A Systematic Review of Functional Outcomes in Cancer Rehabilitation Research

Authors

• Alix G. Sleight, Cedars-Sinai Medical Center, Department of Physical Medicine & Rehabilitation; Center for Integrated Research in Cancer and Lifestyle (CIRCL), Cedars-Sinai; Samuel Oschin Cancer Center, Cedars-Sinai; National Cancer Institute, Division of Cancer Control and Population Sciences. Electronic address: AlixSleight.Warner@cshs.org.
• Lynn H. Gerber, George Mason University, College of Health and Human Services; Inova Health System, Inova Medicine Services.
• Timothy F. Marshall, Ivy Rehab Network.
• Alicia Livinski, National Institutes of Health Library.
• Catherine M. Alfano, Northwell Health Cancer Institute; Center for Personalized Health; Feinstein Institutes for Medical Research; Dept of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.
• Shana Harrington, University of South Carolina, Arnold School of Public Health.
• Ann Marie Flores, Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University; Robert H. Lurie Comprehensive Cancer center, Cancer Survivorship Institute.
• Aneesha Virani, Northside Hospital, Rehabilitation Department.
• Xiaorong Hu, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health; Rehabilitation Medicine School, Nanjing Medical University.
• Sandra A. Mitchell, Outcomes Research Branch; Division of Cancer Control and Population Sciences; National Cancer Institute.
• Mitra Varedi, St. Jude Children's Research Hospital.
• Melissa Eden, Mayo Clinic, Department of Physical Medicine and Rehabilitation.
• Samah Hayek, Clalit Health Services, Clalit Research Institute, Ramat-Gan, Israel.
• Beverly Reigle, University of Cincinnati Cancer Institute, Cancer Survivorship Program.
• Anya Kerkman, Lincoln Cancer Rehabilitation / CHI Health St. Elizabeth.
• Raquel Neves, Czech Rehabilitation Hospital, United Arab Emirates.
• Kathleen Jablonoski, George Washington University, Milken Institute School of Public Health, Department of Epidemiology and Biostatistics.
• Eileen Hacker, Indiana University School of Nursing, Science of Nursing Care.
• Virginia Sun, Department of Population Sciences and Department of Surgery, City of Hope.
• Robin Newman, Boston University College of Health and Rehabilitation Sciences, Department of Occupational Therapy.
• Karen Kane McDonnell, University of South Carolina, College of Nursing.
• Allison L'Hotta, Washington University in St. Louis, Department of Occupational Therapy.
• Alana Schoenhals, University of Southern California, Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy.
• Nicole L. Stout, West Virginia University Cancer Institute, West Virginia University School of Public Health; National Institutes of Health, Clinical Center, Rehabilitation Medicine Department.

Document Type

Journal Article

Publication Date

1-29-2022

Journal

Archives of physical medicine and rehabilitation

DOI

10.1016/j.apmr.2022.01.142

Keywords

functional status; neoplasms; rehabilitation; systematic review

Abstract

OBJECTIVE: To systematically review the evidence regarding rehabilitation interventions targeting optimal physical or cognitive function in adults with a history of cancer, and describe the breadth of evidence as well as strengths and limitations across a range of functional domains DATA SOURCES: PubMed, CINAHL Plus, Scopus, Web of Science, EMBASE. The time scope was January 2008 - April 2019. STUDY SELECTION: Prospective, controlled trials including single- and multi-arm cohorts investigating rehabilitative interventions for cancer survivors at any point in the continuum of care were included, if studies included a primary functional outcome measure. Secondary data analyses and pilot/feasibility studies were excluded. Full text review identified 362 studies for inclusion. DATA EXTRACTION: Extraction was performed by co-author teams, and quality and bias assessed using the American Academy of Neurology (AAN) Classification of Evidence Scheme (Class I-IV). DATA SYNTHESIS: Studies for which the functional primary endpoint achieved significance were categorized into 9 functional areas foundational to cancer rehabilitation: 1) quality of life (109 studies); 2) activities of daily living (61 studies); 3) fatigue (59 studies); 4) functional mobility (55 studies); 5) exercise behavior (37 studies); 6) cognition (20 studies); 7) communication (10 studies); 8) sexual function (6 studies); and 9) return to work (5 studies). Most studies were categorized as class III in quality/bias. Averaging results found within each of the functional domains, 71% of studies reported statistically significant results following cancer rehabilitation intervention(s) for at least one functional outcome. CONCLUSIONS: These findings provide evidence supporting the efficacy of rehabilitative interventions for individuals with a cancer history. The findings should be balanced with the understanding that many studies had moderate risk of bias and/or limitations in study quality by AAN criteria. These results may provide a foundation for future work to establish clinical practice guidelines for rehabilitative interventions across cancer disease types.

APA Citation

Sleight, Alix G.; Gerber, Lynn H.; Marshall, Timothy F.; Livinski, Alicia; Alfano, Catherine M.; Harrington, Shana; Flores, Ann Marie; Virani, Aneesha; Hu, Xiaorong; Mitchell, Sandra A.; Varedi, Mitra; Eden, Melissa; Hayek, Samah; Reigle, Beverly; Kerkman, Anya; Neves, Raquel; Jablonoski, Kathleen; Hacker, Eileen; Sun, Virginia; Newman, Robin; McDonnell, Karen Kane; L'Hotta, Allison; Schoenhals, Alana; and Stout, Nicole L., "A Systematic Review of Functional Outcomes in Cancer Rehabilitation Research" (2022). GW Authored Works. Paper 213.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/213

Department

School of Medicine and Health Sciences Student Works