Ortop Traumatol Rehabil. 2010 Jan-Feb;12(1):80-9.
The dynamics of physical activity in palliative care patients.
Pop T, Adamek J.
Source
Institute of Physiotherapy, University of Rzeszów. popter@interia.pl
Abstract
BACKGROUND:
Active and passive physical exercises in patients under palliative (long term) care in palliative wards and home hospices are a necessary means of prevention or reduction of pulmonary complications, disorders of respiratory function, vascular complications, disorders of lymphatic and venous function, and musculoskeletal dysfunction. The goal of this study was to assess the dynamics of physical activity in patients under long term care.
MATERIAL AND METHOD:
The study group consisted of 60 patients staying in a palliative care ward or a home hospice. The dynamics of physical ability was assessed with the Karnofsky Performance Scale, and the quality of life was evaluated using the 6-point scale of the Rotterdam Symptom Checklist. The study was conducted over eight weeks, with patient information recorded once a week.
RESULTS:
Over consecutive weeks, physical activity increased by 10-20% in 20% of the participants, did not change in 36% of the participants, and 44% of the study group showed a decrease in activity. We found an increase in the quality of life in the consecutive weeks of the study and a correlation with the physical activity level. A higher score on the Karnofsky Scale corresponded with a higher quality of life measured in the six-point scale of the Rotterdam Symptom Checklist. Significant correlations were found both for specific weeks and for the entire study period.
CONCLUSIONS:
1. The rehabilitation of palliative care patients resulted in a significant improvement in the quality of life. 2. The results indicate that there is a need to provide palliative patients with optimum rehabilitation regardless of their pre-rehabilitation clinical status. 3. The Karnofsky Performance Scale and the Rotterdam Symptom Checklist are strongly correlated with each other, which makes them robust investigative instruments for evaluating palliative patients.
Palliat Support Care. 2010 Sep;8(3):359-69.
Improving quality of life through rehabilitation in palliative care: case report.
Kasven-Gonzalez N, Souverain R, Miale S.
Source
Rehabilitation Medicine Service, Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA. kasvenn@mskcc.org
Abstract
OBJECTIVE:
Occupational and physical therapists can have a significant impact on the quality of life of terminally ill cancer patients. In the critical care setting, rehabilitation is often overlooked. However, occupational and physical therapists work with critically-ill patients to create realistic and meaningful goals for improving comfort, mobility, socialization skills, and ability to care for oneself regardless of disease state and medical status. The following case report describes rehabilitation intervention with a young woman diagnosed with osteosarcoma and leukemia during the final stage of her life.
METHOD:
This case report highlights the use of patient-centered goals and the importance of close collaboration between the patient, occupational therapist, and physical therapists to achieve a higher quality of life.
RESULTS:
A collaborative effort by the occupational and physical therapists yielded positive outcomes as defined by the patient, patient family, and the medical staff in the critical care setting.
SIGNIFICANCE OF RESULTS:
Palliative care patients may benefit from occupational therapy (OT) and physical therapy (PT) intervention. Rehabilitation specialists are skilled at working with patients to set realistic and meaningful functional goals. Further study on rehabilitation treatment to improve quality of life among patients in palliative care is needed.
Palliat Support Care. 2009 Dec;7(4):459-67.
"The healthy me appears": palliative cancer patients' experiences of participation in a physical group exercise program.
Paltiel H, Solvoll E, Loge JH, Kaasa S, Oldervoll L.
Source
Physiotherapy Department, St. Olavs University Hospital, Trondheim, Norway. hanne.paltiel@stolav.no
Abstract
OBJECTIVE:
Tentative results from a pilot study showed that patients with advanced cancer were willing and able to take part in a group exercise intervention. Limited knowledge exists, though, about the meaning and significance of such programs. The purpose of the present study was to understand the meaning of such an intervention for the individual participant and thereby to provide knowledge for shaping future clinical practice.
METHODS:
Thirty-four palliative cancer patients with a life expectancy of less than 1 year completed a 6-week group exercise program. Five randomly selected individuals were interviewed 7 months after completion. Results from a self-report evaluation questionnaire identified relevant themes that formed the basis of an interview guide. These were addressed in a semistructured interview. Verbatim transcripts were analyzed with a phenomenological-hermeneutical approach.
RESULTS:
Two main themes emerged from the interviews: (1) perceptions of the group and (2) a secure and caring setting for the group. Themes identified regarding perception of the group were a sense of belonging and commitment. Themes identified regarding a secure and caring setting for the group were a life-empowering group as a setting for enhancing coping, the qualifications of those who led the group, and a public gym as an unsuitable setting.
SIGNIFICANCE OF RESULTS:
Our study indicates that an individually adjusted group exercise program, with competent leaders, can provide a setting to enhance psychological well-being in cancer patients with life expectancy below 1 year. Small sample size, however, limits the possibility to generalize the findings.
Cancer. 2001 Aug 15;92(4 Suppl):1049-52.
Palliative care and rehabilitation.
Santiago-Palma J, Payne R.
Source
Pain and Palliative Care Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Abstract
Disability in patients with advanced cancer often results from bed rest, deconditioning, and neurologic and musculoskeletal complications of cancer or cancer treatment. Terminally ill patients have a high prevalence of weakness, pain, fatigue, and dyspnea in addition to other symptoms. Rehabilitation and palliative care have emerged as two important parts of comprehensive medical care for patients with advanced disease; this article discusses the relationship between the two and the possible role of rehabilitation interventions in the care of terminally ill patients. Palliative care and rehabilitation share common goals and therapeutic approaches. Both disciplines have a multidisciplinary model of care, which aims to improve patients' levels of function and comfort. There is scarce evidence that rehabilitation interventions can impact function and symptom management in terminally ill patients. However, clinical experience suggests that the application of the fundamental principles of rehabilitation medicine is likely to improve their care. Physical function and independence should be maintained as long as possible to improve patients' quality of life and reduce the burden of care for the caregivers. Future research on the rehabilitation of terminally ill patients should focus on better understanding the role of rehabilitation and defining appropriate interventions. The development of an evidence-based body of knowledge will ensure that these patients receive appropriate rehabilitation interventions.
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