Objective Patients with breast cancer face cognitive impairment that affects their quality of life; partially attributable to treatment. Our aim was to detail the prevalence and change of cognitive impairment during the course of treatment. We also investigated the effect of therapy (chemotherapy [CT]) vs. radiotherapy and/or endocrine therapy vs. healthy controls). Methods This article reviews longitudinal cohort studies published to date in Medline and Embase that (i) assess cognition before and after therapy, (ii) report prevalence cognitive impairment or change, and (iii) use standardized and valid neuropsychological tests. We used the original authors' criteria for cognitive impairment. Results The title and abstract of 891 articles were screened, resulting in the identification of 90 potentially relevant articles while applying the eligibility criteria. After full‐text examination, 17 studies were included. Prevalence of cognitive impairment range from 25% before therapy, through 24% after therapy to 21% at maximal 1‐year follow‐up (FU). Compared to their pretreatment cognitive functioning, 24% of patients decline after treatment and 24% at 1‐year FU. Some studies also reported cognitive improvement showing that 15% and 31% of patients improve, respectively. In general, patients undergoing CT have a higher chance of cognitive impairment and decline than no‐CT patients and healthy controls. Conclusions This study shows that one out of four breast cancer patients shows cognitive impairment prior to treatment administration CT and a significant number of patients decline during the course of disease, suggesting that cognitive impairment is not exclusively related to CT and/or no‐CT therapies. This study shows that assessment of cognitive functioning, ideally over time, is crucial and may help the implementation of personalized rehabilitation pathways.

This study provides insight into factors which were related to a positively or negatively experienced outcome of pain rehabilitation. A good match within the patient-professional interaction seems essential. IMPLICATIONS OF REHABILITATION: Within chronic pain rehabilitation good didactic skills and a client-centered attitude of the professional may be helpful in order to make the patient feel being taken seriously. An assessment of the patient's learning style might lead to a better fit of the patient education and training according to an individual's learning style. Relapse might be prevented by paying special attention to the integration of new behavior within important life areas as work and sports.

This study highlights the breadth of symptoms that constitute the earliest phases of RA. Further research is needed to develop measures of symptom patterns and clusters to allow the predictive utility of symptoms to be assessed and to allow the integration of aspects of the patient's history into evidence-based investigative and management algorithms for use in primary and secondary care.

tion programmes, which are based on physical training and behavioural cognitive training, is to improve the health-related quality of life of patients by coaching them to cope with their pain and its consequences (1). Drop-out from low back pain rehabilitation of non-native patients (28.1%) in the Netherlands has been reported to be twice as high as in native Dutch patients (13.7%); the overall drop-out rate is 18.7% (2). The higher drop-out rate of non-native patients is consistent with a study conducted in mental healthcare. In that study the drop-out rate was significantly higher in ethnic minority patients (52%) compared with native patients (30%) (3). Furthermore, the overall drop-out rate in patients with low back pain (18.7%) (2) is consistent with those of previous studies in patients with (low back) pain, which found drop-out rates ranging from 10% to 42% (4-6).There is, however, limited knowledge of the causes of this higher drop-out rate in non-native patients. In a qualitative study, sources of tension in the interaction between non-native patients and native Dutch physicians in chronic non-specific low back pain rehabilitation treatment have been identified (7). These sources of tension, found directly after the first consultation with the rehabilitation physician, were: patients expecting a specific diagnosis and pain relief as the primary aims of treatment; more explicit symptom presentation of patients; different views on responsibilities with regard to the rehabilitation treatment (physicians implied that patients expected more responsibility to be taken by the physician); lack of trust in the rehabilitation physician; contradicting views given by physicians from the patients' country of origin with regard to the cause and treatment of pain; and communication problems, partly due to shame and embarrassment about patients' limited language proficiency in Dutch. These sources of tension potentially lead to future drop-out.More sick leave days (4, 8, 9), higher pain severity (9, 10), being less active in sports (4), a lower age (9) and the idea that exercise did not help or aggravated pain (11) have been identified as predictors of drop-out in low back pain rehabilitation programmes. A systematic review of qualitative and quantitative studies in patients with low back pain regarding INTRODUCTIONPatients with chronic non-specific low back pain can benefit from rehabilitation programmes. The aim of these rehabilita- 567Reasons for drop-out from rehabilitation their expectations and satisfaction with treatment (12) showed that patients in general (i.e. not specifically selected for a non-native background) are dissatisfied with low back pain treatment for a number of reasons, including: not obtaining a specific diagnosis of the pain; pain relief not being the main aim of treatment; lack of physical examination and diagnostic tests; lack of referrals to other therapy or specialists for further treatment; no possibility of sickness certification. This review study seems to show that patients with low ...

Dropout from a rehabilitation programme often occurs in patients with chronic nonspecific low back pain of non-native origin. However, the exact dropout rate is not known. The objective of this study was to determine the difference in dropout rate between native and non-native patients with chronic nonspecific low back pain participating in a rehabilitation programme in The Netherlands. A retrospective study (n = 529) of patient files was performed in two rehabilitation centres and two rehabilitation departments of general hospitals in The Netherlands. Patient files were checked for diagnosis, status of origin, sex, age and outcome, that is, reason for finishing treatment. The difference in dropout rate between patients of Dutch and non-Dutch origin was tested by chi tests and logistic regression-analysis, controlling for age, sex, type of rehabilitation institute and phase of the rehabilitation programme. Dropout occurred among one fifth (18.7%) of the total patient population. Dropout among patients of non-Dutch origin was twice as high as among native Dutch patients (P < 0.001). In regression analyses dropout was related to status of non-Dutch origin, treatment in a rehabilitation centre and the diagnostic phase of a rehabilitation programme. In conclusion, patients of non-Dutch origin drop out considerably more frequently than native Dutch patients. Dropout is higher in the diagnostic phase than in the treatment phase and in rehabilitation centres than in hospitals. Future research should clarify the reasons for the high dropout rate in patients of non-native origin.

Based on pilot results, the greatest barrier to systematic monitoring of the individual wheelchair fitting and learning process in rehabilitation with, among others, instrumented measurement wheels, was interpretation of outcomes. For proper interpretation of individual outcomes, the availability of reference data, smallest detectable differences and visualization of outcomes is of utmost importance.

Low-intensity FES acutely increased blood flow during stimulation, with a progressive increase across subsequent FES bouts. These observations suggest that continuous, low-intensity FES may represent a practical and effective strategy to improve perfusion and reduce the risk of vascular complications.

Sources of tension were identified during the interaction between Dutch physicians and patients of Turkish and Moroccan origin. These factors potentially are associated with future drop-out. Future research should clarify whether these factors indeed are associated with drop-out.