Personalizing Exercise Programs for the Cancer Survivor No abstract available

Fall and My Last Message No abstract available

An Executive Summary of Reports From an International Multidisciplinary Roundtable on Exercise and Cancer: Evidence, Guidelines, and Implementation Physical activity can play an important role in cancer prevention and control, but there is a need to update the state of the science to best facilitate dissemination and implementation of evidence into practice. The American College of Sports Medicine convened an International Multidisciplinary Roundtable on Exercise and Cancer to update recommendations based on current evidence on the role of physical activity and exercise in cancer prevention and survivorship. There was strong evidence for a protective effect of physical activity against colon, breast, endometrial, kidney, bladder, esophagus, and stomach cancer; moderate evidence that pre-diagnosis physical activity may reduce risk of dying from breast and colon cancer; and, moderate evidence that higher levels of physical activity post-diagnosis are associated with lower risk of dying from colon, breast, and prostate cancer. For cancer survivors, an exercise prescription for moderate intensity aerobic and/or resistance exercise at least 3 times per week, 30 minutes/sessions, for at least 8-12 weeks may consistently improve common treatment-related symptoms and side effects. To implement this knowledge, an Exercise Is Medicine approach was adapted to the cancer context. Oncology clinicians are asked to: 1) assess current physical activity levels and safety to engage in exercise, 2) advise patients to increase physical activity if not currently reaching recommended levels, and 3) refer individuals to appropriate services. Exercise can play a vital role in prevention and management of cancer. The Roundtable update provides physical therapists with practical, evidence-based information for utilization of exercise as a treatment strategy and models for implementation.

ReActivate—A Goal-Orientated Rehabilitation Program for Adolescent and Young Adult Cancer Survivors Background: Adolescent and young adult (AYA) cancer survivors tend to have poorer physical and mental health outcomes than their healthy peers or survivors of childhood cancer. This study evaluated the feasibility and acceptability of ReActivate, an 8-week, group-based, goal-orientated rehabilitation program for AYA cancer survivors. Methods: A prospective, single-site cohort study was conducted of all AYA cancer survivors who self-referred to the ReActivate program. Participants were 21 (60%) males and 14 (40%) females, who ranged in age from 16 to 25 years (M = 21.05, SD = 2.62). Weekly group sessions comprised 1 hour of physical activity, followed by 1 hour of education or self-management sessions. The AYAs completed measures assessing physical functioning (ie, cardiovascular fitness, and muscular endurance and strength), psychosocial outcomes (ie, health-related quality of life), and occupational performance. Results: The ReActivate program was found to be feasible and acceptable, with an 87% completion rate and a median attendance rate of 7 sessions (range = 3-8). There were statistically significant increases across most of the physical functioning, health-related quality of life, and perceived occupational performance and satisfaction outcomes, with Cohen's d effect sizes ranging from small to large. Conclusion: The ReActivate program was feasible and acceptable and may have a positive effect on AYA cancer survivors' physical, psychosocial, and occupational functioning. While the findings require replication in a randomized controlled trial, the program has the capacity to optimize delivery of patient care and health resources by bridging the gap that currently exists between the acute and primary care settings.

Multidimensional Outcome Measurement of Children and Youth With Neuropathy Following Treatment of Leukemia: Cross-sectional Descriptive Report Background: Children/youth with chemotherapy induced peripheral neuropathy (CIPN) experience many impairments, activity limitations, and participation restrictions. Objective: The objective of this study was to describe the use and feasibility of selected multi-dimensional outcome measures of functioning, disability, and health in children/youth with CIPN following treatment for acute lymphoblastic leukemia. Methods: A selection of clinician evaluated and patient reported outcome measures encompassing all dimensions of the International Classification of Functioning, Disability and Health was collected from seventeen children/youth with CIPN within a study of 3D instrumented motion analysis. Measures included the pediatric modified Total Neuropathy Scale, ankle strength and range of motion, six-minute walk test, Edinburgh Visual Gait Score, Oxford Ankle and Foot Questionnaire, Bruininks-Oseretsky Test of Motor Proficiency running speed and agility subtest, and Pediatric Outcomes Data Collection Instrument Transfers and Basic Mobility, Sports/Physical Functioning, and Pain/Comfort scales. Results: The measures were shown to be feasible and were able to demonstrate differences compared to normative data. They showed variability within the group of children/youth with CIPN except for the running speed and agility test, which had a floor effect. The Edinburgh Visual Gait Scores correlated significantly (r = −0.668, p <0.001) with the Gait Deviation Index, a summary score of kinematic gait data from the 3D motion analysis study. Conclusion: These measures can contribute clinical practice, research, and the development of core outcome set registries.

The Relationship of Chemotherapy-Induced Peripheral Neuropathy and Obesity: A Systematic Review Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting neurotoxic effect of chemotherapy that affects many survivors. Obesity is also known to have a negative effect on neuropathy. This review aimed to determine what relationship, if any, obesity might have with the incidence and severity of CIPN. Methods: Electronic databases PubMed, PEDro (Physiotherapy Evidence Database), CENTRAL (Cochrane Central Register of Controlled Trials), Ovid, and EBSCO were systematically searched from January 2008 to March 2019. All types of studies, data collections, and review articles were included in the adult population. Results: Twelve articles describing relationships between overweight/obesity and presence of CIPN were included in the review. Associations between body mass index (BMI), body surface area (BSA), and sarcopenic obesity and CIPN incidence and severity were described in patients who had received taxane therapy, platinum compound therapy, or bortezomib. Eleven of the 12 studies indicated an increased incidence of CIPN with higher BMI or BSA or sarcopenic obesity, and the 2 studies that analyzed severity of symptoms found an increase in those who were overweight/obese. Limitations: The number of studies specifically analyzing the relationship between overweight/obesity is limited. Also limiting comparison between studies is the categorization of obesity and the methods used to define CIPN. Conclusions: Overall, being overweight or obese would put one at a higher risk for development of CIPN. Clinicians should encourage healthy lifestyles to help decrease or control symptoms and/or limit dose reductions of chemotherapy. Further research regarding changes in severity of CIPN with weight loss or gain is needed.

What Are the Attitudes and Beliefs of Oncologists Regarding Potential Cancer Rehabilitation in a Tertiary Cancer Center? Introduction: Cancer rehabilitation (CR) is an emerging field in physical medicine and rehabilitation. Current literature highlights the effectiveness of CR in improving functional outcomes, shorter length of hospital stay, and improved quality of life. Despite this, there are very few formalized CR programs across all of North America. Methods: We conducted a survey at a tertiary cancer center without a formalized CR program to assess the perceived need of such a program and its potential development. Results: This survey of medical, surgical, radiation, and pediatric oncologists demonstrated that 92.3% of 39 respondents felt CR was somewhat to very important, particularly for their patients' issues of fatigue, deconditioning, pain management, and disposition planning. Conclusion: These findings highlight the value seen by oncologists in the need for further CR access and formalized program development in order to meet patient needs for improving functional deficits, activities of daily living, and quality of life.

Functional Comparison of a Pediatric Patient With Osteosarcoma and Limb-Sparing Distal Femoral Endoprosthesis With an Identical Twin Background/Objective: In children, limb salvage techniques have been more slowly adopted because of concerns of complications from multiple surgical procedures, the sacrificing of the physis, and the leg-length discrepancy that can ensue. The purpose of this study was to compare gait and function between a pediatric patient with a distal femur replacement and his identical, healthy twin brother. Methods: Design: A single, case-control design was used. Participants: A 13-year-old adolescent boy underwent a distal femoral resection and endoprosthetic reconstruction with a noninvasive extendible endoprosthesis. The control was the healthy, identical twin brother of the case patient. Main Outcome Measure(s): Functional movement testing consisting of 5× Sit-to-Stand Test, 10-m Walk Test, Timed Up and Go (TUG) test, and L-test. Spatiotemporal gait analysis was used to assess degree of asymmetry. Results: Comparisons were mixed across the functional movement testing, with the patient performing inferiorly on the 5× Sit-to-Stand Test and the 10-m Walk Test and superiorly on the TUG test and the L-test. Degree of asymmetry for step time, swing time, single support, and initial double support were all significantly different (P ≤ .05), with the patient being less symmetric in all measures. Limitations: This study is limited by its small sample size and a comparison with a single time point. Conclusion: Although the patient is doing well functionally, asymmetries remain compared with his twin. Future research should focus on more direct comparison of subjects who have undergone different treatment options for sarcoma.

Technology-Based Interventions in the Pediatric Oncology Population No abstract available

Pre-Bone Marrow Transplant Physical Therapy Evaluations in Pediatric Oncology No abstract available