Post-Oncological

Oncological Program FAQs

What is Prehab?

• Establish baseline measurements
  • For ROM, strength, functional mobility
• Preoperative limb volume measurements
  • in order to screen post-surgery for early signs of lymphedema
• Overall goals of prehab include:
  • Improve treatment tolerance (surgery, chemo, radiation)
  • Reduce impact of symptoms post Treatment (surgery, chemo, radiation)
  • Improve patient compliance and engagement in treatment plan
  • Potentially shorten length of treatment

  Why start Rehab 3 weeks post-surgery?

  • Tissue Healing Phases
  • Patient is transitioning from inflammatory phase to proliferative phase of healing (2+ weeks - 2 months)
  • Immature collagen and elastin is forming and is much easier to work with than mature collagen

  Soft-tissue fibrosis is associated with:

  • Impaired lymphatic regeneration and lymphatic function
  • Impaired lymphatic endothelial cell proliferation
  • Abnormal lymphatic microarchitecture
  • Lymphatic fibrosis Fluid Dynamic Impairments Local injury to lymphatic system

  Decreased transport capacity

  • Inflammatory phase = inc. fluid load at injury site
  • Results:
    • Mixed edema (inflammation + lymph fluid)
      • stage 0/1 Lymphedema
    • Cording issues (Axillary Web Syndrome)
      • fluid becomes trapped in fibrotic tissue (lymphovenous stasis)
      • Results in tissue induration, possible seroma formation, also potential for lymphedema

Improve Functional Mobility

Improved shoulder flexion ROM with exercise 2-3 weeks post-surgery and Abduction ROM with exercise 4 weeks post-surgery

Pain, balance impairment, difficulty with ADL's, inability to return to work all contribute to unnecessary disability for the patient and increase the economic burden to the survivor and society.

Decrease Unnecessary Pain

• Improve muscular mobility in order to prevent onset of Myofascial Pain Syndrome (MPS)
  • 50-60% of patients post mastectomy and lumpectomy develop MPS
• MD Anderson study of 5,836 CA survivors found joint pain as 1 of the top 4 most frequently reported health problems
  • Joint pain- exacerbated with poor posture, immobility and muscle atrophy surrounding the joints