Lexi Harlow, PT, DPT, CLT Seattle Cancer Care Alliance

Transcription

1 Lexi Harlow, PT, DPT, CLT Seattle Cancer Care Alliance

2 Importance of Rehabilitation In Oncology Care Patient and family centered care Individualized treatment and management of side effects from cancer modalities Reduce symptom burden Maintain or restore function Enhance quality of life education.healthcaresource.com

3 Importance of Rehabilitation in Oncology Care Education for providers and patients Screening for impairments Rehabilitation referrals Cost containment (Shih, 2009) Evidence based oncologypt.org

4 What services do we uniquely provide to the cancer setting? Enhanced care of unique needs of cancer patients Rehabilitation perspective through oncology lenses Support oncologists in managing side effects Provide prestige, leadership, and marketing opportunities eyesightcorner.com

5 What services do we uniquely provide to the cancer setting? Education outreach to providers, patients, community Research opportunities Program development

6 Melanoma Treatment: What have you experienced? Fatigue Joint pain Joint restrictions Deconditioning/weakness Balance challenges Peripheral neuropathy Cognitive impairments Depression Anxiety Gait difficulties Lymphedema Osteopenia/osteoporosis Scar adhesions Difficulty with daily activities (dressing, bathing) Difficulty with chores, shopping, driving Need for assistive device

7 Rehabilitation Professionals: Who can help me? Rehabilitation Medicine Physician (Physiatrist) Physical Therapists Occupational Therapists Speech/Language Pathologists Rehabilitation Psychologist

8 Rehabilitation Physicians (Physiatrists) Nerve, muscle, and bone experts who treat injuries or illnesses that affect how you move Treat any disability resulting from disease or injury Pinpoint the source of an ailment and design appropriate rehabilitation treatment plan

9 What might a physiatrist do? New and Follow-up Patient Visits Injections Botulinum Fluoroscopic Ultrasound guided Joint Trigger point EMG Testing Medical guidance on physical activity/exercise programs

10 Physical Therapists Examine, diagnosis, and develop an individualized plan of care Work with patients to achieve the following: Reduce pain Improve or restore mobility Prevent or manage condition Minimize disability

11 Typical Physical Therapy Needs Deconditioning/muscle mass loss Scar tissue restrictions and/or fibrosis Cording (Axillary Web Syndrome) Joint contracture Fatigue Pain vanderbilthealth.com

12 Typical Physical Therapy Needs Osteopenia/osteoporosis Peripheral neuropathy Mobility challenges Decreased balance/fall risk Peripheral edema/lymphedema management livingwith peripheralneuropathy.com

13 Physical Therapy Treatment Patient education Cardiovascular conditioning Strength training Flexibility and balance training Edema/lymphedema management Maximize and facilitate independence Pain and fatigue management

14 Occupational Therapists Individualized evaluation with customized intervention Health promotion Prevent or enhance quality of life with injury, illness, or disability ecmc.edu

15 Typical Occupational Therapy Needs Fatigue Peripheral neuropathy (upper extremity) Cognitive impairments Lymphedema Difficulty with ADLs (dressing, bathing) Difficulty with chores, shopping, etc. Need for assistive device or adaptive equipment Home safety evaluation Return to work assessment/workplace evaluation Driving evaluation

16 Occupational Therapy Treatment Patient education Self-care task instruction and/or modifications Task simplification Energy conservation Edema/lymphedema management Hand therapy Maximize and facilitate independence Compensatory strategies for cognitive deficits

17 Evidence Based Practice Musculoskeletal concerns Deconditioning/endurance deficits Fatigue management Balance/falls UE function after breast cancer treatment Pain Sexual functioning Lymphedema usf.edu Silver 2011; Egan 2013

18 Other Rehabilitation Professionals Rehabilitation Psychologist Assess and treat cognitive and emotional disability due to injury or illness Speech Language Pathologist Prevent, assess, diagnose, and treat speech, language, social communication, cognitive communication, and swallowing disorders in children and adults

19 Current State of Our Program Physical therapy services only Staffing: Physical Therapists (7) Department Coordinator Physical Therapy Manager Staff skill set includes the following expertise: lymphedema, orthopedics, neurologic, myofascial techniques, pelvic floor/incontinence

20 Future Treatments and Programs Activities of Daily Living Training Hand Therapy Vestibular Rehabilitation Speech and Swallowing Rehabilitation Return to Work Program Cognitive Rehabilitation Group Exercise/Therapy Survivorship (long-term needs) Integrative Care (massage, acupuncture, etc.)

21 Dr. Julie Silver After Cancer Treatment: Heal Faster, Better, Stronger

22 References Egan MY, McEwen S, Sikora L, Chasen M, Fitch M, Eldred S. Rehabilitation following cancer treatment. Disabil Rehabil Mar 15. Fitzpatrick, TW (2009). Principles of physical and occupational therapy in cancer. In MD Stubblefield, MW O Dell (Ed.), Cancer Rehabiliation: Principles and Practice (pp ). New York: Springer Publishing. Shih YT, Xu Y, Cormier JN, Giordano S, Ridner SH, Buchholz TA, Perkins GH, and Elting LS. Incidence, treatment costs, and complications of lymphedema after breast cancer among women of working age: a 2-year follow-up study. Journal of Clin Onc :12, Silver JK, Baima J, Mayer RS. Impairment-driven cancer rehabilitation: an essential component of quality care and survivorship. CA Cancer J Clin 2013;63: Silver JK, Gilchrist LS. Cancer rehabilitation with a focus on evidence-based outpatient physical and occupational therapy interventions. Am J Phys Med Rehabil 2011;90(suppl):S5-S15. Stout NL, Silver JK, Raj VS, Rowland J, Gerber LH, Cheville AL, Ness KK, Radomski M, Nitkin R, Stubblefield MD, Morris GS, Acevedo A, Brandon Z, Braveman B, Cunningham S, Gilchrist L, Jones L, Campbell G, Hendricks J, Perkin K, Chan L. Toward a national initiative in cancer rehabilitation: recommendations from a subject matter expert group. Arch Phys Med and Rehab. 2016;97:

23 Thank you! Phone: