Detailed Search Results
| Author/Association: | Hunter EG, Gibson RW, Arbesman M, d'Amico M |
| Title: | Systematic review of occupational therapy and adult cancer rehabilitation: part 1. impact of physical activity and symptom management interventions [with consumer summary] |
| Source: | The American Journal of Occupational Therapy 2017 Mar-Apr;71(2):7102100030 |
| Method: | systematic review |
| Method Score: | This is a systematic review. Systematic reviews are not rated. |
| Consumer Summary: | IMPLICATIONS FOR OCCUPATIONAL THERAPY PRACTICE: Most studies in this review are within the scope of occupational therapy practice but lack a focus on important outcomes of function and participation. This evidence should be viewed as indicating initial steps toward achieving functional outcomes and not achievement of the outcomes themselves. Occupational therapy practitioners must interpret and apply this evidence within their unique professional understanding of function, engagement, and participation. Occupational therapy practitioners can use a wellness or health promotion approach to encourage meaningful activity and exercise. AOTA (ND) has called on practitioners to help people prevent and manage chronic disease through a health and wellness model. Practitioners can feel confident in incorporating physical activity into their practice because strong evidence indicates that exercise helps in multiple ways (eg, mental health, physical health, symptom management) and does not make symptoms worse (ie, lymphedema, fatigue). Exercise is clearly beneficial, but it does not have to consist of lifting weights at the gym; yoga and Qigong were found to be beneficial as well. Physical activity is helpful for maintaining weight, increasing muscle strength, improving sleep, and reducing cancer-related fatigue (CRF), among other positive outcomes. Occupational therapy practitioners are well suited to conduct individual and group yoga, Qigong, and mindfulness interventions to improve symptom management, mental health, quality of life, participation in daily living occupations, and social engagement. These are important factors for cancer survivors and are not always addressed as fully as they could be. Practitioners need to keep in mind that cancer survivorship symptom management is far more than lymphedema care. Although this is the symptom rehabilitation professionals have focused on most fully, CRF, pain, sleep disorders, and breathlessness are more common and less often addressed. IMPLICATIONS FOR RESEARCH: More rigorous, better designed research is needed to provide a greater understanding of which people need what type of intervention at what point in their cancer care and survivorship. Specifically, more research is needed that focuses on participation outcomes and occupation-based interventions. The area of exercise is the best researched and has the most robust outcomes in terms of cancer survivorship and cancer rehabilitation, but the occupational therapy focus of participation and occupation is missing in this research. Most of the exercise studies looked at the use of traditional exercise as an intervention; the occupational therapy point of view might provide a richer understanding of how to incorporate the broader idea of physical activity into a client's life. In terms of symptom management, most interventions were not conducted by occupational therapy practitioners. The vast majority were conducted by nurses, social workers, or psychologists. Occupational therapy-specific studies are needed that look at return to participation and occupation-based interventions as they relate to managing symptoms in cancer survivors. In general, few of the studies moved into the realm of occupation, particularly in terms of outcomes. Occupational therapy researchers could make strong contributions toward filling this gap in research. |
| Abstract: | This article is the first part of a systematic review of evidence for the effectiveness of cancer rehabilitation interventions within the scope of occupational therapy that address the activity and participation needs of adult cancer survivors. This article focuses on the importance of physical activity and symptom management. Strong evidence supports the use of exercise for cancer-related fatigue and indicates that lymphedema is not exacerbated by exercise. Moderate evidence supports the use of yoga to relieve anxiety and depression and indicates that exercise as a whole may contribute to a return to precancer levels of sexual activity. The results of this review support inclusion of occupational therapy in cancer rehabilitation and reveal a significant need for more research to explore ways occupational therapy can positively influence the outcomes of cancer survivors. Part 2 of the review also appears in this issue. Copyright by the Amerrican Occupational Therapy Association Inc. Reprinted with permission. Full text (sometimes free) may be available at these link(s):  help |
