Maltser Susan, Cristian Adrian, Silver Julie K, Morris G Stephen, Stout Nicole L
Department of Physical Medicine and Rehabilitation, Hofstra Northwell School of Medicine, Hempstead, NY; Long Island Jewish Medical Center, Manhasset, NY(∗).
Department of Rehabilitation Medicine, Northwell-Glen Cove Hospital, Glen Cove, NY(†).
PM R. 2017 Sep;9(9S2):S415-S428. doi: 10.1016/j.pmrj.2017.08.403.
Cancer and its treatments introduce various adverse effects that may affect survivors' physical, cognitive and psychological functioning. Frequently both tolerance to activity and exercise are affected as well. Rehabilitation providers should have substantive knowledge about the effect of cancer progression and common side effects associated with antineoplastic treatment to safely integrate rehabilitation interventions. Rehabilitation may mitigate loss of function and disability; however, these patients are among the most medically complex that providers treat. This report provides a focused review that synthesizes the current evidence regarding disease progression and oncology-directed treatment side effects within the context of safety considerations for rehabilitation interventions throughout the continuum of cancer care. Descriptive information regarding the evidence for precautions and contraindications is provided so that rehabilitation providers can promote a safe plan of rehabilitation care. It is incumbent upon but also challenging for rehabilitation providers to stay up to date on the many advances in cancer treatment, and there are many gaps in the literature regarding safety issues. Although further research is needed to inform care, this review provides clinicians with a framework to assess patients with the goal of safely initiating rehabilitation interventions.
癌症及其治疗会引发各种不良反应,这些反应可能会影响幸存者的身体、认知和心理功能。通常,对活动和锻炼的耐受性也会受到影响。康复治疗人员应具备关于癌症进展的影响以及与抗肿瘤治疗相关的常见副作用的实质性知识,以便安全地整合康复干预措施。康复治疗可能会减轻功能丧失和残疾状况;然而,这些患者是治疗人员所治疗的医疗情况最为复杂的患者群体之一。本报告提供了一项重点综述,在癌症护理连续过程中康复干预措施的安全考量背景下,综合了有关疾病进展和肿瘤导向治疗副作用的现有证据。还提供了有关预防措施和禁忌症证据的描述性信息,以便康复治疗人员能够制定安全的康复护理计划。紧跟癌症治疗的诸多进展对康复治疗人员来说既是职责所在,也是一项挑战,而且关于安全问题的文献存在许多空白。尽管还需要进一步研究以为护理提供信息,但本综述为临床医生提供了一个框架,以便对患者进行评估,目标是安全地启动康复干预措施。