Exercise physiology in cancer care.

Abstract

135 Background: Cancer survivors can benefit from exercise at many points in the cancer care continuum. The Exercise Physiology Internship was developed by the University of North Carolina at Charlotte and Levine Cancer Institute (LCI) to address the exercise needs of patients with cancer. Although the interns had a background in physical fitness, they required training regarding the medical complexity of this population and how this affects their ability to exercise. To bridge this gap, LCI approached Carolinas Rehabilitation to assist in providing safe and effective exercises to cancer survivors. Methods: The intern program was modified to include cancer rehabilitation. Education was performed by the rehabilitation team, with emphasis on treatment-related side effects, contraindications for exercise, cancer-related fatigue, and safety considerations. Interns assisted therapists with impairment based rehabilitation to learn how physical fitness integrates with rehabilitation. Prior to 1:1 intern consults, the therapist and intern reviewed the most recent oncology notes, and the intern consulted the therapist regarding safety considerations or exercise modifications. The intern also worked with a clinical nurse specialist at LCI who provided information regarding disease processes, treatment side effects and potential residual implications of treatment and disease. Results: Following modification of the program, interns reported feeling more prepared and confident when providing 1:1 consults to survivors. Referrals from providers within LCI grew, with 5 consults in Spring 2016, 13 consults in Summer 2016, and at least 19 consults to be completed this semester. Interns also became more integrated into the cancer center, providing consults during infusion and in physician clinics. Conclusions: Exercise physiology interns are an asset to the cancer survivorship and rehabilitation teams. By collaborating with the rehabilitation team, interns can provide safe and effective exercise prescriptions to cancer survivors. Interns can also provide rehabilitation referrals for patients who require impairment-based therapy. With continued program development, opportunities for intervention may present throughout the continuum of care.