Physical Medicine Rehabilitation Randall Braddom Pdf Free Download
In addition, facilities are changing to accommodate the current COVID-19 state of emergency and to lessen the risk of exposure. Numerous state and local government guidelines have been issued to limit in-person hours of operation. Telehealth programs are being implemented to reduce in-person contact. To maintain human contact with patients, communication technology is being implemented to deliver testing, education, and treatments. The patient-centered care model is emphasizing the importance of communication between each healthcare provider and patient to establish a patient-centered care plan specific to the individual patient’s needs. Substitute telehealth guidelines are proposed, but according to a recent imaging study, one-quarter of cancer patients had little to no access to usual care. Ensuring access to telehealth services and rapid implementation of any guidance proposed by professional bodies will be key to the success of the patient-centered care model in the oncologic community [74].
Physical rehabilitation professionals should assess for systemic conditions, including musculoskeletal (MSK) impairments and decrease physical function with sequelae from cancer. MSK impairment in cancer survivors may be due to direct malignant tumor action, chemotherapy, and radiotherapy. Decreased physical function in patients with malignant cancer is likely to be multifactorial (MSK, mental, and social factors determining function). Over 10% of deaths in cancer survivors are due to secondary disease (cardiovascular, respiratory, and MSK conditions) [75]. These secondary conditions may increase the risk of disability, decrease physical function, and decrease quality of life. While primary cancer treatments can improve function, physical impairment may persist long after treatment completion. The EORTC QLQ-PR25 PF-10 contains two domains—physical function and role function (patient-reported). In the study of patients with advanced cancer treatment, a regression model was used with cognitive function and life stress as covariates to predict physical function. In a sample of patients undergoing palliative chemotherapy, physical function was independent of disease status and prior chemotherapy. Physical function was similarly independent of cancer stage, previous surgery, and number of metastases [76].
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