Do Outpatient Rehabilitation Interventions Improve The Functional Capacity And Quality Of Life Of Colorectal Cancer Survivors?

Colorectal cancer (CRC) is among the leading causes of mortality and morbidity representing a major public health problem. Globally, it is the third most commonly diagnosed cancer in male patients and the second in female ones. Internationally, its incidence is characterized by a wide geographical variation, with almost 55% of the cases being diagnosed in Western countries. In contrast, the incidence and the number of new deaths in Bulgaria, 28.5 and 2,687 (14.04), respectively, are still among the highest in Balkan countries and EU countries as well. Adenocarcinomas originating from epithelial cells of the colorectal mucosa comprise more than 90% of all CRCs. Other types of CRCs include neuroendocrine, squamous cell, adenosquamous, spindle cell, and undifferentiated carcinomas. Recently, the surgical treatment of CRC has made great progress. However, about 50% of patients relapse after treatment, indicating that improving the treatment of CRC with several rehabilitation interventions is still necessary. Rehabilitation is defined as the secret weapon in the holistic management of patients with cancers, aiming to restore mental and/or physical abilities, which might have been lost due to injury or disease, so that the individual is able to lead a normal or near-normal life. Cancer survivors and patients with terminal diseases are highly dependent on rehabilitation in order to optimize quality of life (QoL) and still preserve their dignity. Rehabilitation is an immanent team process that should be integrated throughout the oncology care continuum and delivered by a dedicated physical and rehabilitation medicine (PRM) team. There is an increased demand for a patient-centered approach, tailored to the CRC survivor’s individual needs and wants, which will allow optimal physical, psychological, social, and professional functioning within the limits imposed by cancer and its treatment, as well as maximize the independence and QoL

Conventional physical therapy combined with extracorporeal shock wave leads to positive effects on spasticity in stroke survivors: a prospective observational study

The study aimed to evaluate the effectiveness of radial extracorporeal shock wave therapy (rESWT) and conventional physical therapy (CPT) protocol on the gait pattern in stroke survivors through a new gait analysis technology. Fifteen (n=15) stroke survivors took part in this prospective, observational study and were assessed clinically and through an instrumented treadmill before and after rESWT and CPT. Spasticity grade 95% CI 0.93 (0.79 +/- 1.08), pain intensity 95% CI 1.60 (1.19 +/- 2.01), and clonus score decreased significantly 95% CI 1.13 (0.72 +/- 1.54). The sensorimotor function 95% CI -2.53 (-3.42 +/- 1.65), balance 95% CI -5.67 (-6.64 +/- - 4.69), and gait parameters were enhanced at the end of the program. Step length 95% CI -3.47 (-6.48 +/- 0.46) and step cycle were improved 95% CI -0.09 (-0.17 +/- -0.01), and hip 95% CI -3.90 (-6.92 +/- -0.88), knee 95% CI -2.08 (-3.84 +/- -0.32) and ankle flexion-extension 95% CI -2.08 (-6.64 +/- -4.69) were augmented. Adding the quantitative analysis to the clinical assessment, we gained easy access to track progress and obtained an individualized therapeutic approach for stroke survivors