Ryans Kathryn, Perdomo Marisa, Davies Claire C, Levenhagen Kimberly, Gilchrist Laura
Mercy College, Dobbs Ferry, NY, USA.
University of Southern California, Los Angeles, CA, USA.
J Cancer Surviv. 2023 Feb;17(1):237-245. doi: 10.1007/s11764-021-00991-2. Epub 2021 Jan 22.
A work group from the American Physical Therapy Association Academy of Oncologic Physical Therapy developed and published a clinical practice guideline (CPG) to aid clinicians in identifying interventions for individuals with breast cancer-related lymphedema (BCRL). This guideline reviewed the evidence for risk mitigation and volume reduction beginning at cancer diagnosis and continuing through survivorship. Application of CPGs can be challenging due to the variability of clinical settings, heterogeneous patient populations, and range of rehabilitation clinician expertise. The purpose of this paper is to assist these clinicians in implementing the recommendations from the CPG to develop a patient-centered, evidence-based plan of care.
METHODS/RESULTS: This publication presents important considerations for the implementation of recommended rehabilitation interventions across the trajectory of BCRL.
Current evidence supports specific interventions to treat or mitigate the risk for the various stages of BCRL. As clinicians implement these recommendations into practice, they also need to address other impairments that may exist in every individual. Continued collaboration between clinicians and researchers is necessary to further develop optimal treatment modalities and parameters.
By implementing evidence-based interventions as outlined in the CPG, clinicians can improve the quality of care for survivors of breast cancer.
美国物理治疗协会肿瘤物理治疗学会的一个工作小组制定并发布了一项临床实践指南(CPG),以帮助临床医生确定针对乳腺癌相关淋巴水肿(BCRL)患者的干预措施。本指南回顾了从癌症诊断开始直至生存期的风险降低和体积减小方面的证据。由于临床环境的多样性、患者群体的异质性以及康复临床医生专业知识的范围,CPG的应用可能具有挑战性。本文的目的是帮助这些临床医生实施CPG中的建议,以制定以患者为中心、基于证据的护理计划。
方法/结果:本出版物介绍了在BCRL病程中实施推荐的康复干预措施时的重要注意事项。
目前的证据支持针对BCRL各个阶段进行治疗或降低风险的特定干预措施。临床医生在将这些建议应用于实践时,还需要解决每个个体可能存在的其他损伤问题。临床医生和研究人员之间持续的合作对于进一步开发最佳治疗方式和参数是必要的。
通过实施CPG中概述的基于证据的干预措施,临床医生可以提高乳腺癌幸存者的护理质量。