Physiotherapy and Rehabilitation in Palliative Care and Interventions in Cancer Patients

Yıl 2022, , 191 - 206, 30.04.2022

Hilal Güngör , Naciye Vardar Yaglı

https://doi.org/10.21020/husbfd.824319

Öz

Purpose: The aim of this review is to examine the methods that can be used in palliative care to reduce symptoms that reduce the quality of life.
Materials and Methods: Studies that used physiotherapy in palliative care patients were examined.
Results: Rehabilitation and palliative care team members share many approaches and goals in patient care. Physiotherapists add value to the comprehensive care plans of many patients receiving palliative care, regardless of the stage of the disease, and even as they approach the end of life. Physical evaluation can reveal new or worsening disorders that affect function. Rehabilitation interventions, including individual exercise programs, therapies, equipment and assistive device prescriptions, and other modalities, can assist in patient care. Conclusion: Patients with severe and life-limiting illnesses often experience a common subset of symptoms including fatigue, mood disturbances, shortness of breath, pain, and functional decline. All these symptoms contribute to a reduced quality of life. Many patients want to maintain functional independence as much as possible and reduce the burden on their caregivers. Physiotherapy is an effective strategy for improving the quality of life. We advocate increased collaboration between the palliative care team and physiotherapists in the care of these complex patient populations, as both work together to optimize physical function and patient satisfaction outcomes.

Anahtar Kelimeler

Palliative care, physiotherapy and rehabilitation, cancer

Palyatif Bakımda Fizyoterapi ve Rehabilitasyonun Yeri, Kanser Hastalarında Uygulamaları

Öz

Amaç: Bu derlemenin amacı kanser haslarında, palyatif bakımda yaşam kalitesini düşüren semptomları azaltmak için kullanılabilecek yöntemleri incelemektir.
Gereç ve Yöntem: Palyatif bakım hastalarında fizyoterapi uygulanan çalışmalar incelenmiştir.
Bulgular: Rehabilitasyon ve palyatif bakım ekibi üyeleri hasta bakımında birçok yaklaşımı ve hedefi paylaşırlar. Fizyoterapistler, hastalık evresine bakılmaksızın ve hatta yaşamın sonuna yaklaşırken palyatif bakım alan birçok hastanın kapsamlı bakım planlarına değer katar. Fiziksel değerlendirme işlevi etkileyen yeni veya kötüleşen bozuklukları ortaya çıkarabilir. Bireysel egzersiz programları, terapiler, ekipman ve yardımcı cihaz reçeteleri ve diğer modaliteler dahil olmak üzere rehabilitasyon müdahaleleri hasta bakımında yardımcı olabilir.
Sonuç: Ciddi ve yaşamı sınırlayan hastalıkları olan hastalar genellikle yorgunluk, duygu durum bozuklukları, nefes darlığı, ağrı ve fonksiyonel düşüş gibi ortak bir semptom alt kümesi yaşarlar. Tüm bu semptomlar azalmış yaşam kalitesine katkıda bulunur. Birçok hasta mümkün olduğunca işlevsel bağımsızlığı korumak ve bakıcıları üzerindeki yükü azaltmak istemektedir. Fizyoterapi yaşam kalitesini artırmak için etkili bir stratejidir. Her ikisi de fiziksel işlevi optimize etmek ve hasta memnuniyeti sonuçları için birlikte çalıştığından bu karmaşık hasta popülasyonlarının bakımında palyatif bakım ekibi ve fizyoterapistler arasında iş birliğinin artması gerektiğini savunuyoruz.

Anahtar Kelimeler

Palyatif bakım, fizyoterapi ve rehabilitasyon, kanser

Kaynakça

• Adamsen, L., Stage, M., Laursen, J., Rørth, M., Quist, M. (2012). Exercise and relaxation intervention for patients with advanced lung cancer: a qualitative feasibility study. Scandinavian Journal of Medicine Science & Sports, 22(6):804–15. https://doi.org/10.1111/j.1600-0838.2011.01323.x
• Anna, P., Budzyński J., Wójcik A., Prokop A., Krajnik M. (2017). Physiotherapy programme reduces fatigue in patients with advanced cancer receiving palliative care: randomized controlled trial. Supportive Care in Cancer, 25(9):2899-2908. https://doi.org/ 10.1007/s00520-017-3742-4
• Armstrong, M., Flemming, K., Kupeli, N., Stone, P., Wilkinson, S., Candy, B. (2019). Aromatherapy, massage and reflexology: A systematic review and thematic synthesis of the perspectives from people with palliative care needs. Palliative Medicine, 33(7) 757 –769. https://doi.org/10.1177/0269216319846440
• Barawid, E., Covarrubias, N., Tribuzio, B., Liao, S. (2015). The benefits of rehabilitation for palliative care patients. American Journal of Hospice and Palliative Medicine, 32(1):34-43. https://doi.org/10.1177/1049909113514474
• Bausewein, C., Schunk, M., Schumacher, P., Dittmer, J., Bolzani, A., Booth, S.(2018). Services as a new model of support for patients with respiratory disease. Chronic Respiratory Disease, 15(1): 48–59. https://doi.org/ 10.1177/1479972317721557.
• Borge, C., Hagen, K., Mengshoel, A., Omenaas,E., Moum,T., Wahl, A. (2014). Effects of controlled breathing exercises and respiratory muscle training in people with chronic obstructive pulmonary disease: results from evaluating the quality of evidence in systematic reviews. BMC Pulmonary Medicine, 14: 184. https://doi.org/10.1186/1471-2466-14-184.
• Bradt, J., Dileo, C., Magill, L., Teague, A. (2011).Music interventions for improving psychological and physical outcomes in cancer patients. Cochrane Database of Systematic Reviews, (8):CD006911. https://doi.org/ 10.1002/14651858.CD006911.pub3.
• Brown, J., Medina, T., Pescatello, L., Ryan, S., Pescatello, S., Moker, E., ve diğerleri. (2012). The efficacy of exercise in reducing depressive symptoms among cancer survivors: a meta-analysis. Plos One, 7(1):e30955. https://doi.org/ 10.1371/journal.pone.0030955.
• Buss, T., Walden-Gałuszko K., Modlińska A., Osowicka M., Lichodziejewska-Niemierko M, Janiszewskave J. (2010). Kinesitherapy alleviates fatigue in terminal hospice cancer patients—an experimental, controlled study. Supportive Care in Cancer, 6:743–749. https://doi.org/ 10.1007/s00520-009-0709-0.
• Cheville, A., Kollasch, J., Vandenberg, J., Shen, T., Grothey, A., Gamble, G., Basford, J. (2013). A home-based exercise program to improve function, fatigue, and sleep quality in patients with Stage IV lung and colorectal cancer: a randomized controlled trial. Journal of Pain and Symptom Management, 45(5):811–21. https://doi.org/ 10.1016/j.jpainsymman.2012.05.006.
• Cimete, G. (2002). Yaşam sonu bakım: Ölümcül hastalarda bütüncü yaklaşım: Nobel Tıp Kitabevleri.
• Crevenna, R., Kainberger F., Wiltschke C., Marosi C., Wolzt M., Cenik F., Keilani M. (2020).Cancer rehabilitation: current trends and practices within an Austrian University Hospital Center. Disability and Rehabilitation, 42(1):2-7. https://doi.org/ 10.1080/09638288.2018.1514665.
• Dungen, V., Verhagen C., Graaf W., Berg J., Vissers K., Engels Y. (2013). Feasibility and impact of a physical exercise program in patients with advanced cancer:a pilot study. Journal of Palliative Medicine, 17(10):109 1-8. https://doi.org/ 10.1089/jpm.2013.0638.
• Eva, G., Wee, B. (2010).Rehabilitation in end-of-life management, Current Opinion in Supportive and8 Palliative Care, 4(3):158-62. https://doi.org/ 10.1097/SPC.0b013e32833add27.
• Eyigor, S., Akdeniz, S. (2014). Is exercise ignored in palliative cancer patients? World Journal of Clinic Oncology, 5(3):554-9. https://doi.org/ 10.5306/wjco.v5.i3.554
• Eyigor, S. (2010). Physical activity and rehabilitation programs should be recommended on palliative care for patients with cancer. Journal of Palliative Medicine, 13(10):1183-1184. https://doi.org/ 10.1089/jpm.2010.0064.
• Henshall, C., Lizzie, A., Helen, A. (2018). Systematic Review and Narrative Synthesis to Explore the Effectiveness of Exercise-Based Interventions in Improving Fatigue, Dyspnea, and Depression in Lung Cancer Survivors. Cancer Nursing, 42(4):295-306. https://doi.org/ 10.1097/NCC.0000000000000605
• Jensen, W., Bialy, L. (2013). Physical exercise and therapy in terminally ill cancer patients: a retrospective feasibility analysis, Supportive Care in Cancer, 22(5):1261-8. https://doi.org/ 10.1007/s00520-013-2080-4
• Kanach FA, Brown LM, Campbell RR. (2014) The role of rehabilitation in palliative care services. American Journal of Physical Medicine&Rehabilitation, 93:342–345. https://doi.org/ 10.1097/PHM.0000000000000005
• Koretz, R. (2009). Enteral nutrition: a hard look at some soft evidence. Nutrition in Clinical Practice, 24(3): 316-324. https://doi.org/ 10.1177/0884533609335378
• Kumar, S. (2011).Cancer Pain: A Critical Review of Mechanism-based Classification and Physical Therapy Management in Palliative Care. Indian Journal of Palliative Care, 17(2):116-26. https://doi.org/ 10.4103/0973-1075.84532.
• Laakso, L.(2006).The role of physiotherapy in palliative care. Australian Family Physician, 35(10):781. https://www.racgp.org.au/getattachment/a1ddd2fd-2f39-46a2-b249-7a972b8ea426/attachment.aspx
• Lancker, A., Beeckman, D., Noortgate, N., Verhaeghe, S., Hecke, V. (2017). Frequency and Intensity of Symptoms and Treatment Interventions in Hospitalized Older Palliative Cancer Patients: a Multicentre Cross-sectional Study. Journal of Advanced Nursing, 73(6):1455-1466. https://doi.org/ 10.1111/jan.1323
• Lee, C., ve diğerleri., (2018). Rehabilitation of Advanced Cancer Patients in Palliative Care Unit. Annals of Rehabilitation Medicine, 42(1):166-174. https://doi.org/ 10.5535/arm.2018.42.1.166
• Lipsett A, Barrett S, Haruna F, Mustian K, O'Donovan A. (2017). The impact of exercise during adjuvant radiotherapy for breast cancer on fatigue and quality of life: a systematic review and meta-analysis. Breast, 32:144–155. https://doi.org/ 10.1016/j.breast.2017.02.002.
• Lopez, G., Eddy, C., Liu, W., et.al.(2019). Physical Therapist–Led Exercise Assessment and Counseling in Integrative Cancer Care: Effects on Patient Self-reported Symptoms and Quality of Life. Integrative Cancer Therapies, 18: 1534735419832360. https://doi.org/ 10.1177/1534735419832360
• Maddocks, M., Lovell, N., Booth, S., Man, W., Higginson, I. (2017). Palliative care and management of troublesome symptoms for people with chronic obstructive pulmonary disease. Lancet, 390:988–1002. https://doi.org/ 10.1016/S0140-6736(17)32127-X.
• McIlfatrick S, Connolly M, Collins R, Murphy T, Johnston B, Larkin P.(2017). Evaluating a dignity care intervention for palliative care in the community setting: community nurses' perspectives. Journal of Clinic Nursing, 26(23-24):4300-4312. https://doi.org/10.1111/jocn.13757
• Meiner, D., Morrison, R. (2004). Clinical practice: palliative care. New England Journal of Medicine, 350(25): p. 2582-2590. https://doi.org/10.1056/NEJMcp035232
• Moens, K., Higginson, I., Harding, R. (2014). Are there differences in the prevalence of palliative care-related problems in people living with advanced cancer and eight non-cancer conditions? A systematic review. Journal of Pain and Symptom Management, 48(4):660-667. https://doi.org/10.1016/j.jpainsymman.2013.11.009.
• Morgan, G., & Mikhail, MG.(1996). Pain Management. In:Clinical Anesthesiology, 2 ed. New Jersey: PrentticeHall Interntional, Inc.; 274-316.
• Okamura, H. (2011). Importance of rehabilitation in cancer treatment and palliative medicine. Journal of Clinic Oncology, 41(6):733-738. https://doi.org/10.1093/jjco/hyr061.
• OldervollL, L., ve diğerleril.(2011). Physical exercise for cancer patients with advanced disease: a randomized controlled trial. Oncologist, 16:1649–1657. https://doi.org/10.1634/theoncologist.2011-0133
• Parshall, MB., Schwartzstein, RM., Adams, L., Banzett, RB., ve diğerleri. (2012) An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. American Journal of Respiratory Critical Care Medicine, 185:435-52. https://doi.org/10.1164/rccm.201111-2042ST
• Poletti, S., et.al. (2019). Mindfulness- Based stress reduction in early palliative care for people with metastatic cancer:A mixed-method study. Complementary Therapies in Medicine, 47:102218. https://doi.org/10.1016/j.ctim.2019.102218
• Pyszor, A., Budzyński, J., Wójcik, A., Prokop, A., Krajnik, M.(2017). Physiotherapy programme reduces fatigue in patients with advanced cancer receiving palliative care: randomized controlled trial. Supportive Care in Cancer, 25:2899–290. https://doi.org/ 10.1007/s00520-017-3742-4.
• Quist, M., Adamsen L., Rørth M., Laursen J., Christensen K., Langer S.(2015). The impact of multidimensional exercise intervention on physical and functional capacity, anxiety, and depression in patients with advancedstage lung cancer undergoing chemotherapy. Integrative Cancer Therapies, 14(4):341–9. https://doi.org/10.1177/1534735415572887
• Reddy, S., Bruera, E., Pace,E., Zhang, K., Gibby, C. (2017).Clinically important improvement in the intensity of fatigue in patients with advanced cancer. Journal of Palliative Medicine, 5:1068–1075. https://doi.org/10.1089/jpm.2007.0007
• Salakari, M., Surakka, T., Nurminen, R., Pylkkänenve, L. (2015). Effects of rehabilitation among patients with advanced cancer: a systematic review. Acta Oncology, 54(5):618-628. https://doi.org/10.3109/0284186X.2014.996661
• Sepúlveda, C., Marlin, A., Yoshida, T., Ullrich, A. (2002).Palliative care: the World Health Organization's global perspective. Journal of Pain and Symptom Management, 24(2): p. 91-96. https://doi.org/10.1016/S0885-3924(02)00440-2
• Simon, S., Weingärtner, V., Higginson, I., Benalia, H., Gysels, M., ve diğerleri. (2016).“I can breathe again!” Patients’ self-management strategies for episodic breathlessness in advanced disease, derived from qualitative interviews. Journal of Pain Symptom Management, 52:228–234. https://doi.org/10.1016/j.jpainsymman.2016.02.016
• Steen, J., Cees, L., Hertogh, M., Boer, M, Hughes, J., Larkin, P., ve diğerleri. (2014).White paper defining optimal palliative care in older people with dementia: a Delphi study and recommendations from the European Association for Palliative Care. Palliative Medicine, 28(3): p. 197-209. https://doi.org/10.1177/0269216313493685
• Stone, C., Lawlor, P., Savva, G., Bennett, K., Kenny, R., (2012). Prospective study of falls and risk factors for falls in adults with advanced cancer. Journal of Clinic Oncology, 30(17):2128-2133. https://doi.org/ 10.1097/rnj.0000000000000173
• Uster, A., ve diğerleri., (2018). Effects of nutrition and physical exercise intervention in palliative cancer patients: A randomized controlled trial. Clinical Nutrition, 37(4):1202-1209. https://doi.org/ 10.1016/j.clnu.2017.05.027.
• Wiskemann, J., Hummler, S., Diepold, C., Keil, M., Abel, U., ve diğerleri. (2016). POSITIVE study: physical exercise program in non-operable lung cancer patients undergoing palliative treatment. BMC Cancer, 19:16:499. https://doi.org/ 10.1186/s12885-016-2561-1.
• Wittry, S., Lam, N., McNalley,T.(2018). The Value of Rehabilitation Medicine for Patients Receiving Palliative Care. American Journal of Hospice & Palliative Medicine, 35(6):889-896. https://doi.org/ 10.1177/1049909117742896
• Word Health Organization. (1996). Cancer pain relief: with guide to opioid availability 2. Edition. Geneva Switzerland.
• Yılbaş, A., Çelebi, N. (2014). Pain management and difficulties in palliative care, Journal of Anesthesia – JARSS, 22(3):124 – 134.