Search Results (89)

Background/Objectives: The COVID-19 pandemic exposed critical vulnerabilities in healthcare systems, especially in ensuring continuity of care for patients with chronic diseases. Rehabilitation services, essential for recovery following SARS-CoV-2 infection, were among the most disrupted. This exploratory study aimed to assess Romanian patients’ perceptions of the accessibility and quality of post-COVID-19 rehabilitation services, focusing on individuals with chronic conditions. Methods: This exploratory cross-sectional study was conducted over a 12-month period in 2024. Data were collected from 76 adult patients diagnosed with at least one chronic condition (hypertension, diabetes mellitus, ischemic heart disease, cancer, or chronic obstructive pulmonary disease) and with confirmed prior SARS-CoV-2 infection. Most participants were recruited during outpatient specialty consultations, with a smaller number included from hospital settings, all located in Bucharest. A structured questionnaire was administered by the principal investigator after obtaining informed consent. Quantitative data were analyzed using non-parametric methods following confirmation of non-normal distribution via the Shapiro–Wilk test (p < 0.05). Satisfaction scores were reported as medians with interquartile ranges (IQR), and group comparisons were performed using the Mann–Whitney U test. A mixed-methods approach was employed, including thematic analysis of open-ended responses. Results: Patient satisfaction with rehabilitation services was consistently low. The median satisfaction scores [IQR] were accessibility 1.0 [0.0–2.0], quality of services 0.0 [0.0–4.0], staff empathy 0.0 [0.0–5.0], and perceived effectiveness 0.0 [0.0–5.0]. The median score for perceived difficulties in access was 1.0 [1.0–2.0], indicating widespread barriers. No statistically significant differences were observed between urban and rural participants or across chronic disease categories. Thematic analysis (n = 65) revealed key concerns including lack of publicly funded services, cost barriers, limited physician referral, service scarcity in rural areas, and demand for home-based rehabilitation options. Conclusions: Romanian patients with chronic illnesses and previous SARS-CoV-2 infection continue to face substantial barriers in accessing post-COVID-19 rehabilitation services. These findings highlight the need for more equitable and integrated recovery programs, especially for vulnerable populations in underserved settings. Full article

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, debilitating side effect of cancer treatment. Characterized by symptoms like pain, numbness, and muscle weakness, CIPN significantly impacts patients’ quality of life. Current management strategies vary, with limited consensus on effective treatments. This scoping review aims to explore comprehensive rehabilitation interventions for CIPN, focusing on enhancing patient well-being and functional abilities. Methods: A scoping review, guided by Arksey and O’Malley’s framework and Levac et al.’s refinements, was conducted to assess rehabilitation programs for CIPN. Searches across six databases were performed, with inclusion and exclusion criteria focusing on studies with physical rehabilitation interventions. Data were charted, detailing interventions, demographics, and outcomes. Results were synthesized descriptively and presented narratively with tables. Results: The review included 24 studies covering diverse cancer types and treatments, involving a total of 1167 participants. Various interventions for CIPN were assessed, and results were thematically categorized according to exercise category. Physical modalities like ultrasound and exercise showed promise in symptom relief for colorectal and breast cancer patients. No distinct advantage was found in the timing of exercise interventions. Complementary therapies such as acupuncture and yoga demonstrated effectiveness in managing CIPN symptoms. Conclusions: This review highlights the effectiveness of diverse physical and complementary interventions in managing CIPN, advocating for their integration into standard protocols. It emphasizes the need for holistic, patient-centered approaches that combine exercises, physical therapy, and complementary therapies to improve patient outcomes. These findings set a direction for future research and clinical practices focused on comprehensive and personalized CIPN management strategies. Full article

Dragon boating and rowing are reported to be safe and provide physical benefits for women with breast cancer. Sculling, characterized by a distinct biomechanical technique, may serve as a potential tool to mitigate the adverse side effects of cancer treatments. This study investigated the feasibility and impact of a 6-month integrated physical activity program in breast cancer survivors. A longitudinal intervention study was conducted involving 20 women with breast cancer (age: 55.8 ± 6.1 yrs; BMI: 24.6 ± 3.3 kg/m², stages I-III; surgery performed 6 months to 20 years prior) who participated in a 6-month exercise program consisting of three weekly one-hour sessions of adapted physical activity, walking, and sculling, with assessments conducted at baseline, 3 months, and 6 months. Physical activity, arm lymphedema, flexibility, and fatigue were tested. The program did not lead to the development or worsening of pre-existing lymphedema. A reduction of 78.9 cm³ was observed in the operated limb over 6 months (p = 0.005). An improvement in flexibility was also observed with a 2.7 cm increase in the back scratch test for the operated limb (p < 0.001). However, no significant change in fatigue-related variables was recorded. This is a novel study, as sculling has not previously been investigated in the context of breast cancer rehabilitation. The findings suggested that, when integrated into a structured exercise program, sculling is not only a safe and accessible activity but also effective in promoting physical and health-related improvements, with no adverse events reported. Therefore, it should be considered as part of a comprehensive rehabilitation plan for breast cancer survivors. Full article

Background: The incidence of cancer in older patients is high, reaching 2.3 million world-wide in 2018 for patients aged over 80. Because the characteristics of this population make therapeutic choices difficult, co-management between geriatricians and other cancer specialists has gradually become essential. Methods: This narrative review aims to synthesize current data on the contribution of geriatric assessment in the management of elderly patients with non-colorectal digestive cancers. Oncogeriatric assessment is multi-domain, including the evaluation of co-morbidities, autonomy, nutrition, cognition, mood, and functional assessment. Results: Oncogeriatric parameters are predictive of mortality and adverse events. In the peri-operative phase of non-colorectal digestive cancer surgical management, geriatric management can assist in the decision-making process, identify frailties, and arrange a specific and personalized trimodal preoperative rehabilitation program, including nutritional management, adapted physical activity, and psychological care. Its aim is to limit the risks of confusion and of decompensation of comorbidities, mainly cardio-respiratory, which is associated with the highest morbidity in biliary-pancreatic surgery for older adults, facilitate recovery of previous autonomy when possible, and shorten hospital stay. For metastatic cancers, or during multimodal management, such as peri-operative chemotherapy for localized gastric cancers or pre-operative radio-chemotherapy for oesophageal or rectal cancers, specific assessment of the tolerance of chemotherapy is necessary. Neuropathic toxicity and chemobrain have a greater impact on elderly patients, with an increased loss of autonomy. Joint geriatric management can reduce the rate of grade 3–5 adverse effects of chemotherapy in particular and improve quality of life. Conclusions: Co-management between geriatricians and other specialties should be encouraged wherever possible. Full article

Background and Clinical Significance: Colorectal cancer (CRC) remains a global health challenge with significant postoperative complications and functional declines. Telerehabilitation offers an accessible alternative to improve preoperative physical condition and postoperative recovery. Case Presentation: Five CRC patients scheduled for laparoscopic surgery participated in an asynchronous telerehabilitation multimodal program, including two weeks of prehabilitation and four weeks of postoperative rehabilitation. Delivered via a digital platform with remote physiotherapist support, the intervention improved functional capacity and muscle strength preoperatively, with partial recovery noted post-surgery. Conclusions: Integrating telerehabilitation into the CRC surgical pathway is feasible and may enhance functional outcomes and quality of life. Further studies are required to confirm these preliminary findings. Full article

Background: Models of second-phase cardiac rehabilitation (CR) following myocardial infarction (MI) differ across countries. The aim of this study was to compare outcomes in MI survivors participating in outpatient and inpatient CR programs. Methods: All patients hospitalized for acute MI in Poland between October 2017 and December 2018 (n = 96,634) were included in the study. Among them, 4411 patients were referred to and commenced outpatient CR, whereas 11,626 patients started inpatient CR within 30 days following discharge. Results: The mean follow-up period was 332.8 ± 128.1 days. Younger age, male sex, and a history of cancer were associated with a higher probability of participating in outpatient CR, whereas diabetes, heart failure, chronic kidney disease, chronic obstructive pulmonary disease, ST-elevation MI, and myocardial revascularization were associated with a lower likelihood of outpatient CR participation. Participation in outpatient CR was linked to a reduced risk of all-cause mortality, in both univariable (hazard ratio [95% confidence interval]: 0.37 [0.26–0.51]) and multivariable analyses (0.53 [0.38–0.74]). Outpatient CR was also associated with a lower risk of death, MI, or stroke (0.57 [0.48–0.67] in univariable analysis and 0.72 [0.61–0.84] in multivariable analysis), as well as a lower risk of death or cardiovascular hospitalization (0.78 [0.73–0.84] and 0.85 [0.80–0.91], respectively). Conclusions: Outpatient CR following MI tends to occur alongside a better prognosis compared to inpatient programs. Full article

Background: Adolescent and young adult (AYA) cancer survivors have unique needs, yet few tailored rehabilitation programs exist. CaRE-AYA is an 8-week multidimensional rehabilitation program for AYAs that targets impairments, activity limitations and participation restrictions and comprises an individualized exercise prescription and weekly group-based exercise and self-management education. Methods: We conducted a single-arm multi-method pragmatic feasibility study evaluating CaRE-AYA’s feasibility, acceptability, and safety (primary outcomes) and assessed disability, physical functioning, mental health, and social functioning at baseline (T0), immediately post-intervention (T1), and 3 months post-intervention (T2). Results: Twenty-five participants (median age: 32.8, 76% female) were enrolled. Participation (60%), retention (84% at T1, 72% at T2), and program adherence (76% for education classes, 74% for exercise classes) supported feasibility. Qualitative interviews (n = 9) supported strong perceptions of feasibility and acceptability. No serious adverse events (≥grade 3) attributed to CaRE-AYA occurred. Conclusions: The results suggest CaRE-AYA is feasible, acceptable, and safe. A randomized controlled trial is needed to determine the effectiveness. Full article

Objectives: The purpose of the present study was to verify if performance in the 6-min walking test (6MWT) during the preoperative evaluation phase is associated with the development of cardiopulmonary postoperative complications in patients who underwent uniportal VATS (U-VATS) for lung cancer. Methods: This retrospective, monocentric study included patients submitted to U-VATS anatomical lung resections (March 2022–December 2023). The patients were enrolled in a preoperative rehabilitation program carried out 15 days before surgery. The 6MWT was performed at counseling (T0) and after pre-habilitation (T1). Univariate analysis followed by logistic regression verified the association of baseline patients’ characteristics and performance in the 6MWT (meters walked during T0 and T1 and the difference between T1 and T0—T1-T0 variation) with postoperative cardiopulmonary complications (CPCs). Youde’s index was used to establish the optimal cut-offs for ergometric parameters significantly correlated with CPCs. Results: We enrolled 212 patients scheduled to undergo U-VATS lung resection (lobectomies: 177; bilobectomies: 2; segmentectomies: 33). Twenty-three (10.8%) patients developed CPCs. None of the baseline patients’ characteristics were associated with CPCs. Complicated patients showed more significant differences compared to non-complicated ones for meters walked during the 6MWT T1 (6MWT-T1-complicated: 450 vs. 6MWT-T1-non-complicated: 517; p: 0.01) and for variation-T1-T0 (variation-T1-T0-complicated: 4 m vs. variation-T1-T0-non-complicated: 20 m; p: 0.02). The best cut-offs for discriminating between patients with CPCs and those with uneventful courses were 458 m for 6MWT-T1 and 31 m for variation-T1-T0. After multivariate analysis, 6MWT-T1 < 458 m and variation-T1-T0 < 31 m were the unique parameters independently correlated with CPCs (p: 0.03 and p: 0.05, respectively). Conclusions: The 6MWT results (in particular, 6MWT-T1 < 458 m and variation-T1-T0 < 31 m) in the context of a pre-habilitation program are associated with the development of CPCs after U-VATS lung resection. Full article

Background: Breast cancer survivors often face physical and psychological challenges, including weight gain, metabolic syndrome, and reduced quality of life. To address these concerns, a mobile app-based rehabilitation program called “THRIVE” was developed to improve physical activity, medication adherence, and health-related quality of life (HRQoL) in this population. Methods: This prospective, single-arm study assessed the feasibility and effectiveness of the “THRIVE” app among breast cancer survivors undergoing hormonal therapy. Participants were recruited from Queen Mary Hospital in Hong Kong between December 2022 and June 2023. Eligible survivors had completed treatment within the last five years or had stable advanced disease on hormonal therapy. Participants monitored their exercise, medication adherence, and self-care via the app and a Fitbit activity tracker for 16 weeks. Primary outcomes included recruitment, dropout, adherence rates, and safety. Secondary outcomes, measured at baseline and week 16, included physical activity intensity, HRQoL, psychological stress, body composition, and app satisfaction. Results: A total of 50 participants, with a median age of 53 years, completed the study. The recruitment rate was 70.4% with no dropouts. The adherence rate, measured by completing exercises recommended in the mobile app at least three times per week, was 74%. No severe adverse events were reported. While physical activity intensity showed no significant changes from baseline to week 16 (p = 0.24), cognitive function (p = 0.021), future perspective (p = 0.044), arm symptoms (p = 0.042), depression (p = 0.01), and anxiety (p = 0.004) improved. All participants reported perfect medication compliance (100%). Satisfaction with the app was high. Conclusions: This mobile app-based rehabilitation program demonstrated good feasibility, with satisfactory recruitment, adherence, and safety, providing valuable insights into future definitive studies. Full article

Breast cancer is the most common malignancy among women worldwide, and advances in early detection and treatment have significantly increased survival rates. However, people living beyond breast cancer often suffer from late sequelae, negatively impacting their quality of life. Prehabilitation, focusing on the period prior to surgery, is a unique opportunity to enhance oncology care by preparing patients for the upcoming oncological treatment and rehabilitation. This article provides a clinical perspective on a patient-centered teleprehabilitation program tailored to individuals undergoing primary breast cancer surgery. The proposed multimodal program includes three key components: patient education, stress management, and physical activity promotion. Additionally, motivational interviewing is used to tailor counseling to individual needs. The proposed approach aims to bridge the gap between diagnosis and oncological treatment and provides a holistic preparation for surgery and postoperative rehabilitation in breast cancer patients. The aim of this preparation pertains to improving mental and physical resilience. By integrating current evidence and patient-centered practices, this article highlights the potential for teleprehabilitation to transform clinical care for breast cancer patients, addressing both logistical challenges and holistic well-being. Full article

Background/Objectives: Inpatient exercise-based rehabilitation has been shown to improve health-related quality of life (HRQOL) in cancer survivors. However, there is a lack of studies on the impact of community-based cancer rehabilitation programs on health-related quality of life, especially in Asian countries. Methods: This was a retrospective cohort study involving patients with cancer at an outpatient community-based rehabilitation center. There were 197 patients who were recruited and enrolled in a physician-led rehabilitation program which included physiotherapists, occupational therapists, nutritionists and exercise physiologists. Results: Most of the patients had a diagnosis of breast cancer (61.4%), while 76 (38.6%) had a diagnosis of other cancers. On initial assessment, we found a mean Distress Thermometer (DT) level of 3.37 (SD = 2.41) and a mean Functional Assessment of Cancer Therapy-General-7 Item Version (FACT-G7) score of 11.83 (SD = 4.01). On follow-up assessment after 3–6 months of rehabilitation, there was a significant reduction in mean DT level to 2.42 (SD = 2.25) and an improvement in mean FACT-G7 score to 13.09 (SD = 4.77). Multivariate regression analysis revealed that significant factors for improvement in FACT-G7 scores were age (p = 0.046) and number of exercise therapy sessions (p < 0.001). Conclusions: This study demonstrates the positive impact of a community-based cancer rehabilitation program on HRQOL among cancer patients. Full article

Women undergoing breast surgery with axillary lymph node dissection continue to experience complications in the ipsilateral upper limb, impacting their daily lives and quality of life. This study aims to evaluate the relationship between quality of life (overall and specific) and the functional capacity of patients undergoing breast surgery with lymph node clearance before and after implementing a rehabilitation program. This short-term quasi-experimental study included 48 women, and the design did not include control groups. Data collection involved a sociodemographic and clinical characterization questionnaire, the Disabilities of the Arm, Shoulder and Hand questionnaire, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 and Breast Cancer questionnaires. The study revealed a significant negative association between all general functional subscales and the functionality of the ipsilateral upper limb, except for emotional (p 0.941) and cognitive (p 0.927) functional scales. The functional capacity of the ipsilateral upper limb following surgery influences the quality of life of women undergoing breast surgery. The study concluded that monitoring the quality of life is essential to underscore the importance of providing access to rehabilitation to minimize or eliminate these changes, thus contributing to a better quality of life for these women. Full article

Purpose: The increasing elderly patient population is contributing to the rising worldwide load of cervical spinal disorders, which is expected to result in a global increase in the number of surgical procedures in the foreseeable future. Cervical rehabilitation plays a crucial role in optimal recovery after cervical spine surgeries. Nevertheless, there is no agreement in the existing research regarding the most suitable postsurgical rehabilitation program. Consequently, this review assesses the ideal rehabilitation approach for adult patients following cervical spine operations. Materials and Methods: This review covers activities of daily living and encompasses diverse treatment methods, including physiotherapy, specialized tools, and guidance for everyday activities. The review is organized under three headings: (1) historical perspectives, (2) patient-reported functional outcomes, and (3) general and disease-specific rehabilitation. Results: Rehabilitation programs are determined on the basis of patient-reported outcomes, performance tests, and disease prognosis. CSM requires strengthening of the neck and shoulder muscles that have been surgically invaded. In contrast, the CCI requires mobility according to the severity of the spinal cord injury and functional prognosis. The goal of rehabilitation for CCTs, as for CCIs, is to achieve ambulation, but the prognosis and impact of cancer treatment must be considered. Conclusions: Rehabilitation of the cervical spine after surgery is essential for improving physical function and the ability to perform daily activities and enhancing overall quality of life. The rehabilitation process should encompass general as well as disease-specific exercises. While current rehabilitation protocols heavily focus on strengthening muscles, they often neglect the crucial aspect of spinal balance. Therefore, giving equal attention to muscle reinforcement and the enhancement of spinal balance following surgery on the cervical spine is vital. Full article

(1) Background: Intensive interdisciplinary rehabilitation services more effectively promote recovery from acquired brain injury than a single discipline approach. However, research literature is lacking regarding the perceived feasibility and utility of an interdisciplinary approach across disciplines for patients within a tertiary care pediatric hematology/oncology setting. (2) Methods: The Acute Neurological Injury (ANI) service applied an acquired brain injury/inpatient rehabilitation interdisciplinary approach to a pediatric hematology/oncology population, with a focus on interdisciplinary communication, shared goal setting, and coordinated transition planning. Caregivers whose children received coordinated ANI program care were interviewed regarding the perceived feasibility and utility of ANI program components. (3) Results: An interdisciplinary approach to a pediatric hematology/oncology population is feasible for caregivers and for providers of rehabilitation and psychosocial services within a tertiary care cancer hospital setting. Parents perceived benefits from aspects of this approach including coordinated interdisciplinary care planning, the implementation of an interdisciplinary goal, parent brain injury education, neuropsychological assessment reports, and weekly cognitive intervention sessions. Parents were interested in both having a peer mentor while managing new cancer diagnoses and later serving in a mentor role for a newly diagnosed family. (4) Conclusions: An interdisciplinary acquired brain injury approach to a pediatric hematology/oncology population is feasible with perceived benefits to families managing new cancer diagnoses. Full article

Background: Cancer survivors are at higher risk of developing severe complications from influenza due to their compromised immune systems. Despite their increased vulnerability to influenza and the availability of vaccines, vaccine hesitancy among cancer survivors remains a significant public health concern in China. Methods: A multicenter, cross-sectional study was conducted among cancer survivors in China from January to December 2023. A total of 500 participants were recruited from the oncology departments of five tertiary hospitals. A structured, self-administered questionnaire was used to collect data on socio-demographic characteristics, cancer-related information, medical history, lifestyle factors, and influenza vaccine hesitancy. Univariate and multivariate logistic regression analyses were performed to identify factors associated with influenza vaccine hesitancy. Results: The response rate was 97.0% (485/500). Among all participants, 204 (42.06%) reported vaccine hesitancy. The results of multiple logistic regression showed that the longer the end of anti-cancer treatment, without a history of adverse vaccine reactions, and the level of family support played a protective role in vaccine hesitancy. Current rehabilitation status, frequent colds, not being informed by doctors about vaccination, exercising, lack of community vaccination education programs, and concerns about vaccine safety were risk factors that increase vaccine hesitancy. Conclusions: A high proportion of cancer survivors in our study reported influenza vaccine hesitancy. Addressing concerns about vaccine safety, improving access to vaccination services, and enhancing doctor–patient communication are crucial for increasing influenza vaccine uptake in this vulnerable population. Full article