PTOTSLPNarrative ReviewPM & R : the journal of injury, function, and rehabilitation2017

A Focused Review of Safety Considerations in Cancer Rehabilitation.

Susan Maltser, Adrian Cristian, Julie K Silver and 2 others

PMID 28942913

WHAT IT FOUND

Cancer rehabilitation safety depends on treatment-related risks: blood counts, cardiopulmonary toxicity, neuropathy, lymphedema, frailty, bone metastases, neurologic changes, and emergencies.

These are expert recommendations, not tested interventions.

Key findings

01Blood counts set activity limits: hemoglobin ≤8 g/dL warrants caution with progressive resistive and moderate to high intensity aerobic exercise, and platelets below 20,000 k cells/uL generally restrict activity to walking and activities of daily living.

02Neutropenia is not automatically a contraindication to rehabilitation, but patients need symptom and infection monitoring.

03Bone metastases require fracture-risk precautions; prophylactic fixation is recommended for a score ≥9, and rehabilitation can proceed with limits on excessive resistive, compressive, or rotational forces.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

This is a narrative review, not a systematic review or original study, so it does not report methods for selecting evidence or tested outcomes. The recommendations are broad safety considerations for cancer rehabilitation, not interventions proven to improve function or survival. Tables are referenced but not included in the text provided. Many statements cite other studies without enough detail in this text to judge their design or certainty. The population ranges from pre-treatment to advanced cancer, so the safety advice may not apply equally to every patient.

The easy way to misread this

Do not treat the blood-count limits, exercise precautions, and fracture-risk rules as tested rehabilitation interventions. This paper is a narrative review without original methods or results, so the advice is expert-based and should be combined with local oncology guidance.

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