Efficacy of pulsed electromagnetic field therapy on pain and physical function in patients with non-specific low back pain: a systematic review.

INTRODUCTION: Non-specific low back pain is a common and clinically significant condition with substantial socioeconomic implications. Pulsed electromagnetic field (PEMF) therapy has shown benefits in pain reduction and improvement of physical function in patients with pain-associated disorders like osteoarthritis. However, studies had heterogeneous settings. The aim of this study was to assess the effects of PEMF on pain and function on patients with non-specific low back pain. METHODS: A systematic literature search of randomized controlled trials in PubMed, MEDLINE, EMBASE, Cochrane Library, and PEDro was performed (from inception until 15/5/2023). Outcome measures assessed pain and function. RESULTS: Nine randomized controlled trials with 420 participants (n = 420) were included. The studies compared PEMF vs. placebo-PEMF, PEMF and conventional physical therapy vs. conventional physical therapy alone, PEMF and conventional physical therapy vs. placebo-PEMF and conventional physical therapy, PEMF vs. high-intensity laser therapy (HILT) vs. conventional physical therapy, and osteopathic manipulative treatment (OMT) and PEMF vs. PEMF alone vs. placebo-PEMF vs. OMT alone. Five of the nine included studies showed statistically significant pain reduction and improvement in physical function in comparison to their control groups (p < 0.05). There was substantial heterogeneity among the groups of the study, with a wide range of duration (10-30 min), treatments per week (2-7/week), applied frequencies (3-50 Hz), and intensities (2mT-150mT). No serious adverse event had been reported in any study. The included studies showed solid methodological quality, with an overall score of 7.2 points according to the PEDro scale. CONCLUSION: PEMF therapy seems to be a safe and beneficial treatment option for non-specific low back pain, particularly if used as an addition to conventional physical therapy modalities. Future research should focus on standardized settings including assessment methods, treatment regimens, frequencies, and intensities.

Effects of whole-body vibration therapy on pain, functionality, postural stability, and proprioception in patients with subacute and chronic non-specific low back pain: a systematic review.

INTRODUCTION: Non-specific low back pain (NLBP) is a common and clinically significant condition with substantial socioeconomic implications. Whole-body vibration therapy (WBVT) has shown effectiveness in improving pain and sensorimotor function (e.g., in osteoporosis) in previous studies. However, studies had heterogeneous settings. The aim of this study was to assess the effects of WBVT on pain, function, proprioception, and postural stability in patients with subacute and chronic NLBP. METHODS: A systematic literature search was conducted in the scientific databases PubMed, EMBASE, and PEDro (from inception until 17.05.2023). Only prospective controlled and uncontrolled studies were included. Outcome measures assessed were pain intensity, function (activities of daily living and physical function), proprioception, and postural stability. RESULTS: A total of 12 original articles (n = 821) were included in the analysis. Ten of the studies were randomized controlled trials, one study had a crossover design, and one study had a one-group pre-post study design. The studies compared WBVT vs. no intervention, WBVT vs. basic physical therapy, WBVT vs. core stabilization exercises with and without respiratory resistance, WBVT vs. lumbar extension exercises, and WBVT vs. whole body electromyostimulation training. The treatment approaches varied in terms of duration (2-18 weeks), frequency (2-3 times per week, two applications with a 2-week break), vibration frequency (5-30 Hz), type of exercises (WBVT with or without static or dynamic exercises), and vibration direction (horizontal and vertical). Significant pain reduction was observed in all 10 studies that investigated pain levels. Significant improvement in daily activity function was reported in five of the six studies that investigated daily function, while improvement in physical function was observed in all four studies that investigated physical function. Improvement in proprioception was reported in all three studies that investigated proprioception, and significant improvement in postural stability was observed in four out of six studies that investigated postural stability. No adverse events or side effects related to WBVT were reported. CONCLUSION: The majority of the included studies demonstrated significant pain reduction, improvement in physical and daily functioning, and enhanced proprioception. Improvement in postural stability was less consistent. WBVT appears to be a safe and effective treatment modality for subacute and chronic NLBP when used within a multimodal approach. Future research should focus on standardized settings including assessment methods, treatment regimens, frequencies, and intensities.

Prescribing Exercise to Cancer Patients Suffering from Increased Bone Fracture Risk Due to Metastatic Bone Disease or Multiple Myeloma in Austria-An Inter- and Multidisciplinary Evaluation Measure.

INTRODUCTION: In the current absence of specific functional fracture risk assessment technology, the planning of physical exercise interventions for cancer patients suffering from increased bone fracture risk remains a serious clinical challenge. Until a reliable, solely technical solution is available for the clinician, fracture risk assessment remains an inter- and multidisciplinary decision to be made by various medical experts. The aim of this short paper is depicting how this challenge should be approached in the clinical reality according to Austrian experts in cancer rehabilitation, presenting the best-practice model in Austria. Following referral from the specialist responsible for the primary cancer treatment (oncologist, surgeon, etc.), the physiatrist takes on the role of rehabilitation case manager for each individual patient. Fracture risk assessment is then undertaken by specialists in radiology, orthopedics, oncology, and radiation therapy, with the result that the affected bone regions are classified as being at highly/slightly/not increased fracture risk. Following internal clearance, exercise planning is undertaken by a specialist in exercise therapy together with the physiatrist based on the individual's fracture risk assessment. In the case in which the patient shows exercise limitations due to additional musculoskeletal impairments, adjuvant physical modalities such as physiotherapy should be prescribed to increase exercisability. CONCLUSION: Exercise prescription for cancer patients suffering from increased fracture risk is an inter- and multidisciplinary team decision for each individual patient.

Impact of self-determination theory in a physiotherapeutic training : A pilot-study on motivation for movement of obese adolescents.

BACKGROUND: This study determined to what extent the underpinning of physiotherapeutic interventions with the evidence-based motivational psychological concept of the self-determination theory (SDT) by Ryan and Deci can increase motivation and enjoyment of movement in obese adolescents. METHODS: In this study 12 obese adolescents aged 14-18 years were offered a targeted group-specific sports program including a home exercise program of 8 weeks. The group leaders were trained in the SDT and supported to integrate motivational aspects. A SDT-based questionnaire by Kohake and Lehnert was used to evaluate motivational interventions. RESULTS: In total, seven (58%) patients finished the study. In the before-after comparison there were little changes in motivation. Results showed that contrary to expectations the motivation of the obese adolescents to move and to participate in the study was generally high. In the study, more internalized forms of motivation dominated, the highest quality form of motivation. CONCLUSION: Digital technologies could be a successful way to further increase motivation and compliance of our target group. This MotiMove study is a basis for future research programs and empower physiotherapists and movement experts to develop and implement training programs for obese adolescents and children.

The effect of biofeedback on smoking cessation-a systematic short review.

PURPOSE: The aim of this systematic review was to focus on the effect of biofeedback on smoking cessation. MATERIAL AND METHODS: This review was conducted following the PRISMA guidelines. Peer-reviewed original articles including biofeedback and/or neurofeedback training as an intervention for smoking cessation were included. The PubMed, MEDLINE, Web of Science, Scopus, and Cochrane Library databases were screened for trials published up to July 2021. The effects on smoking rates and smoking behavior, and biofeedback/neurofeedback training measures are summarized here. RESULTS: In total, three articles fulfilled the inclusion criteria. The total Downs and Black checklist scores ranged from 11 to 23 points, showing that the articles were of poor to good methodological quality. The included studies were heterogeneous, both in terms of treatment protocols and in terms of outcome parameters. Pooling of data for a meta-analysis was not possible. Therefore, we were limited to describing the included studies. The included biofeedback study demonstrated that skin temperature training might improve the patients' ability to raise their skin temperature aiming at stress alleviation. All three studies reported positive effects of biofeedback/neurofeedback in supporting smokers to quit. Furthermore, individualized electroencephalography neurofeedback training showed promising results in one study in modulating craving-related responses. CONCLUSION: The results of the present review suggest that biofeedback/neurofeedback training might facilitate smoking cessation by changing behavioral outcomes. Although the investigated studies contained heterogeneous methodologies, they showed interesting approaches that could be further investigated and elaborated. To improve the scientific evidence, prospective randomized controlled trials are needed to investigate biofeedback/neurofeedback in clinical settings for smoking cessation.

Effectiveness of focused extracorporeal shock wave therapy in the treatment of carpal tunnel syndrome : A randomized, placebo-controlled pilot study.

BACKGROUND: The carpal tunnel syndrome is the most common entrapment neuropathy in the general population. A conservative treatment should be considered in mild to moderate cases. The aim of this study was to assess the effect of a focused extracorporeal shock wave therapy in the treatment of mild to moderate carpal tunnel syndrome. MATERIAL AND METHODS: In this study 30 patients were randomly assigned into 2 groups. Subjects in the study group received three sessions of focused extracorporeal shock wave therapy, whereas the control group underwent a sham therapy. Patients were evaluated 3 and 12 weeks after treatment. The primary outcome was the visual analogue scale score. Secondary outcome measurements included hand grip strength, Boston Carpal Tunnel Syndrome Questionnaire, SF-36 Health Survey and electrodiagnostic measurements. RESULTS: A significant improvement of visual analogue scale at week 3 (p = 0.018) and week 12 (p = 0.007) as well as hand grip strength at week 12 (p = 0.019) could be observed in the study group. The study group showed a significantly better sensory nerve conduction velocity at week 12 than the control group, before correcting for multiple testing, and also a significant improvement in distal motor latency of the median nerve at week 12 (p = 0.009) as well as in both questionnaires (SF-36 subscale bodily pain, p = 0.020 and severity symptom scale, p = 0.003). No such improvement was observed in the control group. CONCLUSION: Focused extracorporeal shock wave therapy is an effective and noninvasive treatment method for mild to moderate carpal tunnel syndrome.

Can reminders improve adherence to regular physical activity and exercise recommendations in people over 60 years old? : A randomized controlled study.

PURPOSE: The purpose of the study was to investigate whether additional reminders could enhance adherence to a 12-week program consisting of regular physical activity. METHODS: The study collective consisted of pensioners insured with the Austrian Insurance Fund for Civil or Public Servants. They were made aware of our program through the public service union. The subjects were randomized to an intervention group (group A) that received reminders and to a control group (group B) that did not receive such notifications. Adherence to physical activity was assessed by the use of diaries. RESULTS: Group A performed 96 min more moderate intensity regular physical activity per week than group B (group A median 269 min, r = 0-1560 min; group B median 173 min, r = 0-2700 min). The Mann-Whitney U-test showed no significant differences (p = 0.080) between the study groups. There was no difference in muscle strengthening activity (group A: median: 2, r = 0-13 sessions; group B: median: 2, r = 0-20 sessions). CONCLUSION: The major positive observation was that both the experimental and control group participants exceeded the recommended level of physical activity. Nevertheless, there were some differences concerning the minutes of physical activity performed in favor of the intervention group.

Resistance exercise and breast cancer-related lymphedema-a systematic review update and meta-analysis.

BACKGROUND: The purpose of this systematic review update and meta-analysis was to analyze resistance exercise (RE) intervention trials in breast cancer survivors (BCS) regarding their effect on breast cancer-related lymphedema (BCRL) status and upper and lower extremity strength. METHODS: Systematic literature search was conducted utilizing PubMed, MEDLINE, and Embase databases. Any exercise intervention studies-both randomized controlled and uncontrolled-which assessed the effects of RE on BCRL in BCS in at least one intervention group published between 1966 and 31st January 2020 were included. Included articles were analyzed regarding their level of evidence and their methodological quality using respective tools for randomized and nonrandomized trials of the Cochrane collaboration. Meta-analysis for bioimpedance spectroscopy (BIS) values as well as upper and lower extremity strength was conducted. RESULTS: Altogether, 29 studies were included in the systematic review. Results of six studies with altogether twelve RE intervention groups could be pooled for meta-analysis of the BCRL. A significant reduction of BCRL after RE was seen in BIS values (95% CI - 1.10 [- 2.19, - 0.01] L-Dex score). Furthermore, strength results of six studies could be pooled and meta-analysis showed significant improvements of muscular strength in the upper and lower extremities (95% CI 8.96 [3.42, 14.51] kg and 95% CI 23.42 [11.95, 34.88] kg, respectively). CONCLUSION: RE does not have a systematic negative effect on BCRL and, on the contrary, potentially decreases it.

First exercise group for Turkish breast cancer patients in Vienna - a pilot project to include Turkish migrants.

Background: The aim of this pilot study was to describe the acceptance and feasibility of an exercise intervention in breast cancer patients of Turkish origin in Austria by using a hand-held swinging-ring system.Methods: The inclusion period lasted 1 year (1 February 2016-31 January 2017). In a multicentre cooperation, Turkish female breast cancer patients were included by using face-to-face information, email, facebook®, phone, and notice boards. The exercise program consisted of 1) supervised and 2) home-based exercise by using the smovey® vibroswing system. Feasibility and acceptance were assessed by using the Austrian school grading system and a qualitative approach after 3 months. Furthermore, the six-minute walk test (6MWT), handgrip strength, body composition (BIA), and health-related quality of life (QOL) were assessed at baseline (T0) and after 3 months (T1).Results: Only 5 breast cancer patients could be included, from whom one dropped out due to breast cancer recurrence. The exercise intervention showed no side effects and was well accepted by all 4 patients. Furthermore, results of the 6MWT, handgrip strength, BIA, and QOL improved.Conclusion: These results indicate notable barriers towards regular physical activity in female Turkish breast cancer patients in Austria. Four out of five of those involved were comfortable with the intervention. Therefore, it seems to be essential to further address these barriers in order to plan and implement effective interventions.Implications for RehabilitationExercise is an effective means of improving health and quality of life experienced by female patients suffering from breast cancer.Although extensive efforts were taken only a minority of Turkish female patients attended a structured exercise program.It seems to be essential to further address barriers to exercise in order to plan and implement effective interventions.

Gait analysis and body composition after treatment of quadriceps tendon ruptures showed equal results independent of suture anchor or transosseus repair technique used: a pilot study.

Purpose: Suture anchor repair is a fairly new surgical technique for quadriceps tendon ruptures. It is supposed to be superior to the standard transosseus sutures because of biomechanical superiority and - due to a less invasive surgery - earlier rehabilitation onset. This study focused on analyzing functionality of the quadriceps muscle during gait as well as body composition between a suture anchor and a transosseus suture repair group and is the first study that undertook systematic gait analyses in this patient population.Materials and methods: Seventeen patients who underwent either suture anchor (9 subjects) or transosseus suture repair surgery (8 subjects) at two different trauma surgery centers between 2010 and 2015 were included. Gait analysis was performed with a three dimensional motion capture system (Vicon) and body composition was assessed with bioelectrical impedance analysis (Nutribox). Parametrical statistical analyses were conducted using independent t-tests.Results: No statistically significant differences were found in any outcome parameter of gait analysis or body composition measurement.Conclusion: Suture anchor repair shows equal results to transosseus suture repair technique regarding gait quality and body composition.Implications for rehabilitationIn a long term follow-up suture anchor repair shows similar results to the transosseus suture technique regarding body composition and musculus quadriceps function in gait.Without the implementation of an appropriate rehabilitation protocol incorporating the earlier load-carrying capacity, early biomechanical advantages of suture anchor technique over transosseus sutures might vanish over time.The decision which surgery technique might be best for the individual patient, should not be based on the expectation that suture anchor repair alone without considering appropriate rehabilitation would lead to long term functional advantages over transosseus suture technique.

Resistance exercise and breast cancer related lymphedema - a systematic review update.

Background: Purpose of this systematic review update was analyzing resistance exercise (RE) intervention trials in breast cancer survivors (BCS) regarding their effect on breast cancer-related lymphedema (BCRL) status. Articles published until 31 September 2017 were included.Methods: A systematic literature search was conducted utilizing PubMed, MEDLINE, and EMBASE databases. Included articles were analyzed regarding their level of evidence and their methodological quality using the Cochrane risk of bias tool.Results: Altogether, 23 articles could be included of which 16 were independent RE intervention studies and seven additional articles. Lymphedema assessment was so heterogeneous that conduction of a thorough meta-analysis regarding lymphedema status was still impossible. In all but one study, which reported a small but methodologically weak increase in arm volume, no negative effects of RE on BCRL was recorded.Conclusions: RE seems to be a safe exercise intervention for BCS and not to be harmful concerning the risk of lymphedema. Lymphedema assessment methods that allow for a qualitative analysis of arm tissue composition should be favored.Implications for rehabilitationBreast cancer-related lymphedema affects a considerable proportion of breast cancer patients and is debilitating on the physical, functional, social, and psychological domain.At the current time breast cancer related lymphedema is incurable but well manageable by a number of physical therapy modalities, especially complete decongestive therapy (CDT).One of the encouraging treatment methods is resistance exercise.

Impact of supportive therapy modalities on heart rate variability in cancer patients - a systematic review.

Purpose: To systematically review literature for interventional studies and their impact on autonomic dysfunction assessed by heart rate variability in cancer patients.Methods: Research was conducted using the databases Medline/Pubmed, Scopus, and Web of science from their inception to October 2017. Original articles with an interventional design that reported changes in at least one heart rate variability parameter as outcome parameter were included and described.Results: Ten studies were identified as eligible for subsequent analysis. The main application field in oncological therapy setting was music therapy intervention, Traditional Chinese Medicine related treatments, exercise interventions, relaxation, and myofascial release techniques. Breast cancer was the most frequently described single cancer entity. Heart rate variability recording was performed with standard electrocardiography devices or wearable heart rate monitors, within a time range between 5 and 20 min and a sampling rate varying from 200 to 1000 Hz. No adverse events were reported in all studies.Conclusions: Supportive therapy modalities may have the potential to enhance vegetative functioning. In this context, heart rate variability analysis appears to be an easily applicable and safe method to evaluate cancer related autonomic dysfunction. More large prospective multicentre randomised controlled trials are needed.Implication for rehabilitationMost cancer patients face autonomic dysfunction due to the disease itself the applied treatments or combination of both.HRV measurement is an easy and safe method to asses autonomic dysfunction.Supportive treatments targeting on an elevation of the vagal tone and autonomic balance in general might have beneficial effects for cancer patients.

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.

Relevant parameters for recommendations of physical activity in patients suffering from multiple myeloma : A pilot study.

PURPOSE: This pilot study aimed to describe physical performance, self-reported physical activity, health-related quality of life, anxiety and depression in patients who were assigned from Austrian self-help groups for multiple myeloma patients. These parameters were then discussed in the context of clinical decision-making concerning the recommended type of regular physical activity and exercise. METHODS: Members of the self-help groups were invited to participate. Physical performance and physical activity were assessed with the 6 min walk test (6MWT), handgrip strength test, timed up and go test (TUG), Tinetti performance oriented mobility assessment (POMA), falls efficacy scale (FES), international physical activity questionnaire (IPAQ), health-related quality of life (EORTC QLQ-C30) and the hospital anxiety and depression scale (HADS). RESULTS: A total of 40 patients (female:male = 15:25, mean age: 63.8 ± 9.0 years, range 41-80 years) were identified. In total 20 (50%) reached the performance of healthy peers in the tests 6MWT, handgrip strength, TUG and POMA, while 50% showed at least 1 result below the reference value or cut-off-point for each test. Self-reported activity levels were high. Patients showed a tendency to overestimate the risk of falling but a case by case analysis revealed a tendency for underestimating the actual performance in the respective tests (TUG, POMA). CONCLUSION: The performance of healthy peers was reached by a substantial number of the participants in tests of physical performance and they reported high levels of physical activity. Nevertheless, they tended to overestimate the specific risk of falling. Patients with notably impaired physical performance might be suitable to perform regular physical activity and exercise in an individual therapy, whereas those with good physical performance are suited for training in exercise groups; however, individual contraindications and clinical considerations should be noted in a multiprofessional and interdisciplinary setting.

Functional outcome after recurrent patellar dislocation : Comparison of two surgical techniques-Medial patellofemoral ligament reconstruction (MPFL) vs. Elmslie Trillat procedure.

BACKGROUND: There is no final consensus regarding the ideal surgical technique for the treatment of patellar dislocation. The aim of this retrospective pilot study was to describe muscle strength, body composition, self-reported physical performance, and pain in male patients after patellar dislocation treatment with two different surgical techniques: medial patellofemoral ligament (MPFL) reconstruction vs. the Elmslie-Trillat procedure. METHODS: Isokinetic testing of knee extensor muscles was performed using a Biodex System 3 pro dynamometer at an angular velocity of 60°/s. Body composition was measured with bioelectrical impedance analysis (Nutribox). Self-reported physical performance and pain were assessed by the SF-36 subscales of physical functioning, role physical and bodily pain. The outcome variables of peak torque normalized to participant's body mass (Nm/kg), lean body mass, phase angle, self-reported physical performance, and pain were compared between the study groups. RESULTS: Of the 12 included male patients, 6 had been treated with MPFL reconstruction (age: median = 33 years, range = 18-38 years; BMI: median = 26 kg/m2, range = 23-29) and 6 with the Elmslie-Trillat procedure (age: median = 26 years, range = 19-32 years; BMI: median = 23 kg/m2, range = 19-28). No statistically significant differences were found between the groups in any outcome parameter of muscle strength, body composition, self-reported physical performance, or pain. CONCLUSIONS: The results of the present pilot study revealed that MPFL reconstruction shows equal results to the Elmslie-Trillat procedure, with respect to isokinetic knee muscle strength, body composition, self-reported physical performance and pain in male patients suffering from recurrent patellar dislocation.

Extracorporeal shock wave therapy in the supportive care and rehabilitation of cancer patients.

PURPOSE: Cancer patients sometimes show immobilizing musculoskeletal conditions which prohibit active exercise due to severe bodily pain. Therefore, before starting a rehabilitative exercise program, the pain has to be reduced to enable the patient to participate actively in the exercise program. Extracorporeal shock wave therapy (ESWT, the application of radial and/or focused shock waves with low or high energy) has been shown to be effective and efficient in the treatment of musculoskeletal disorders. However, one historical paradigm was the fact that, in the past, cancer was seen as a contraindication for the use of ESWT. METHODS: Clinical note to present indications, benefits, and contraindications of shock wave treatment in cancer patients. RESULTS: Malignant tumors in the treatment area have to be seen as a contraindication for the use of ESWT treatment. Cancer itself-in the form of the underlying disease-is not a contraindication for the treatment with radial and focused shock wave therapy with low or high energy. Plantar fasciitis and calcaneal spurs, calcified shoulder, tennis elbow or Achilles tendinopathy, and delayed healing and chronic wounds are typical approved standard indications for ESWT, and are allowed when the malignant tumor is not in the treatment area. There are also other musculoskeletal and non-musculoskeletal indications (e.g., myofascial syndrome, erectile dysfunction, polyneuropathy, and lymphedema) that are relevant for cancer survivors. These indications are recommended by the International Society for Medical Shockwave Treatment (ISMST) for "common empirically tested clinical use" and as exceptional indications/expert indications. CONCLUSION: ESWT is a safe and relevant modality for the supportive care and rehabilitation of cancer patients.

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.

Role of physical medicine for cancer rehabilitation and return to work under the premise of the "Wiedereingliederungsteilzeitgesetz".

BACKGROUND: With the intention of enabling people a phased return to work after long-term sick leave the so-called "Wiedereingliederungsteilzeitgesetz" (WIETZ) was implemented in Austria on 1 July 2017. METHODS: To explore the overall awareness about the WIETZ and the value of physical modalities together with further supporting measures in return to work of cancer survivors, a survey by using a self-constructed questionnaire was performed in 30 experts 6 months after the WIETZ came into force. RESULTS: The awareness of Austrian specialists regarding the WIETZ seems to be excellent. Regarding expert opinions, return to work in cancer survivors is notable hampered in workplaces with great physical stress even in times of the WIETZ, whereas for professions in offices and banks it is easier to return to work, with and without WIETZ. The highest impact on return to work seems to be due to exercise, as an intervention of the field of physical medicine and rehabilitation to improve sensorimotor functions and to increase endurance capacity as well as muscular strength. CONCLUSION: Early information about cancer rehabilitation and the WIETZ seems to be necessary to facilitate return to work of cancer survivors. Furthermore, exercise interventions seem to be the most important measures from the field of physical medicine and rehabilitation.

The first online conference for breast cancer survivors-SURVIVA 2018: an innovative information tool.

PURPOSE: The implementation of a new online conference tool, with the goal of providing competent answers, information, and support from experts in their fields, about diagnosis, treatment, and rehabilitation in breast cancer patients. METHODS: The implementation process and data of the first online conference are described. RESULTS: Following the idea and initiative of a breast cancer survivor, and under the umbrella of a leading oncologist in breast cancer treatment, and with the cooperation of further leading experts in the fields, plus their therapeutic teams, the new online conference SURVIVA 2018 was implemented as an innovative platform-free of charge, online, and with easy and anonymous access-to provide breast cancer survivors with in-depth information and help from the leading Austrian experts in their fields. This first online conference for German-speaking breast cancer survivors is an innovative and modern concept, which seems to have been very well accepted. CONCLUSION: This concept could also be of interest to survivors of other cancer entities.