Oncology Physiotherapy Management

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This article is currently under review and may not be up to date. Please come back soon to see the finished work! (26/09/2020)

Intervention Models

"Physical therapists are ideally situated to provide secondary preventive interventions and treatment, using prospective surveillance, to those surviving breast cancer."

1. Breast Cancer–Related Lymphedema: Comparing Direct Costs of a Prospective Surveillance Model and a Traditional Model of Care by Nicole L. Stout, Lucinda A. Pfalzer, Barbara Springer, Ellen Levy, Charles L. McGarvey, Jerome V. Danoff, Lynn H. Gerber and Peter W. Soballe.Physical Therapy January 2012 vol. 92 no. 1 152-163
2. Prospective Surveillance Model of Care provided by Physical Therapists incorporates examination of physical and functional domains into the medical model currently used for breast cancer care.
3. Traditional Model of Care in Advanced-stage lymphedema by a specialized provider requires intensive decongestive therapy for adequate management.

Breast Cancer–Related Lymphedema: Comparing Direct Costs of a Prospective Surveillance Model and a Traditional Model of Care by Stout et. al.

Prospective Surveillance Model of Care	Traditional Model of Care in Advanced-stage Lymphedema
Preoperative examination: UE ROM, strength, limb volume, anthropometric measures (eg, body mass index), functional status, and level of physical activity	Complete decongestive therapy (CDT) requires daily, one-on-one skilled therapy with a specialized provider over the course of 4 to 6 weeks.
Education for a postoperative plan of care & how to monitor for signs and symptoms of early adverse effects of treatment such as pain, joint immobility, weakness, and lymphedema.	Complex materials for limb volume decongestion, including short-stretch compression bandages, various types of padding, and other materials to bandage the limb.
Exercise for ROM and strength Early identification, and intervention for lymphedema. Ongoing clinical monitoring	Compression garments are applied daily --replaced at 6- to 9-month intervals to ensure effectiveness
Advice on returning to activities during and after treatment
Regular follow-up visits for routine surveillance are conducted at 3-month intervals postoperatively to repeat baseline tests and measures, identify changes indicative of impaired body structure and function, and provide ongoing education and monitoring for potential early and late adverse effects of treatment

Key Evidence

Physical Therapy Intervention Following Surgical Treatment of Carpal Tunnel Syndrome in an Individual With a History of Postmastectomy Lymphedema by Julie E Donachy and Emily L Christian.  Physical Therapy 2002 Vol. 82 

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