Importance of Physical Therapy in Cancer Recovery

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By: Terry Abrams

Cancer rehabilitation is a growing area in medicine due to the increase in cancer survivorship. More and more individuals are beating cancer because of advances in medical technology, treatment and early detection. According to recent research from the American Cancer Society, the five-year survival rate of all cancers that were diagnosed between 2003 and 2009 is 68 percent. This is a 20 percent increase from 1975 to 1977. It is also estimated that over 13 million Americans have a history of cancer, and in 2014 there were an expected 1.6 million new cases. This means that the number of cancer survivors will continue to increase in the U.S. With more cancer survivors, there will need to be more recovery strategies.

Cancer treatment is a grueling course, leaving many people exhausted, weak and with a compromised immune system. Just getting out of bed can be a huge and daunting task, let alone exercising in a gymnasium or playing at the park with grandchildren. This is where a physical therapist comes in. Despite advances in medical treatments, individuals that receive cancer treatments typically experience extensive physical limitations during and after treatments. These limitations include and are not limited to cancer-related fatigue (CRF), pain, nerve damage, lymphedema, deconditioning, as well as incontinence.

There is strong evidence to support conservative management of these impairments through physical therapy. As each individual experiences different impairments during and after cancer treatment, it is important to have an individualized evaluation to focus your rehabilitation. Physical therapy can address common cancer related impairments including:

Lymphedema: Effective lymphedema management is accomplished through manual lymph drainage, range of motion exercises, aerobic exercise, and lymphatic bandaging.

CRF: Individualized aerobic training, strength training and functional management training is known to reduce effects of cancer related fatigue both during and after medical cancer treatments.

Pain: There are many pain relief strategies that can reduce the intensity and frequency of pain after cancer treatment. Specifically, treatment strategies including soft tissue mobilization, therapeutic massage, modalities, therapeutic stretching and strengthening.

Peripheral neuropathy: Often times, cancer survivors experience peripheral neuropathy, which is abnormal nerve function that can be experienced as pain, numbness and tingling. Physical therapy can help to improve nerve function or compensate for nerve dysfunction.

Deconditioning: Rebuilding endurance for activities and cardiovascular function can be difficult during and after cancer treatment. A skilled physical therapist is able to educate and monitor cardiovascular endurance training.

Genitourinary complications: For men undergoing treatment for prostate cancer and women undergoing treatment for bladder or ovarian cancer, incontinence and sexual dysfunction are common. A skilled physical therapist can help to rebuild the strength of the pelvic floor in order to improve urinary continence and reduce pain related to sexual function.

In a recent study published April 2015 in Physical Therapy Journal, researchers found that physical therapy services are more commonly sought out for individuals surviving breast and genitourinary cancers. Researchers sought to find the characteristics of patients with cancer that were referred for outpatient physical therapy and common clinical findings. Over the course of two years, data from 418 patients were analyzed. Genitourinary and breast cancers were the most common types of cancer in their sample. The most common impairments were strength loss and soft tissue dysfunction. Lymphedema was the most common issue for people with breast cancer and incontinence was the most common complaint for people that had genitourinary cancers. They also noted that pain and high fatigue levels were prevalent in individuals that had undergone radiation therapy. This study shows that therapy services are being utilized for individuals that have survived cancer, particularly breast and genitourinary cancer. However, this study also suggests that a large portion of cancer survivors are not seeking out rehabilitation services, even though they would likely find it highly beneficial.

According to the European Journal of Physical and Rehabilitation Medicine, most-mastectomy physical therapy ‘widely improves’ a patient’s quality of life. After mastectomy surgery, patients may experience tightness around the surgical site caused by scar tissue formation. The result can be very dense tissue under the incision, which is painful and can restrict range of motion. The restricted range of motion puts women at risk for a painful condition known as Frozen Shoulder. Early treatment by a physical therapist can help reduce the pain and help regain functional range of motion and strength.

The good news is that it is never too late to utilize rehabilitation services for cancer recovery. If you find that you are having trouble accomplishing daily tasks or functioning at your prior level of independence, seek out a rehabilitation expert and regain your vitality.

Article credits to CUREToday.com and Susan G. Komen.

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Importance of Physical Therapy for Cerebral Palsy

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Physical therapy is often the first step in treating cerebral palsy. It can help improve motor skills and can prevent movement problems from getting worse over time. Physical therapy implements strength and flexibility exercises, heat treatment, massages and special equipment to give individuals with cerebral palsy more independence, as reported by the Cerebral Palsy Guide.

The extent to which physical therapy helps depends on the severity and type of each case of cerebral palsy. Individuals with milder cases of CP may only require some physical therapy to treat their condition. In more severe cases, it may be used alongside other treatments or medications. Beginning physical therapy as early as possible usually gives them the best chances at improvement.

Many individuals with CP live highly functional lives as adults. Many have careers and families. In adulthood, people with CP often focus on pain management, conserving energy, adaptive equipment, and environment modifications to promote independence at work and at home. Physical therapists can help with managing these concerns. Like many adults, individuals with CP have muscle and joint pain in adulthood. Physical therapists can prescribe an exercise routine that enables the individual to stay strong and minimize joint issues.

Physical therapists are skilled in all of these areas, and they partner with people with CP and their caregivers to address their individual goals for realistic, positive outcomes. There are many benefits of physical therapy, from improving mobility to preventing future issues such as contractures and joint dislocations by keeping the body strong and flexible. Many children and adults with CP increase their level of self-reliance through physical therapy.

The main goal of physical therapy is to make everyday movements easier for people with cerebral palsy.

Physical therapy can improve: Coordination, Balance, Strength, Flexibility, Endurance, Pain management, Posture, Gait, and overall health.

The types of exercises used vary and have specific benefits for each type of cerebral palsy. Some of the benefits by cerebral palsy type include:

1. Spastic – Physical therapy can reduce the muscle tension and jerky movements associated with spastic cerebral palsy. Exercises such as stretching can even relieve stiffness over time.
2. Athetoid – People with athetoid cerebral palsy use physical therapy to increase muscle tone and gain more control over their movements.
3. Ataxic – There are exercises that can improve balance problems faced by those with ataxic cerebral palsy.

Physical therapists also tailor treatment based on the location of movement issues. Movement issues in children with cerebral palsy can be limited to one half of the body (hemiplegia), the legs (diplegia) or in the torso and all four limbs (quadriplegia). Therapists prescribe special exercises and routines for hemiplegia, diplegia and quadriplegia that may help the child regain movement in the affected area over time.

Physical therapy can also treat a range of other issues experienced by children and adults with CP, including:

– Scoliosis – an abnormal curvature in the spine, common in up to 30 percent of children with cerebral palsy.
– Thoracic kyphosis – a contortion of the upper spine.
– Lumbar lordosis – a contortion of the lower spine.
– Pelvic inclination – a protrusion of the pelvis either in the front or rear.
– Pelvic rotation – a horizontal contortion of the pelvis.
– Pelvic obliquity – a contortion of the pelvis at angle.
– Knee deformity – abnormally straight or bent knees that may be caused by pelvic deformities.
– Shortened Achilles tendon – a shortened tendon that causes issues with walking and standing.
– Hand and wrist deformities – abnormal flexing in the hand and wrist that prevents development of fine motor skills.

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Cardiovascular Rehab in Physical Therapy

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Cardiovascular Rehab in Physical Therapy is a growing area of PT that serves those who have had cardiopulmonary surgeries, diseases, and general deconditioning. Because of an aging population and an increase in Physician Physical Therapy referrals, Cardiovascular PT should continue to increase in popularity well into the future.

Most people think of Cardiovascular Rehab as using cardio machines only.  Although patients generally will utilize the cardio equipment at a Physical Therapy Facility, they can also do many different therapeutic exercises that will increase their muscular strength and endurance. These exercises will in turn assist patients to become more functional and to be healthier overall.

As the patients are doing exercises and using cardio machines, the Physical Therapist will be monitoring their vital signs using a Pulse Oximeter and a Blood Pressure Cuff. This will give a reading on their O2 Saturation Level, Heart Rate, and Blood Pressure. Taking measurements before, during, and after their workouts will give the PT an idea of how the patient can tolerate the routine, at what levels they can perform at, and also will help to measure improvement.

If patients have vital measures that are not within the normal ranges, then the Physical Therapy will have to decide the next course of action. For instance, if a patient has low blood pressure, then they will need to sit down and drink a lot of water before they are allowed to continue. If a patient’s heart rate gets too high or O2 Saturation gets too low, then they will need to take a break until their vitals go back into the normal ranges.

The best cardiovascular type of machines are the Recumbent Bicycle, Elliptical, Treadmill, and Rower. Alternate machines include an Upper Body Ergonometer (UBE), Airdyne Bicycle, Recumbent Elliptical, and Versa-climber. All of these machines have positives and negatives to them, and can be incorporated into a Cardiovascular Rehab program. It’s best to have at use 3-4 cardio machines in the program, to build up different muscle groups, and avoid boredom.

Also, changing up the therapeutic exercises and the order of things can help to keep the program exciting and new. The best therapy for cardiovascular patients are whole-body, functional exercises. These include Squats, Lunges, Dead-lifts, Push-ups, Pull-ups, Lifting, Carrying, Pushing, Pulling, Rows, Bridges, Crunches, Obliques, Leg Lifts, Throwing, Dips, Calf Raises, etc.  Any exercises can be used and mixed into the program, as long as they’re functionally relevant for the patient.

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