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Physical Therapy Interventions for Children and Adolescents with Cancer: Collating the Evidence from Research and Clinical Practice

  • Author / Creator
    Ospina Lopez, Paula A
  • Purpose: Children and adolescents with cancer who undergo cancer treatment are at high risk of developing serious late and long-term physical effects, many of which may be amenable to physical therapy (PT). Little is known about the benefits of PT or the services currently provided to address late and long-term effects of cancer and its treatments. This study aims to collate and synthesize the research evidence and current clinical rehabilitation practices to inform a strategy to guide future research in pediatric oncology PT. Methods: A two-phase study was conducted. Phase I consisted of a scoping review on PT interventions including studies indexed in three relevant databases (MEDLINE, EMBASE, and PEDro) from January 2002 to October 2017. Based on the findings, a protocol was developed for a Cochrane Systematic Review to further examine PT interventions for children and adolescents with cancer. Phase II involved a cross-sectional web-based survey administered to healthcare professionals (HCPs) who provide and/or refer children and adolescents with cancer to physical rehabilitation (PR) services. Results: Phase I - A total of 12 papers were included in the scoping review, with studies supporting feasibility of PT. Findings demonstrate a (1) lack of high quality research; and (2) wide variability of studies in terms of patient populations, interventions and chosen outcomes, limiting our ability to synthesize the findings and make recommendations for clinical practice. A systematic review protocol was developed to further evaluate research quality and provide direction for future research. Phase II - A total of 54 responses were received including responses from PTs (n= 27), nurses (n= 10), oncologists and oncology residents (n= 9), occupational therapists (n= 6), a speech-language pathologist (n= 1), and an exercise professional (n= 1). Expertise in pediatric oncology PR exists among PR HCPs working across the country. However, the majority of the PR interventions reported were primarily physical exercise interventions. Limitations in activities, alterations in motor performance, muscle weakness and peripheral neuropathy were reported as top priorities for PR programs. Funding/resources (18.8%), inappropriate space for PR (17.4%), and staffing (16%) were reported as barriers to the provision of PR services. Conclusions: This thesis work serves as a guide to future research in the field. Given the low numbers of children diagnosed with cancer, collaborative efforts are needed on the part of researchers and clinicians to propose and conduct multicenter trials to further the field of pediatric oncology PT.

  • Subjects / Keywords
  • Graduation date
    2018-06
  • Type of Item
    Thesis
  • Degree
    Master of Science
  • DOI
    https://doi.org/10.7939/R3JD4Q46V
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.