Background Cancer has a major impact on societies across the world and there is a significant rise in the global cancer burden. Due to advancements in cancer diagnosis and treatment, the number of cancer survivors is increasing. However, they face physical and cognitive challenges, which may affect their quality of life. The study aims to identify current clinical practice patterns and barriers to cancer rehabilitation from the perspective of Saudi healthcare professionals. Method All healthcare professionals providing care for cancer patients at King Fahad Medical City were invited to participate. Two semi-structured focus groups and 9 interviews were conducted. Participants were physicians and allied health professionals. The researcher led the discussions and recorded comments, facial expressions, and other non-verbal communication nuances. Content analysis was performed to identify and summarize themes. Results Four key themes related to barriers in cancer rehabilitation are identified: healthcare providers’ competencies and knowledge, communication barriers, limited rehabilitation services for cancer patients, and patient- and family-related barriers. Conclusion The study identifies current clinical practice patterns and various barriers to cancer rehabilitation from Saudi health care professionals’ perspective. The findings may help policy makers and stake holders to design effective rehabilitation guidelines for cancer rehabilitation.

Objectives: To evaluate the efficacy of physical therapy or exercise intervention on quality of life )QOL(, fatigue, sleep, and psychological and physical functioning in adults diagnosed with Lymphoma. Methods:A systematic literature search of the PubMed, CINAHL, Cochrane Library, and PEDro databases was carried out to identify articles published from March 2010 until December 2020. The risk of bias, methodological quality, and level of evidence was evaluated using the Physiotherapy Evidence Database )PEDro( checklist.Results: Out of the 577 articles identified from the initial search, a total of 12 randomised control trials were shortlistd for this systematic review. From the 12 articles, 9 studies included participants with Systematic ReviewLymphoma who were at various stages of chemotherapy or had completed treatment and 3 studies included participants with various haematological malignancies and had stem cell transplantation. The quality of each study was assessed using the PEDro scale with the a mean score of 6.3±0.89. The PEDro scores regarding the quality of studies ranged from 5-8 )fair to good(. Conclusion:There is moderate evidence strength suggesting that exercises therapy for persons diagnosed with Lymphoma can include aerobic or cardiovascular exercise, strength training, and mind-body exercise has beneficial effects on fatigue, physical performance, and QOL in persons diagnosed with Lymphoma patients.

To identify the impact of inpatient rehabilitation services on the functional levels of cancer patients. Methods: This was a retrospective study of data from the Rehabilitation Hospital, King Fahad Medical City, Riyadh, Saudi Arabia, from 2012 to 2018. The functional independence measure (FIM) tool was used to assess functional changes from admission to discharge to determine the impact of inpatient rehabilitation. Results: A total of 81 eligible records were reviewed. The median hospital length of stay (LOS) was 50 days, mean±SD of the FIM gain was 25 (15.3), and 91.4% were discharged home, while only 4.9% were readmitted. Although statistically significant gains were observed in both motor and cognitive scores, motor scores Original Article improved more than the cognitive. The LOS was less (30 days) in patients requiring minimal assistance, at the time of admission, compared to the LOS in patients with moderate and low levels of independence. The level of significance was set at p≤0.05 Conclusions: In patient cancer rehabilitation service demonstrated statistically significant functional gains during rehabilitation at King Fahad Medical City. This study may help the policymakers to provide similar rehabilitation services to all cancer patients as well as in other health care hospitals to improve the functional status of cancer survivors.

Background:The adverse effects of psychological distress and quality of life are common outcomes in breast cancer survivors. Psychoeducational interventions have been widely used to reduce these adverse outcomes among those patients. This study aims to assess the impact of the Blossom support group on psychological distress and quality of life in breast cancer patients in Saudi Arabia. Methods: This study is a retrospective cohort study for the Blossom program, which was held yearly for eight weeks from 2014 until 2018. Data was collected from the survivors' records at the Zahra Breast Cancer Association in Riyadh, Saudi Arabia. Outcome measurements: include the quality of life scale (SF-36) and Hospital Anxiety Depression Scale (HADS) with both were available in the Arabic translated version. Both tools were used as the screening measurement for the assessment of the quality of life, depression, and anxiety before and after the program. The data were analyzed using the Statistical Analytical Software (SAS), version 9.4. Statistical differences in median scores of SF-36 and HADS before and after the program was tested using Wilcoxon signed-rank test. Result: A total of 54 breast cancer survivors were enrolled in the Blossom support program over the period 2014 to 2018. Of these participants, only 25 participants completed the full eight weeks program. There were statistically significant differences in the overall quality of life (SF-36) before and after the 8 weeks from baseline of the experiment (W = 60, P-value =0.0125). Moreover, the overall anxiety and depression scores were tested separately and the results reveal statistically significant differences in both dimensions before and after the program (Anxiety: W=132, P-value = 0.0059; depression: W=157, P-value = 0.0002). Conclusion: The Blossom support program showed a positive impact on the quality of life and the psychological well-being of breast cancer survivors. It is recommended to utilize this support program across a wide range of health organizations with breast cancer survivors as a baseline of psychological care to improve the quality of life.

BackgroundRheumatoid arthritis is a chronic systemic inflammatory disease that often affects the cervical spine. Cervical disorders in rheumatoid arthritis (RA) patients have been an important problem for a long timeObjectivesinvestigate association between poor sleep complaints in rheumatoid arthritis patients and subclinical cervical spine involvement measured by MRI and its relation to disease activity in a population-based cross-sectional study.Methods200 Egyptian RA patients fullfilling the American college of Rheumatology Criteria 2010 who were under follow up in the rheumatology and pain clinic, Assuit university hospital, Egypt. All patients underwent a complete history and physical examination with a focus on the cervical spine to assess disease duration, age of disease onset, swollen and tender joint counts. ESR, Hb, CRP, RF levels and disease activity was measured using the disease activity score 28 (DAS28). Oswestry-Neck-Pain-Questionnaire were completed. All patients filled out the Pittsburgh sleep quality index to evaluate their sleep quality, anxiety and depression scale. Symptomatic patients and previously diagnosed cervical subluxation were excluded. Radiographs of the cervical spine included lateral views taken in flexion, extension, neutral position of neck and antero-posteriorly and odontoid projection view.Patients suspicious for atlantoaxial affection underwent Magnetic Resonance Imaging to evaluate the cervicomedullary angle, dens erosion, amount of hypervascular –active pannus, atlantoaxial impaction, vertebral plate erosion, subaxial subluxation, apophyseal joints and disc materialResultsAsymptomatic cervical spine subluxation was found in 46 of the 200 RA patients (23%). The prevalence among involved patients of, anterior atlanto-axial subluxation, atlantoaxial impaction and subaxial subluxation was 25 (54.3%), 8 (17.4%) and 13 (28.2%), respectively. Posterior subluxation was not detected. There is significant relationship with cervical spine subluxation and sleep disturbance (interruption pattern) (P=0.006). The main baseline risk factor for difficulty falling asleep was anterior atlanto-axial subluxation, whereas for cervical spine subluxation it was higher patient age. Logistic regression confirmed early final awakening and short sleep respectively (HR 1.109, 95% CI 1.120–1.260, p=0.05) and (HR 1.095, 95% CI 0.991–0.998, p=0.005) as independent predictors of anterior atlanto-axial subluxation. The main risk factors for incident hypervascular atlantoaxial joint active pannus was disease activity score and older age. The frequency of early final awakening and short sleep were higher in relation to cervical spine involvement. Male sex, CRP positivity, and older age were risk factors for incident anterior atlantoaxial subluxation.ConclusionsCervical spine involvement is common and may be asymptomatic indicating routine cervical spine imaging is needed in patients with RA specially patients with sleep disturbances and high disease activityReferences Delamarter RB, Bohlman HH. Postmortem oss...