End of Life Care : Role of Physical Therapy intervention Within Hospice Palliative Care
Bibliographic record
Abstract
BackgroundPalliative care (PC) and best Supportive Care are complex areas to promote and advance. Many people need and benefit from them, therefore education, spreading knowledge and existence of interdisciplinary teams (IDT) are required to ensure best quality of life.Nowadays only 15% of Countries haveHospice and Palliative Care (HPC) integrated inside their national health system. Among those countries, fewoffer physical therapies.Complementary and other non-pharmacological strategies used alongsidetraditional analgesic approach aims to help patients in maintaining and improving functionality in order to obtain at the same time psychological benefits.Physical therapies (PT) are part of a no pharmacological approach, including several different techniques applied by physical therapists (PTs) with the purpose not only to manage the symptoms but also to improve Quality Of Life (QOL) of patients receivingpain rehabilitation and palliative care. It allows PTs to be part of an IDT and being active part of the holistic care of the patient.AimsLinking PC with physical rehabilitation or physical exercise (PE), the aim was to critically evaluate the evidence for the effectiveness, benefits and weaknesses of PT (exercise) in end-of-life care.Due to the results obtained and the strength of the evidence, the author suggests a first protocol involving an IDT to best fit the evidence.MethodsA systematic review has been conducted, screening and reviewing the most recent studies published and related to this topic. More than 10 among databases and journals has been investigated to answer the aim.ResultsEight studies fitted for the analysis discussing the role of physical therapy intervention in palliative care setting. The quality of the studies was done following QASP/CASP checklists.Improvements (p u2264 0.01) were observed in physical performance, fatigue, and overall quality-of-life scores. A first physical exercise programme is suggested.ConclusionsAn holistic biopsychosocial intervention (Total Pain concept) is the key for those people withcomplex and life-threatening illnesses. Not only for patients but also for the caregivers underlying the importance of a IDT. PTs play an important role inside a team focusing their intervention in improving functionality and QOL turning tophysical and functional dimensions of care.Around 75% of the population will need PC therefore it is indispensable to start offering i) the best services, ii) where patients want, iii) taking the best decisions (right care, right place, right time).PT/PE plan has to be tailor-made and based on the general prospective evolution of the patient, in his capability to recover his functionality and his desire to take part to the rehabilitation programme.References:Chong Guan, N., Kiah Tian, L., Seng Beng, T., Ahmad Hatim, S. and Nor Zuraida, Z. (2016). The Effect of 5 Minutes of Mindful Breathing to the Perception of Distress and Physiological Responses in Palliative Care Cancer Patients: A Randomized Controlled Study. Journal of Palliative Medicine 19:917.IASP. (2009). Global Year Against Cancer Pain. IASP: International Association for the Study of Pain.Jensen, W., Bialy, L., Ketels, G., Freerk T. Baumann, F. T. and Bokemeyer, C. (2014). Physical exercise and therapy in terminally ill cancer patients: a retrospective feasibility analysis. Supportive Care in Cancer 22:1261-1268.Litterini, A. J., Fieler, V. K., Cavanaugh, J. T. and Lee, J. Q. (2013). Differential effects of cardiovascular and resistance exercise on functional mobility in individuals with advanced cancer: a randomized trial. Arch Phys Med Rehabil 94:2329-2335.Malcolm, L., Mein, G., Jones, A., Talbot-Rice, H., Maddocks, M. and Bristowe, K. (2016). Strength in numbers: patient experiences of group exercise within hospice palliative care. BMC Palliative Care 15:97.McGrillen, K. and McCorry, N. (2014). A physical exercise programme for palliative care patients in a clinical setting: Observations and preliminary findings. Progress in Palliative Care 22:352-358.Putt, K., Faville, K. A., Lewis, D., McAllister, K., Pietro, M. and Radwan, A. (2017). Role of Physical Therapy Intervention in Patients With Life-Threatening Illnesses. Am J Hosp Palliat Care 34:186-196.Saunders, C. (1993). The Management of Terminal Malignant Disease. Edward Arnold, p. 305.Talbot Rice, H., Malcolm, L., Norman, K., Jones, A., Lee, K., Preston, G., McKenzie, D. et al. (2014). An evaluation of the St Christopher's Hospice rehabilitation gym circuits classes: Patient uptake, outcomes, and feedback. Progress in Palliative Care 22:319-326.Turner, F., Seiger, C. and Devine, N. (2013). Impact of patient and caregiver transfer training provided by a physical therapist in the hospice setting: a case study. Am J Hosp Palliat Care 30:204-209.Wilson, C. M., Stiller, C. H., Doherty, D. J. and Thompson, K. A. (2017). The Role of Physical Therapists Within Hospice and Palliative Care in the United States and Canada. Am J Hosp Palliat Care 34:34-41.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.016 | 0.010 |
| Science and technology studies | 0.000 | 0.003 |
| Scholarly communication | 0.002 | 0.010 |
| Open science | 0.012 | 0.008 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".