Oncology Physical Therapy Research Articles

Academy of Oncologic Physical Therapy CSM 2024 Platform and Poster Presentations

Academy of Oncologic Physical Therapy CSM 2024 Platform and Poster Presentations

Barriers and facilitators to implementation of APTA's breast cancer-related lymphedema diagnosis and intervention clinical practice guidelines.

The purpose of this study was to identify barriers and facilitators influencing implementation ofthe diagnosis and intervention clinical practice guidelines (CPGs) related to the management of patients with breast cancer-related lymphedema (BCRL). A descriptive, cross-sectional web-based survey was conducted. Participants included physical therapists and assistants who were members of the APTA's Academy of Oncologic Physical Therapy and Lymphology Association of North America. Desriptive statisitcs were computed for all demographic and barriers and facilitators data. Individual exploratory factor analyses (EFA) were performed on survey items for both CPGs to identify themes of barriers and facilitators to implementation. A total of 180 respondents completed the survey. 34.9%of respondents read the diagnosis CPG and 22.4% read the intervention CPG. A total of 77.8% reported that they did not have issues in changing their clinical routines and 69.5% did not have resistance working according to CPGs. The EFA resulted in 3 themes for each CPG, accounting for 46% of the variance for the diagnostic CPG and 54% of the variance for the intervention CPG. The 3 themes, clinician characteristics, patient demographics, therapist practice setting and beliefs/values, were weighted differently for each EFA. Most respondents did not read either CPG, however, report a willingness to make changes to clinical practice and utilization of CPGs. For those who have attempted to implement the CPGs, this study was the first to identify the barriers and facilitators impacting the implementation of the CPGs related to the management of BCRL. The results will inform the development of targeted implementation strategies to improve access to and adherence to recommendations from the CPGs ultimately improving the efficiency and efficacy of care delivery to patients.

Current State of Entry-level Physical Therapy Oncology Curricula in the United States: A Faculty Survey.

The purpose of this study was to determine the extent of oncology rehabilitation education in current physical therapist educational programs in the United States, including oncology rehabilitation content characteristics, delivery, and instructional resources. By 2030, more than 21 million survivors of cancer in the United States (US) will be living with multisystem side effects depending on the treatment delivered. In addition, the sociopsychological factors associated with cancer treatment require that physical therapists are equipped with a unique body of knowledge, skills, and abilities. Insufficient cancer rehabilitation education is problematic across the health care spectrum. Program directors at 235 US physical therapist educational programs. An online survey was developed in REDCap using the American Board of Physical Therapy Specialist's Description of Specialty Practice: Oncology Physical Therapy as a guide. An electronic link to the survey was sent to the email of the chair/program director at 235 Commission for the Accreditation of Physical Therapy Education-accredited programs. The overall response rate was 40.4% (95/235) and represented 36 of the 50 states. Private universities represented 54.3% of the responses, and 65% of the surveys were completed by core faculty. Four programs reported having an independent oncology course, ranging from 1 to 3 credit hours. Integrated content hours averaged 14.8 contact hours (range: 1-60) in the 69 reporting programs. Fifty-four percent of respondents were aware of published rehabilitation cancer guidelines. The majority of respondents (62%) felt their students received adequate instruction related to oncology rehabilitation. Certified lymphedema therapists (68%) were primarily responsible for teaching the oncology content. Goodmans' Pathophysiology text was most reported (87%), whereas 38% used evidence-based research in Rehabilitation Oncology Journal. About half of the respondents (52%) reported offering students full-time clinical experiences in oncology rehabilitation. This survey demonstrated how oncology rehabilitation education is incorporated into physical therapist educational programs and highlights areas for improvement. The results from this study lay the groundwork for developing core competencies for prelicensure education in oncology rehabilitation.

Immediate Lymphatic Reconstruction: The Future of Lymphedema Risk Reduction?

Board Certified Clinical Specialist in Oncologic Physical Therapy, and Assistant Professor, Midwestern University, Downers Grove, Downers Grove, IL Correspondence: Elizabeth Campione, PT, DPT, CLT-LANA, Midwestern University–Downers Grove, 555 31st St, Downers Grove, IL 60515 ([email protected]). The author declares no conflicts of interest. Online Publication date: May 15, 2023

Academy of Oncologic Physical Therapy CSM 2023 Platform and Poster Presentations

Academy of Oncologic Physical Therapy CSM 2023 Platform and Poster Presentations

Body composition a category for resizing oncologic physical therapy: theoretical review

Movement is essential for human beings and is influenced by physical, psychological, social and environmental factors. Within the internal factors are metabolic changes, such as in body composition and interacts with comorbidities given by chronic diseases, including cancer. The role of the physiotherapist is to enhance the maximum achievable movement. Therefore, this review will seek to gather evidence on how physiotherapeutic intervention modifies body composition in pediatric oncology patients Methodology: This study is a retrospective documentary search.1 A search was carried out in PubMed, OVID and PeDro databases. The selection was carried out in three stages, the first was title review, the second abstracts, the third full text reading, and the extraction of information using the PICO format. Results: A total of 789 were found in the search, eliminated by title (n=721), by abstracts (n=56), in the complete reading (n=7). In total (n=5) were included for the final analysis. The result with the highest statistical significance was given in bone density and anthropometric measurements with a (p<0.02). Conclusions: A clear relationship is found between body composition and physiotherapeutic practice in pediatric oncology. The instruments and measures that are used in the evaluation, as well as the interaction modalities, require further research, however, if an intervention such as those found in the reviewed studies, based on movement, is carried out, it would contribute to the improvement of the intervened patient and therefore the improvement of the quality of life of the affected population.

Physical Therapists in Oncology Settings: Experiences in Delivering Cancer Rehabilitation Services, Barriers to Care, and Service Development Needs.

ObjectivePhysical therapist-delivered rehabilitation aims to manage the side effects of cancer and its treatments. Although access to cancer rehabilitation is not yet a standard of care in many countries, physical therapists practice in many types of cancer services with different cancer populations. The purpose of this study was to explore the experiences of physical therapists in cancer care practice with regard to their role, the factors influencing service delivery and development, and physical therapists’ professional development needs.MethodsIn this qualitative study with semistructured interviews, physical therapists in cancer care settings in the Republic of Ireland were interviewed via telephone. Participants (n = 17) represented a variety of clinical settings and roles. Two researchers performed thematic analysis of transcriptions using a semantic, inductive approach. Key themes and codes were identified and illustrative quotes were selected.ResultsSix main themes were found: the need for more services, barriers to service development and delivery, a lack of awareness of the role of physical therapy, facilitators to service development, goals for the future of oncology physical therapy, and training needs of staff.ConclusionsPhysical therapists provide valuable interventions across the spectrum of cancer care but experience barriers to the delivery and development of services. Investment in oncology physical therapy and developing international standards of care will allow physical therapists to meet the rehabilitation needs of survivors of cancer.ImpactAs international guidelines increasingly recommend development of cancer rehabilitation programs, it is important to understand physical therapists’ experiences of working in cancer care to assist in the development of effective oncology physical therapy services. This study demonstrates that physical therapist–led cancer rehabilitation services need investment and public promotion to enable the provision of optimal services to all patients with cancer and to meet standards of care.

An Online Elective Entry-Level Physical Therapy Oncology Course Guided by Qualitative Analysis of the Student Perspective

Background: As prevalence of cancer survivors continues to grow, physical therapists will play a major role in cancer rehabilitation. To meet growing educational needs for oncology physical therapy, the George Washington University DPT program developed an online elective course. Objectives: The purpose of this study was to explore student motivation for course enrollment, student self-perceived strengths and weaknesses in oncology physical therapy, and personal learning objectives. Design: Retrospective qualitative analysis. Methods: Pre and postcourse student narrative responses, based on self-reflection, were analyzed using a general inductive approach to identify themes. Results: Sixteen students enrolled in the course over 2 years. Students were interested in complex patient management and understood the effect of changing survival rates in future practice. Self-perceived strengths related to oncology physical therapy were rooted in communication skills, adaptability, compassion, and empathy. Students' perceived weaknesses and objectives ranged from oncological disease and treatment to safe physical therapy interventions. Students expressed concerns related to the emotional toll working with this population; they identified areas for future self-study. Conclusion: This course provided additional learning experiences in the management of patients with a cancer history. As adult learners, students identified learning objectives and explored topics in a supportive, self-directed learning environment. Educational needs related to oncological medical management and provision of safe and effective physical therapy interventions and psychosocial concerns expressed by our student group are similar to those of practicing clinicians. Qualitative analysis served as a useful tool to identify future course direction.

Growing the Workforce in Oncology Physical Therapy: From Entry Level to Specialist Care

Growing the Workforce in Oncology Physical Therapy: From Entry Level to Specialist Care

Oncology Residency and the Evolution of Specialty Practice

Over the past few decades, oncology rehabilitation has transformed from a niche clinical area to an established specialty practice with a defined scope of knowledge and skills. Since the passage of board certification in the APTA House of Delegates in 2016, the Description of Specialty Practice has defined the scope and parameters of this specialization and has set benchmarks for practitioner knowledge, skills, and behaviors. Concurrently, several institutions have established oncology residencies for physical therapists, with many others in the developing stages. Residencies are extensive postgraduate, on-the-job training opportunities whereby a resident is closely mentored by a team of clinical experts. Accreditation standards for oncology residencies are established by the American Board of Physical Therapy Residency and Fellowship Education. This article provides perspectives on the current role of and future opportunities for oncology physical therapy residency programs. The infrastructure, institutional support, and development of residents and faculty mentors show great potential to further the specialty area, enhance patient access, and elevate the quality of services available to persons living with and beyond cancer.

Academy of Oncologic Physical Therapy CSM 2022 Platform and Poster Presentations

Academy of Oncologic Physical Therapy CSM 2022 Platform and Poster Presentations

Rehabilitation interventions for the management of breast cancer-related lymphedema: developing a patient-centered, evidence-based plan of care throughout survivorship.

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. 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.

Academy of Oncologic Physical Therapy CSM 2021 Platform and Poster Presentations

Academy of Oncologic Physical Therapy CSM 2021 Platform and Poster Presentations

Translating Evidence Into Practice Through Knowledge Implementation

It is well established that it can take upward of 20 years to implement research findings into clinical practice. Research findings do not always translate well into the clinical environment for a number of reasons including organizational/individual resistance to change, disruption in workflow, lack of intervention adaptability, and the complexity of patients in the rehabilitation setting. Physical therapists will benefit from an understanding of implementation science (IS) in order to optimize the integration of evidence-based practices (EBPs) into the clinical setting. Implementation science focuses on how interventions work in real settings, how to improve them, and how to sustain them. It provides a framework for identifying barriers and facilitators to the uptake of the desired behavior and engages stakeholders of multiple levels into the process. Two frameworks, the Knowledge-to-Action framework and the Consolidated Framework for Implementation Research, are presented to provide guidance to clinicians and researchers in oncology rehabilitation who are interested in embarking upon IS projects. A hybrid version of the 2 frameworks is proposed with the aim of providing stakeholders with stronger and targeted tools to increase the likelihood of successful implementation of EBP. The purpose of this perspective is to describe IS, key frameworks, and strategies of knowledge implementation and to identify barriers and facilitators to implementation of contemporary research into clinical practices. The secondary purpose of this article is to demonstrate its application for the Academy of Oncologic Physical Therapy.

Health Promotion, Wellness, and Prevention Practice in Oncologic Physical Therapy: A Survey Study

Background: Cancer and its treatments cause a variety of symptoms and sequelae that can be impacted by patients' health behaviors. Objective/Purpose: To examine the perceptions of their role and the extent to which physical therapists (PTs) and physical therapist assistants (PTAs) include health promotion, wellness, and prevention (HPWP) in the care of patients with cancer. Design: Survey. Methods: A survey was developed to examine the perceptions, current practice, and barriers to HPWP practice in oncologic physical therapist practice. After reliability testing and survey refinement, the survey was administered electronically to PTs and PTAs who provide care for individuals with cancer. The responses of 69 PTs and 4 PTAs who completed the survey were analyzed. Results: Respondents reported their perceived role versus current practice in discussing the following behaviors with their patients: physical activity/exercise (99%/99%), stress management (93%/72%), sleep hygiene (92%/61%), tobacco use (83%/28%), healthy eating (82%/71%), alcohol/substance abuse (74%/7%), and vaping/e-cigarettes (73%/3%). Reported barriers to HPWP practice included economic limitations, lack of time, level of patient interest, inadequate skills, and lack of organizational support and resources. Conclusions: There was close alignment between respondents' perceived roles and HPWP practice for physical activity, healthy eating, and stress management but less agreement with the behaviors of sleep hygiene, alcohol/tobacco/substance use, and vaping. Limitations included a low response rate and limited psychometric testing of the survey. Because of the potential positive effect of healthy behaviors in those diagnosed with cancer, there is opportunity to better incorporate HPWP into oncologic physical therapist practice.

An Executive Summary of the APTA Academy for Oncologic Physical Therapy Clinical Practice Guideline: Interventions for Breast Cancer–Related Lymphedema

Background: Breast cancer–related lymphedema (BCRL) is a sequela of cancer treatment that can impact quality of life. Interventions to address this impairment should be tailored for each lymphedema stage throughout the trajectory of care, from diagnosis of cancer throughout survivorship. Methods: Studies were included in this clinical practice guideline if the purpose was to investigate interventions intended to reduce lymphedema risk, interstitial fluid, or upper extremity volume in individuals during and after breast cancer treatment. This executive summary presents the recommendations on interventions developed from the evidence review, according to stage of BCRL to allow for clinical implementation based on patient presentation.

Interventions for Breast Cancer-Related Lymphedema: Clinical Practice Guideline From the Academy of Oncologic Physical Therapy of APTA.

A work group from the American Physical Therapy Association (APTA) Academy of Oncologic Physical Therapy developed a clinical practice guideline to aid clinicians in identifying interventions for people with breast cancer–related lymphedema, targeting volume reduction, beginning at breast cancer diagnosis and continuing through cancer treatments and survivorship. Following a systematic review of published studies and a structured appraisal process, recommendations were developed to guide physical therapists and other health care clinicians in their intervention selection. Overall, clinical practice recommendations were formulated based on the evidence for each intervention and were assigned a grade based on the strength of the evidence. The evidence for each specific intervention was synthesized and appraised by lymphedema stage, when the information was available. In an effort to make recommendations clinically applicable, they were presented by modality throughout the care trajectory. Methodology and research populations varied significantly across studies, and it will be important for future research to use standardized definitions for participant characteristics, diagnostic criteria, and interventions.

Balancing Falls at the End of Life: The Dilemma of Acceptance

1Principal Consultant, Hospice Physical Therapy Associates, Chico, CA 2Founding Chair of the Hospice and Palliative Care Special Interest Group of the Academy of Oncologic Physical Therapy, Purcellville, VA 3Board Certified Geriatric Clinical Specialist and Assistant Professor, Oakland University, Rochester, MI 4Oncology Residency Director, Beaumont Hospital, Troy, MI Correspondence: Christopher M. Wilson, PT, DScPT, DPT, Oakland University, 433 Meadow Brook Dr, Rochester, MI 48309 ([email protected]). The authors declare no conflicts of interest.

Academy of Oncologic Physical Therapy CSM 2020 Platform and Poster Presentations

Academy of Oncologic Physical Therapy CSM 2020 Platform and Poster Presentations

2019 Academy of Oncologic Physical Therapy Slate of Candidates

2019 Academy of Oncologic Physical Therapy Slate of Candidates