Purpose Physical activity has been shown to improve survival and quality of life of cancer patients. Due to differences in patient populations, healthcare settings, and types of intervention, cost-effectiveness analyses of physical activity interventions in cancer survivors are difficult to compare. Available evidence from breast cancer survivor research has shown inconsistent results, and transfer of results to other types of cancer is not straightforward. This paper systematically reviewed current evidence on the cost-effectiveness of physical activity interventions in cancer survivors independent of cancer type compared to usual care or another experimental intervention. Methods The literature search was conducted in seven databases and enhanced by a search for gray literature. Eligible studies were restricted to developed countries and assessed using the CHEERS, CHEC, and PHILIPS checklists. The study protocol was pre-published in PROSPERO. Results Seven studies, five cost-utility, and two combined cost-utility/cost-effectiveness analyses fully met the inclusion criteria. They covered eight different types of cancer and various interventions. The cost-effectiveness analyses were of moderate to high methodological quality. A high probability of cost-effectiveness was reported in two analyses. One intervention appeared to be not cost-effective, and one to be cost-effective only from an organizational perspective. Three other analyses reported a cost-effectiveness better than US$ 101,195 (€ 80,000) per QALY gained. Conclusions Physical activity interventions in cancer survivors of developed countries were cost-effective in some but not all clinical trials reviewed. Implications for Cancer Survivors Cost-effectiveness of physical activity interventions appear to depend upon the intensity of the activity.

Zusammenfassung Hintergrund Patientenedukation gilt als Standard im klinischen Management von Patienten und wird wegen der Zunahme von chronisch kranken Menschen immer wichtiger. Auch in der Physio- und Ergotherapie gilt sie als zunehmend zentrale Intervention. Das tatsächliche Verständnis von Patientenedukation und deren Anwendung ist jedoch unklar. Ziel Das Verständnis von Patientenedukation und die selbst-deklarierte Anwendung im Berufsalltag von Physio- und Ergotherapeuten eines Universitätsspitals zu evaluieren. Methode Online-Querschnittserhebung unter allen 139 Physio- und Ergotherapeuten des Universitätsspitals. Ergebnisse Die Rücklaufquote betrug 42 % (n = 59); 55 Fragebögen wurden ausgewertet. Im Verhältnis zur Gesamtgruppe antworteten mehr Ergo- (16; 64 %) als Physiotherapeuten (39; 34 %). Mit zunehmender Berufserfahrung wurden individuelle Definitionen von Patientenedukation differenzierter und umfassender. Es zeigten sich keine Unterschiede im Verständnis und der benannten Anwendung von Patientenedukation zwischen den beiden Berufsgruppen. Alle Therapeuten (mit wenig oder viel Berufserfahrung) nannten die Informationsvermittlung am häufigsten als Teil von Patientenedukation (91 %). Mit zunehmender Berufserfahrung werden öfter Aspekte der Beratung und Verhaltensinterventionen erwähnt. Die Hälfte der Physio- und Ergotherapeuten (n = 28) berichtete, dass Patientenedukation in ihrer Grundausbildung ein wichtiges Thema war, und etwas mehr als ein Drittel (n = 19) besuchte schon eine Weiterbildung zum Thema. Praktisch alle Therapeuten (n = 54) wünschten sich, mehr zu Patientenedukation dazuzulernen. Schlussfolgerung Patientenedukation ist für Physio- und Ergotherapeuten ein wichtiges Thema. Die Ergebnisse dieser Erhebung bilden die Basis für eine weitere, vertiefte Auseinandersetzung. Aspekte der Beratung oder der Verhaltensinterventionen wurden im Vergleich zur Informationsvermittlung weniger häufig genannt; dem sollte bei der Planung von In-house-Weiterbildungen Rechnung getragen werden.

Analysis showed that the ICF can be used to record precise information on patients' functioning in the acute hospital. Typical impairments and restrictions, intervention goals and trajectories of functioning could be documented. The qualifiers used in our clinical example were sensitive to change. Definitions of qualifiers, however, should be the subject of further research.

Poor riding performance may be due to medical issues with the horse or a variety of other factors, such as inadequate equipment or deficiencies in training. The physical fitness of the equestrian is one of the most unexplained factors of current research. The aim of this study is to investigate the association between the physical fitness of the equestrian and riding performance. 115 equestrians were assessed for physical fitness and riding performance. Seven components of physical fitness (balance, endurance, flexibility, reaction, speed, strength, symmetry) were measured by a physiotherapist using equestrian-specific tests. Based on a video-recorded riding test, individual riding performance was rated by two equestrian judges. The riding test included the horse and rider performing a walk, sitting trot, rising trot and canter in both directions. A linear model for riding performance, including the domains of physical fitness and potential confounders (body-mass-index, riding experience, hours of riding per week, and test-motivation), was fitted to the data. Inter-rater reliability of the judges was investigated by calculating the intraclass correlation coefficient (ICC). Endurance, reaction and strength were positively associated with riding performance, whereas flexibility had a negative association. The final model could explain 16.7% of the variance in riding performance. The effects of endurance and strength were significant (P<0.05), but not that of reaction. No association with riding performance was found for the components of balance, speed and symmetry. The inter-rater reliability of judges was confirmed to be ‘good’ to ‘excellent’ (ICC=0.9, 95% confidence interval: 0.86-0.93). Findings suggest that physical fitness is positively associated with riding performance. Fitness-training for equestrians should be included in current training concepts. Future research should investigate whether similar associations exist for junior and elite athletes.

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