Cancer rehabilitation: current trends and practices within an Austrian University Hospital Center.

Background: Cancer rehabilitation has the goal to improve functional status, quality of life, participation, and can improve quality of patient-centered programs and health care efficiencies. In Austria, inpatient cancer rehabilitation is well established but outpatient rehabilitation has not yet established well.Methods: The present article is describing current rehabilitation in practice and focuses on cancer rehabilitation in Austria, namely bringing together a descriptive account of current trends and practices within an Austrian University Hospital Center (General Hospital of Vienna linked to the Medical University of Vienna) and the Comprehensive Cancer Centre (CCC) Vienna, Austria.Results: Cancer Rehabilitation in the described Austrian University Hospital Center is well developed due to the help of all different clinics dealing with cancer patients and of the opinion leaders of the CCC Vienna. The Department of Physical Medicine, Rehabilitation, and Occupational Medicine of the Medical University of Vienna as a part of the CCC Vienna with his "Pioneer-Status" and the described milestones has been integrated in the national cancer rehabilitation concept of our country from the beginning.Conclusions: Also in Austria, Physical Medicine and Rehabilitation with competencies in diagnostic and therapy as well as of coordination of the multiprofessional and interdisciplinary rehabilitation teams is an important part of cancer rehabilitation.Implications for rehabilitationCancer rehabilitation is an important part in the treatment and care of cancer patients with the goal to improve functional status, quality of life, and participationCancer rehabilitation helps cancer survivors to be integrated in their normal live, namely to increase social participation and/or workabilityThe field of Physical Medicine and Rehabilitation with competencies in diagnostic and therapy as well as of coordination of the multi-professional and interdisciplinary rehabilitation teams is an important part of cancer rehabilitationInterventions and treatment approaches from the field of Physical Medicine and rehabilitation include the application of Physical Modalities like electrotherapy, thermotherapy, balneology and climatic therapy, phototherapy, and mechanotherapy Cancer rehabilitation has to be early integrated into the cancer care continuum.

Typical aspects in the rehabilitation of cancer patients suffering from metastatic bone disease or multiple myeloma.

BACKGROUND: The aim of this study was to present a practical concept focusing on typical aspects of regular physical activity, exercise and physical modalities for patients suffering from metastatic bone disease or multiple myeloma. METHODS: A narrative review of the relevant scientific literature and presentation of clinical experiences. RESULTS: In cancer patients with metastatic bone disease or multiple myeloma, pain is treated in an interdisciplinary and multimodal setting by using medication, radiotherapy and physical medical modalities (e.g. transcutaneous electrical nerve stimulation); however, modalities increasing local blood flow, such as ultrasound therapy, thermotherapy, massage, various electrotherapy options, are not performed at the site of the tumor. For physical activity and exercise, a suitable indication of the static and dynamic capacity of the affected skeletal structures is essential. This process includes strategies to maintain and improve mobility and independence. Individually tailored and adapted physical activity and exercise concepts (programs) within a multidisciplinary and interdisciplinary setting (tumor board) are used to manage the condition and bone load-bearing capacity of the patient. Typical clinical features and complications, such as pathological fractures in patients suffering from metastatic bone disease and additionally hypercalcemia, monoclonal gammopathy with bone marrow aplasia and risk of renal failure in patients with multiple myeloma have to be considered when planning supportive strategies and rehabilitation. CONCLUSION: In order to ensure the safety and effectiveness of regular physical activity, exercise, and physical modalities in patients with metastatic bone disease or multiple myeloma, typical contraindications and considerations should be noted.

Neuromuscular electrical stimulation of the thighs in cardiac patients with implantable cardioverter defibrillators.

BACKGROUND: The aim of this systematic review was to update scientific knowledge concerning the safety of neuromuscular electrical stimulation (NMES) to increase exercise capacity and prevent cardiac cachexia in patients with implantable cardioverter defibrillators (ICDs). METHODS: A systematic review including the electronic databases PubMed, MEDLINE, and SCOPUS was conducted for the time period from 1966 to March 31, 2016. RESULTS: Only four articles fulfilled the inclusion criteria (three original articles/safety studies and one case report). The three (safety) studies used NMES to increase muscle strength and/or endurance capacity of the thighs. NMES did not show electromagnetic interference (EMI) with ICD function. EMI was described in a case report of 2 patients with subpectoral ICDs and application of NMES on abdominal muscles. CONCLUSION: This review indicates that NMES may be applied in cardiac ICD patients if 1) individual risks (e. g., pacing dependency, acute heart failure, unstable angina, ventricular arrhythmic episode in the last 3 months) are excluded by performing a safety check before starting NMES treatment and 2) "passive" exercise using NMES is performed only for thighs and gluteal muscles in 3) compliant ICD patients (especially for home-based NMES) and 4) the treatment is regularly supervised by a physician and the device is examined after the first use of NMES to exclude EMI. Nevertheless, further studies including larger sample sizes are necessary to exclude any risk when NMES is used in this patient group.

Use of mental techniques for competition and recovery in professional athletes.

BACKGROUND: The present study aims to describe knowledge about and usage of mental techniques to prepare before competitions and after sport-associated injuries (SAIs) by professional athletes (team sports) in Austria. METHODS: In this cross-sectional study, 191 professional athletes (basketball, football, hockey, ice hockey, and volleyball teams, m:f = 142:49, 24 ± 5, 18-39 years) filled in a questionnaire assessing socio-demographic data, duration/frequency of sport practice, rate and severity of SAIs. Furthermore, the use of mental techniques and of spiritual practices before competitions and for recovery after SAI was assessed. The use of mental techniques before competitions and after SAI was correlated with socio-demographic data, duration and frequency of sport practice, and injury patterns of SAIs of the last 24 months. RESULTS: Approximately, 96 % reported knowledge about at least one mental technique. Only 13 participants used them for regeneration after SAI. Approximately, 31 % of males and 13 % of females reported the use before competitions (p = 0.017). 54 % of participants using spiritual practices used mental techniques before competitions, whereas only 13 % of participants not using spiritual practices used them (p < 0.001). 67 % of participants not using mental techniques before competitions and 88 % using them believed in the effectiveness of mental techniques in the regeneration after a SAI (p = 0.03). A significant increase of the probability of using mental techniques before competition with increasing age was found [Odds ratio (OR) = 1.101, confidence interval (CI) = (1.03, 1.18), p = 0.006]. CONCLUSION: Mental techniques seem to be well-accepted but rarely used among professional athletes. Further studies are needed to give new information about this relevant topic in professional sports.