared torque output at stimulation frequencies of 20 Hz v 60 Hz in healthy volunteers (n = 11) and demonstrated that 20 Hz preserved a significantly higher torque time integral (TTI) than 60 Hz over a 60 min session (38288.3 vs 30496.5 Nm.s, p = 0.008,when using a 10 s ON: 15 s OFF ratio) [53]. The 20 Hz group achieved a mean contraction intensity of >11% MVC over 12 contractions (target MVC: 15%). Therefore, since HF-NMES effectiveness is dictated by the strength and duration of the contraction (i.e. TTI), a frequency which may delay the onset of fatigue and preserve a high level of evoked force may have the greatest impact on muscle strength. This observation has important and clinically relevant implications for cancer rehabilitation. Fatigue, a well-documented secondary complication in cancer has also been noted as a limiting factor during the clinical application of repetitive HF-NMES and may affect adherence to NMES protocols [54]. Frequencies of 20 Hz may be a more effective and tolerable frequency parameter for HF-NMES in cancer for muscle strengthening.
Return to work after cancer. A multi-regional population-based study from Germany
Published in Acta Oncologica, 2019
Volker Arndt, Lena Koch-Gallenkamp, Heike Bertram, Andrea Eberle, Bernd Holleczek, Ron Pritzkuleit, Mechthild Waldeyer-Sauerland, Annika Waldmann, Sylke Ruth Zeissig, Daniela Doege, Melissa S. Y. Thong, Hermann Brenner
All European countries provide some type of social security for employees – and some countries also for the self-employed. However, national solutions for employees with chronic health conditions and for the unemployed greatly differ [1,6]. In Germany, in contrast to many other countries, employers, health insurance, and pension insurance pay for (partial) wage continuation. As a result, these stakeholders have an intrinsic interest and financial incentive to support quick and successful resumption of work [6]. In addition, cancer patients in Germany are entitled to participate in a 3-week inpatient cancer rehabilitation program at specialized institutions, which is usually initiated by hospital physicians or social workers after completion of primary treatment. The cancer rehabilitation program has a multidimensional therapeutic approach that includes patient education, exercise and physical therapy along with psychosocial as well as occupational counseling to enhance coping skills and facilitate return to work at the earliest possible time [1]. In addition, specific programs for gradual reintegration into the working life are provided.
Socioeconomic position, referral and attendance to rehabilitation after a cancer diagnosis: A population-based study in Copenhagen, Denmark 2010–2015
Published in Acta Oncologica, 2019
Susanne Oksbjerg Dalton, Maja Halgren Olsen, Ida Rask Moustsen, Carina Wedell Andersen, Jette Vibe-Petersen, Christoffer Johansen
Even though the health care system ensures tax-funded and equal access to health care, there is a marked social inequality in cancer prognosis in Denmark. This is documented at all levels from the GP [1,2] to the highly specialized multidisciplinary in-hospital cancer treatments (i.e., [3,4]). The social differences in prognosis are not trivial. If all cancer patients independent of income had the same favorable prognosis, 2000 of all deaths (∼12,000 deaths) among Danish cancer patients at 5 years after diagnosis could be avoided [5]. Cancer rehabilitation aims to optimize daily functioning and quality of life by addressing adverse physical, psychological and social symptoms that patients may suffer in parallel with and after cancer treatment [6]. The Danish health authorities have defined rehabilitation as an integral part of cancer treatment. Health staff at both hospitals and in primary care is responsible for assessing the needs of cancer patients in order to refer to needs-based rehabilitation and survivorship care [7].