Lymphedema Surveillance and Prevention.

ABSTRACT: Lymphedema is a chronic condition, which can impact a person's quality of life and function. Identifying lymphedema at an early stage is key to preventing a person from developing chronic lymphedema. Physiatry can play an important role in education, identification of risk factors, performing prospective lymphedema surveillance programs, and prevention/treatment of lymphedema. Incorporating lymphedema surveillance programs into routine cancer care provides physiatry with the opportunity to assess additional rehabilitation and functional needs of a cancer patient.

Fractured Knowledge: Making Sense of Exercise in Patients With Bone Metastases.

PURPOSE: Traditional dogma suggests that individuals with cancer-related bone metastases should restrict their physical activity, potentially engaging cautiously in isometric exercises. However, occurrences of adverse skeletal events during supervised exercise in patients with known metastatic bone lesions are exceedingly rare, contrasting with the substantial risks of inactivity. Recent studies advocate for well-designed exercise regimens for individuals with bone metastases, highlighting the potential benefits of enhanced mental well-being, fatigue mitigation, enhanced physical function, and an overall improved quality of life. As cancer rehabilitation physicians, it falls within our scope of practice to diagnose, assess, and manage risk while emphasizing the role of exercise and rehabilitation therapies, accompanied by necessary precautions, for individuals with metastatic cancer. This review aims to explore the safety and feasibility of exercise interventions for individuals affected by metastatic bone disease.

Caregivers as Interventionists and Trainers: Teaching Mands to Children with Developmental Disabilities.

We evaluated the use of behavioral skills training (BST) to train caregivers to conduct procedures commonly associated with mand training. We trained two caregivers on the following procedures: (a) conducting preference assessments, (b) delivering preferred items contingent on appropriate behavior, (c) capturing and contriving motivating operations, (d) conducting probes to assess the child's current mand repertoire, (e) errorless prompting procedures using echoic prompts, (f) vocal shaping, (g) collecting data, and (h) correcting errors. We also assessed whether a trained caregiver could in turn train their spouse on these procedures. We evaluated the effects of the intervention on the frequency of child spontaneous and prompted mands. The three caregivers performed near zero percent accuracy during baseline but increased to above 80 % accuracy with training, and high performance persisted during most maintenance probes. These results were replicated for the parent who received training from their spouse. In addition, spontaneous mands were occurring more frequently than prompted mands by the end of the study. The implications of caregivers implementing mand training procedures based on Skinner's analysis of verbal behavior are discussed.