In this article, we will discuss the Role of Rehabilitation in Malignant Conditions. So, let’s get started.
Rehabilitation
The primary goal of rehabilitation in the context of cancer is to assist the patient in achieving maximum physical and psychological functioning within the
limits imposed by disease or treatment of cancer.
“To minimize some of the effects, which the disease or its treatment has on them. It is often possible to improve the quality of life regardless of their prognosis by helping them to achieve their maximum potential of functional ability and independence or gain relief from distressing symptoms” – ACPOPC 1993.
“Within the context of palliative care, realistic joint goal setting gives the patient a measure of control, often at a time when they are experiencing helplessness and loss of independence” – Robinson 2000.
The overall goals of rehabilitation as described by HJ Diet:
1. “Preventive – When treatment before development of a potential disability can be expected to lessen its severity or shorten its duration.
2. Restorative – When the patient can be expected to become able to return to premorbid status without essential handicap or known residual disease,
and where return to gainful occupation can be planned.
3. Supportive – When on-going disease is able to be controlled and the patient may remain active and to some degree productive, but with known residual disease and possibly slowly progressive handicap; and where increased tolerance and circumvention of residual disability can be expected from adequate supportive training and care.
4. Palliative – When increasing disability is to be expected from relentless progression of disease, but where appropriate program provision will prevent or reduce some of the complications that might otherwise develop”.
The Role of the Physiotherapist in Palliative Care
Physiotherapists work with respiratory, neurological, lymphatic, orthopaedic, musculoskeletal, pain and haemotalogical conditions.
• Education and training of multidiscipilinary team, patients and carers.
• Dissemination of information
• Discharge planning
• Communication and collaboration between primary and secondary care
• Mobility and functional assessment
• Prevention and management of acute, chronic and latent effects of cancer treatment
Physiotherapy Interventions
• Positioning – Prevention of pressure sores
• TENS – Pain and nausea control
• Respiratory care – Non pharmacological approach and prevention of retained secretions and oxygen therapy
• Neurological rehabilitation – E.g.,: SCC, Brain tumours and peripheral neuropathies
• Mobility – Exercise tolerance, maintenance and independence
• Passive/active range of movement –
• Prevention of contractures
• Individual exercise program, deconditioning
• Strength and cardiovascular training
• Relaxation techniques
• Anxiety management
• Acupuncture treatment
• Managing fatigue
• Laryngectomy management
• Lymph edema management
Benefits of Physiotherapy (WHO)
• Increased physical activity can prevent risk of some cancers and may enhance survival in cancer patients.
• Exercise is safe during and after cancer treatments and it improves physical functioning, quality of life and cancer-related fatigue in several cancer survivor groups.
• Exercise may prevent recurrence of cancer.