Prospective surveillance and targeted physiotherapy for arm morbidity after breast cancer surgery: a pilot randomized controlled trial

Rafn, Bolette Skjødt; Hung, Stanley; Hoens, Alison M.; McNeely, Margaret L.; Singh, Chiara; Kwan, Winkle; Dingee, Carol; McKevitt, Elaine; Kuusk, Urve; Pao, Jin-Si; Laeken, Nancy Van; Goldsmith, Charlie H.; Campbell, Kristin L.

doi:10.1177/0269215518757292

Cited by 30 publications

(45 citation statements)

References 31 publications

(44 reference statements)

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“…In fact, perspective surveillance and target physiotherapy, as compared to education, show that target physiotherapy is more suitable for women with mammary carcinoma due to the early identification of upper limb morbidity. In Rafn's study, in fact, the patients treated for mammary carcinoma are divided into two groups with randomized modality: one group is followed with prospective surveillance and target physiotherapy and one group is followed with standard care, consisting of preoperative education and the delivery of a booklet of exercises to be performed at home [7]. Perspective surveillance consists of the quarterly monitoring of the patients, assessing the shoulder articulation variables, strength, volume, and functionality of the upper limb.…”

Section: Resultsmentioning

confidence: 99%

“…In many situations, together with the preoperative assessment, patients are given an educational booklet with a summary of the advice and precautions to be implemented in the period following the surgical operation, so as to have a reinforcement role on the information obtained during the preoperative meeting [7][8]. McNeely's study, in particular, suggests that a supervised rehabilitation intervention is preferable to the standard one, which instead uses an informative booklet, a written educational package, or unstructured or non-individualized exercises [8].…”

Section: Introductionmentioning

confidence: 99%

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The Physiotherapy Intervention for Shoulder Pain in Patients Treated for Breast Cancer: Systematic Review

Giacalone¹,

Alessandria²,

Ruberti³

2019

Cureus

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Physiotherapy Intervention for Shoulder Pain in Patients Treated for Breast Cancer: Systematic Review

Giacalone¹,

Alessandria²,

Ruberti³

2019

Cureus

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“…To begin to address this, we have developed freely available self-management upper body rehabilitation 18 19 and surveillance 20 21 resources and demonstrated them to be feasible and acceptable to include in public settings 18 22 and able to support BCSs in performing measurements for upper body issues on themselves in a reliable and valid manner. 20 22 Future research will establish if integrating such self-management resources into clinical programmes can enable early detection and management and lower the prevalence 23–25 and complexity 26 of upper body issues as demonstrated by therapist-administered surveillance programmes.…”

Section: Discussionmentioning

confidence: 99%

Shared concern with current breast cancer rehabilitation services: a focus group study of survivors’ and professionals’ experiences and preferences for rehabilitation care delivery

et al. 2020

Self Cite

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ObjectivesBreast cancer survivors experience a wide spectrum of physical sequelae from cancer treatment. National and international guidelines recommend that rehabilitation is offered from the point of diagnosis. However, there is a lack of data on the translation of these recommendations into clinical care. The objective of this study was to explore the experiences of breast cancer survivors, rehabilitation professionals and breast surgeons on current rehabilitation services including preferences for care delivery, specific ways to promote early detection and timely management of upper body issues and attitudes towards self-managed surveillance and rehabilitation.DesignQualitative focus groups. Breast cancer survivors completed a questionnaire about rehabilitation services received and experience of upper body issues. These quantitative data were collected to provide context for the qualitative data and increase transferability. Transcripts were analysed using content analysis.SettingFive geographically distinct health authorities in British Columbia, Canada.ParticipantsEleven focus groups were conducted with 35 breast cancer survivors, 29 rehabilitation professionals and 5 breast surgeons.ResultsThree categories captured participants’ concern and wish for improved care: (1) cut the cancer out and goodbye; (2) you have to look out for yourself and (3) in a perfect world. All breast cancer survivors reported chronic upper body issues (mean 4.5 unique issues). Breast cancer survivors expressed worry and uncertainty in their solo management of the rehabilitation. The current services were reported to not enable early detection and timely management. Suggestions included reorganising the timing of patient education and improving the quality of and access to rehabilitation services by elevating the knowledge among healthcare professionals and providing multimodal self-management resources.ConclusionsThe results revealed a gap between oncology guidelines and the current clinical reality. The rehabilitation services were reported in need of revamping to increase equity of care. Multiple upper body issues were reported by many breast cancer survivors.

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“…A new standard of practice in cancer care is warranted because of the improvement in outcomes evident when exercise is integrated into cancer care from diagnosis through treatment. The value proposition of prospective personalized exercise clinical pathways in oncology is that they promote early detection of physical decline and prompt exercise interventions that mitigate or ameliorate many cancer treatment–related symptoms, reduce impairment and disability, 83,84 enhance return to work and social roles, 85,86 and positively influence health endpoints such as infection rates, hospitalization rates, and chemotherapy tolerability in some populations 87‐89 . The proposed 5 domains offer a framework for efficient and effective screening that enables exercise referrals best suited to an individual's existing and evolving needs.…”

Section: Integration To Practice: a Call To Actionmentioning

confidence: 99%

An exercise oncology clinical pathway: Screening and referral for personalized interventions

Stout

Brown

Schwartz

et al. 2020

Cancer

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INTRODUCTIONThere are approximately 17 million cancer survivors living in the United States, and by 2040, this estimate is predicted to increase to 26.1 million. 1 Exercise provides a myriad of health benefits to individuals during and after cancer treatment by reducing treatment-related symptoms, improving functional status and quality of life, and lowering the risk of disease recurrence. 2,3 Despite the established benefits, an individual's level of physical activity often decreases during treatment and does not return to prediagnosis levels after treatment completion. 4,5 Although exercise is regarded as safe and beneficial for individuals with cancer, promoting exercise for this population is complex. A patient-centered pathway is needed that can guide oncology and primary care professionals in the efficient assessment of an individual's condition and enable personalized referrals for exercise interventions that promote physical activity. The purpose of this article is to provide a framework for clinical decision making that enables personalized condition assessment, risk stratification, and referral to optimal settings for exercise promotion for cancer survivors. Implementation strategies are also offered to support the integration of this model into an oncology clinical workflow.With guidance from their medical provider, individuals are more likely to engage in exercise and maintain levels of physical activity during cancer treatments. 6 However, the number of individuals with cancer who report receiving exercise-specific guidance from their health care providers is low. 7 Of particular concern is the lack of knowledge and training among health care professionals about exercise prescription for this complex population. 8

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Prospective surveillance and targeted physiotherapy for arm morbidity after breast cancer surgery: a pilot randomized controlled trial

Abstract: Our results suggest that PSTP is feasible among women with breast cancer for early identification of arm morbidity. A larger study is needed to determine the cost and effectiveness benefits.

Cited by 30 publications

References 31 publications

The Physiotherapy Intervention for Shoulder Pain in Patients Treated for Breast Cancer: Systematic Review

The Physiotherapy Intervention for Shoulder Pain in Patients Treated for Breast Cancer: Systematic Review

Shared concern with current breast cancer rehabilitation services: a focus group study of survivors’ and professionals’ experiences and preferences for rehabilitation care delivery

An exercise oncology clinical pathway: Screening and referral for personalized interventions

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