Clinical questions on rehabilitation in cancer patients with skeletal metastasis: a content analysis of the multidiscipl
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ORIGINAL ARTICLE
Clinical questions on rehabilitation in cancer patients with skeletal metastasis: a content analysis of the multidisciplinary tumor board records Nobuki Yamanaka 1 & Shinji Tsukamoto 1,2 & Yukako Ishida 1 & Hideki Shigematsu 2 & Masatoshi Hasegawa 3 & Marina Sajiki 1 & Tomoo Mano 1 & Yasuhito Tanaka 2 & Akira Kido 1 Received: 19 May 2020 / Accepted: 19 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Cancer rehabilitation addresses the functional needs of patients who have various impairments. Disease control is a critical oncological consideration, while physical intervention increased weights of importance in several situations. To identify the clinical status that necessitates active physical intervention in cancer patients with skeletal metastasis, we performed a content analysis in the multidisciplinary tumor board (MDTB) records. Methods From January 2017 to September 2019, the MDTB discussed 168 consecutive patients with skeletal metastasis. We reviewed the MDTB records and asked responsible physicians to frame clinical questions. Based on these data, we identified the predictor valuables with the association to rehabilitation-related clinical questions using univariate and multivariate analyses. Moreover, we investigated a predictor of the change in Barthel index (BI) scores using univariate analyses. Results Rehabilitation-related questions arose more frequently in older patients (p = 0.011), in patients with slow-growth vs. rapid-growth tumor (p = 0.002), and in patients with skeletal-related events (p = 0.001) at MDTB. The tumor growth speed was associated with the change in BI scores, as slower-growth tumors had the benefit of BI gains (p = 0.017). Conclusions Regarding rehabilitation in patients with skeletal metastasis, we should pay attention to three parameters: occurrence of skeletal events, patient age, and growth speed of tumors. Rehabilitation-related questions may reflect patients’ functional needs that occur more frequently in patients with pathological fractures or neurological symptoms, older patients, and patients with slow-growth tumors. Keywords Impairments . Cancer rehabilitation . Multidisciplinary tumor boards
Background Advancements in cancer treatment markedly improved the survival of cancer patients. The number of cancer survivors is rapidly increasing in many countries. Therefore, physiatrists have more significant numbers of opportunities to treat cancer survivors [1–4]. Cancer rehabilitation medicine is a * Akira Kido [email protected] 1
Department of Rehabilitation Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
2
Department of Orthopedic Surgery, Nara Medical University, Nara, Japan
3
Department of Radiation Oncology, Nara Medical University, Nara, Japan
subspecialty of physical medicine and rehabilitation (PM&R) that can optimally address the functional needs of patients who have a set of impairments, partially due to the primary disease, and partly due to the adverse ef
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