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Linero-Bocanegra M, García-Conejo C, Ramírez-Pérez L, Cuesta-Vargas AI, Trinidad-Fernández M. Effectiveness of Therapeutic Exercise for Children Undergoing Treatment for Cancer: A Systematic Review: Therapeutic Exercise Children Cancer. Pediatr Phys Ther 2024:00001577-990000000-00094. [PMID: 38980218 DOI: 10.1097/pep.0000000000001122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
PURPOSE To evaluate the effectiveness of therapeutic physical exercise (TPE) interventions on the physical functioning, psychosocial well-being, and quality of life (QoL) of children undergoing treatment for cancer. METHOD Systematic review: databases were searched in April 2023. Selection criteria: children (<18 years old) undergoing treatment for cancer or a malignant neoplasm, randomized controlled trial design, utilization of TPE, and including physical and psychosocial outcomes. Internal validity was measured with Physiotherapy Evidence Database scale. RESULTS Seven randomized controlled trials were included. Most studies showed that strength, fatigue, and QoL improved after the intervention. Cardiorespiratory capacity through 6-minute walk test and physical activity levels were better in the experimental groups. No changes were noted in other variables. CONCLUSIONS This review supports the importance of a TPE program during cancer treatment, with the aim of maintaining physical capacities and counteracting physical inactivity.
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Affiliation(s)
- Miriam Linero-Bocanegra
- Grupo de Investigación Clinimetría F-14, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, Spain (Mss Linero-Bocanegra, García-Conejo, and Ramírez-Pérez, and Drs Cuesta-Vargas and Trinidad-Fernández); Departamento de Fisioterapia, Universidad de Málaga, Málaga, Spain (Mss García-Conejo and Ramírez-Pérez and Drs Cuesta-Vargas and Trinidad-Fernández)
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Le D, Martin K, Clark SC, Ruso D, Hoyen A, Hunter K, Kim TWB. Trends in functional outcome measures in orthopedic oncology. J Orthop Res 2024. [PMID: 38578623 DOI: 10.1002/jor.25846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/25/2024] [Accepted: 03/09/2024] [Indexed: 04/06/2024]
Abstract
The purpose of this study was to identify trends in the use of functional outcome measures within orthopedic oncology. The search engine, PubMed, was reviewed for all articles over an 11-year period from 2011 to 2021 from five major journals that publish in the field of orthopedic oncology. The functional outcome measures used in the articles were recorded along with study date, study design, clinical topic/pathology, and level of evidence. Out of 5968 musculoskeletal tumor-focused articles reviewed, 293 (4.9%) included at least one outcome measure. A total of 28 different outcome tools were identified. The most popular were Musculoskeletal Tumor Society (MSTS) score (61.1%) and Toronto Extremity Salvage (TESS) score (14.0%), followed by 36-Item Short Form Survey (SF-36) (4.1%) and Patient-Reported Outcomes Measurement Information System (PROMIS) (3.8%). The use of MSTS scores decreased by 0.7% each year, whereas PROMIS increased by 1.2% each year. Seventy-four articles used more than one outcome measure. Of these 74 articles, 61 had the MSTS as one of the outcome measures. Orthopedic oncology utilizes functional outcome measures less commonly in comparison to other orthopedic subspecialties. However, this may be due in large part to orthopedic oncologists putting more emphasis on outcomes such as local recurrence, implant failure, and mortality. MSTS score is the most widely used functional outcome measure, but the utilization of PROMIS has increased recently, and could be the next step in evaluating outcomes in orthopedic oncology as it is patient-derived rather than physician-derived.
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Affiliation(s)
- David Le
- University of Washington Medical Center, Seattle, Washington, USA
| | - Kelsey Martin
- Cooper Bone and Joint Institute, Camden, New Jersey, USA
| | - Sean C Clark
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Devyn Ruso
- Cooper Bone and Joint Institute, Camden, New Jersey, USA
| | - Alex Hoyen
- Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA
| | - Krystal Hunter
- Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Tae Won B Kim
- Cooper Bone and Joint Institute, Camden, New Jersey, USA
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Farid N, Chun S, Hassanain O, Salama M, Esam E, Adel F, Rashad I, El Ghoneimy AM. Cross-cultural adaptation and validation of a self-reporting tool to assess health-related quality of life for Egyptians with extremity bone sarcomas in childhood or adolescence. Health Qual Life Outcomes 2023; 21:81. [PMID: 37516838 PMCID: PMC10386605 DOI: 10.1186/s12955-023-02165-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/18/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Validated self-reporting tools are required to evaluate the functional outcome and health-related quality of life (HRQOL) for those who had extremity bone sarcomas in their childhood or adolescence. Our study pursued cross-cultural adaptation and validation of the pediatric Toronto Extremity Salvage Score (pTESS) and Toronto Extremity Salvage Score (TESS) to assess the functional outcome for Egyptian children and adult survivors following surgeries of extremity bone sarcomas. In the modified versions of pTESS and TESS, mental domains were added to allow the evaluation of HRQOL using a specific instrument for childhood bone cancer. METHODS The internal consistency and test-retest reliability of the studied forms were assessed with Cronbach's alpha and Intra-class coefficients (ICC), respectively. For convergent validity, correlations between scores of the generic Pediatric Quality of Life Inventory (PedsQL 4.0) and pTESS /TESS scores were reported. Factor Analysis was feasible for pTESS-leg; due to the insufficient samples, only the average inter-item correlation coefficients were reported for the remaining versions. RESULTS Out of 233 participants, 134 responded to pTESS-leg, 53 to TESS-leg, 36 to pTESS-arm, and only 10 to TESS-arm. All versions showed excellent internal consistency (Cronbach's alpha >0.9), good test-retest reliability (ICC >0.8), moderate to strong correlations with PedsQL, and acceptable average inter-item correlation coefficients (≥0.3). Three factors were extracted for the pTESS-leg, in which all mental items were loaded on one separate factor with factor loadings exceeding 0.4. Active chemotherapy, less than one year from primary surgery, or tibial tumors were associated with significantly inferior pTESS/TESS scores in the lower extremity group. CONCLUSION The Egyptian pTESS and TESS are valid and reliable self-reporting tools for assessing the functional outcome following surgeries for extremity bone sarcomas. The modified pTESS and TESS versions, which include additional mental domains, enabled the assessment of the overall health status of our population. Future studies should include a larger sample size and evaluate the ability of pTESS/TESS to track progress over time.
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Affiliation(s)
- Nesma Farid
- Institute of Global Health and Human Ecology, American University in Cairo and Clinical Research Department, Children's Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt.
| | - Sungsoo Chun
- Institute of Global Health and Human Ecology, American University in Cairo, Cairo, Egypt
| | - Omneya Hassanain
- Clinical Research Department, Children's Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Mohamed Salama
- Institute of Global Health and Human Ecology, American University in Cairo, Cairo, Egypt
| | - Elham Esam
- Nursing department, Children's Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Fatima Adel
- Clinical Research Department, Children's Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Ismail Rashad
- Department of Orthopedic Oncology, Cairo University and Children's Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Ahmed Mohamed El Ghoneimy
- Department of Orthopedic Oncology, Cairo University and Children's Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
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Wiffen J, Mah E. Determining functional outcomes after resection and reconstruction of primary soft tissue sarcoma in the lower extremity: A review of current subjective and objective measurement systems. J Surg Oncol 2023; 127:862-870. [PMID: 36683344 DOI: 10.1002/jso.27202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/27/2022] [Accepted: 01/02/2023] [Indexed: 01/24/2023]
Abstract
The surgical management of soft-tissue sarcoma has evolved significantly over the last two decades due to the routine use of adjunct therapies, with an increased focus on postoperative functional outcome. The literature suffers from methodological inconsistency and use of low quality outcome measures to assess an already heterogeneous population. This article aims to review the most frequently used subjective and objective methods of functional outcome assessment and highlight the current benefits and limitations of these.
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Affiliation(s)
- James Wiffen
- St Vincent's Hospital, The University of Melbourne, Melbourne, Australia
| | - Eldon Mah
- Department of Plastic & Reconstructive Surgery, St Vincent's Hospital, Melbourne, Australia
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Gonzato O, Schuster K. The role of patient advocates and sarcoma community initiatives in musculoskeletal oncology. Moving towards Evidence-Based Advocacy to empower Evidence-Based Medicine. J Cancer Policy 2023; 36:100413. [PMID: 36806641 DOI: 10.1016/j.jcpo.2023.100413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 01/29/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023]
Abstract
Musculoskeletal sarcomas are rare cancers that as the whole family of sarcomas pose several challenges at different levels, ranging from medical knowledge to clinical research and policymaking. Addressing these challenges, necessarily calls for the inclusion of patient perspective inside the decision-making processes of every area that contributes to treatment improvement, from the provision of high-quality services by healthcare organisations to research issues. Without patient-provided inputs to inform decisions, the current paradigm of patient-centred care makes no sense and sounds at the least irrational if not unethical. Putting PROMs on "centre stage" in cancer research and care, could allow to build a truly Evidence Based Advocacy (EBA) and therefore to empower Evidence Based Medicine (EBM).
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Affiliation(s)
- Ornella Gonzato
- Fondazione Paola Gonzato-Rete Sarcoma ETS, Italy; Sarcoma Patient Advocacy Global Network (SPAGN), Germany.
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Dalton JF, Furdock R, Cluts L, Jilakara B, Mcdonald D, Calfee R, Cipriano C. Pre- and Post-Operative Patient-Reported Outcome Measurement Information System Scores in Patients Treated for Benign Versus Malignant Soft Tissue Tumors. Cureus 2022; 14:e25534. [PMID: 35800809 PMCID: PMC9246055 DOI: 10.7759/cureus.25534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/05/2022] Open
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Moon TM, Furdock R, Rhea L, Pergolotti M, Cipriano C, Spraker MB. PROMIS scores of patients undergoing neoadjuvant and adjuvant radiation therapy for surgically excised soft tissue sarcoma. Clin Transl Radiat Oncol 2021; 31:42-49. [PMID: 34622039 PMCID: PMC8479243 DOI: 10.1016/j.ctro.2021.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/10/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
First to evaluate PROMIS for patients undergoing radiotherapy and surgery for sarcoma. Patients exhibited meaningful change in PROMIS scores throughout the treatment. Analyses show PROMIS scores were similar between pre- and post-operative radiotherapy. Wound complications were associated with increases in anxiety and decreases in function. These data should be considered when selecting ideal therapy.
Introduction Few recent studies have examined patient reported outcomes (PROs) during pre- or post-operative radiation therapy (RT) for soft tissue sarcoma (STS), and none have used PROMIS. This study aims to examine PROMIS scores across peri-operative time points for patients receiving pre- or post-operative RT. Methods Anxiety, depression, pain interference, and physical function PROMIS domains were collected at the pre-operative (1), immediate post-operative (2), and post-treatment completion (3) timepoints for patients undergoing surgery and either pre-operative or post-operative RT. Median scores were compared between groups using the Kruskal-Wallis test. The reliable change index was used to determine minimum important change in PROMIS scores and to compare scores between timepoints. Results 95 patients were included (19 pre-operative, 76 post-operative). Both groups had significant decreases in function during treatment. Patients with wound complications were more likely to have significant increases in anxiety (36.4% vs. 8.3%; p = 0.020) and decreases in physical function (57.1% vs. 16.2%; p = 0.011) independent of RT timing. Conclusions This study demonstrates minimum significant change thresholds to detect PROMIS changes in STS patients undergoing pre- and post-operative radiotherapy. As expected, more patients with pre-operative RT than post-operative RT had wound complications (p = 0.06), but patients with complications in both groups had worse anxiety and function at the completion of treatment compared with those that did not. The association of wound complications with worse anxiety and physical function at completion of treatment should be considered when making individualized treatment recommendations regarding the timing of RT.
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Affiliation(s)
- T M Moon
- Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - R Furdock
- Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - L Rhea
- Division of Biostatistics, Washington University in St. Louis, St. Louis, MO, United States
| | - M Pergolotti
- ReVital Cancer Rehabilitation Program, Select Medical, Mechanicsburg, PA, United States.,Department of Occupational Therapy, University of North Carolina in Chapel Hill, Chapel Hill, NC, United States
| | - C Cipriano
- Department of Orthopedic Surgery, Washington University in St. Louis, St. Louis, MO, United States
| | - M B Spraker
- Department of Radiation Oncology, Washington University in St. Louis, St. Louis, MO, United States
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den Hollander D, Van der Graaf WTA, Fiore M, Kasper B, Singer S, Desar IME, Husson O. Unravelling the heterogeneity of soft tissue and bone sarcoma patients' health-related quality of life: a systematic literature review with focus on tumour location. ESMO Open 2021; 5:e000914. [PMID: 33082266 PMCID: PMC7577059 DOI: 10.1136/esmoopen-2020-000914] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 12/18/2022] Open
Abstract
Patients with sarcoma experience many physical and psychological symptoms, adversely affecting their health-related quality of life (HRQoL). HRQoL assessment is challenging due to the diversity of the disease. This review aims to unravel the heterogeneity of HRQoL of patients with sarcoma with regard to tumour location and to summarise the used measures in research. English-language literature from four databases published between January 2000 and April 2019 was reviewed. Studies that described adult sarcoma HRQoL outcomes were included and classified according to primary sarcoma location. Eighty-seven articles met the inclusion criteria covering sarcoma of the extremities (n=35), pelvis and axial skeleton (n=9), pelvis and extremities (n=5), head and neck (n=4), retroperitoneum (n=2) and multiple sarcoma locations (n=33), respectively. Urogenital and thoracic sarcoma were lacking. Fifty-four different questionnaires were used, most often cancer-generic or generic HRQoL questionnaires. Patients with sarcoma reported lower HRQoL than the general population. Distinctive patterns of HRQoL outcomes according to tumour location regarding symptoms, physical functioning, disability and psychosocial well-being were identified. In metastatic sarcoma, mostly constitutional symptoms were present. To comprehensively assess HRQoL, a sarcoma-specific measurement strategy should be developed and used covering the heterogeneity of sarcoma including location-specific issues to improve personalised HRQoL assessment in future research and clinical practice.
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Affiliation(s)
- Dide den Hollander
- Medical Oncology, Antoni van Leeuwenhoek Netherlands Cancer Institute, Amsterdam, The Netherlands; Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Winette T A Van der Graaf
- Medical Oncology, Antoni van Leeuwenhoek Netherlands Cancer Institute, Amsterdam, The Netherlands; Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marco Fiore
- Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Bernd Kasper
- Sarcoma Unit, University of Heidelberg, Mannheim University Medical Center, Mannheim, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre Mainz, Mainz, Germany
| | - Ingrid M E Desar
- Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Olga Husson
- Medical Oncology, Antoni van Leeuwenhoek Netherlands Cancer Institute, Amsterdam, The Netherlands; Division of Clinical Studies, Institute of Cancer Research, London, United Kingdom.
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Blank AT, Shaw S, Wakefield CJ, Zhang Y, Liu WJ, Jones KB, Randall RL. What factors influence patient experience in orthopedic oncology office visits? World J Clin Oncol 2020; 11:136-142. [PMID: 32257844 PMCID: PMC7103527 DOI: 10.5306/wjco.v11.i3.136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 02/06/2020] [Accepted: 02/11/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patient satisfaction and reported outcomes are becoming increasingly important in determining the efficacy of clinical care. To date no study has evaluated the patient experience in the orthopedic oncology outpatient setting to determine which factors of the encounter are priorities to the patient.
AIM To evaluate what factors impact patient experience and report satisfaction in an outpatient orthopedic oncology clinic.
METHODS Press Ganey® patient surveys from a single outpatient orthopedic oncology clinic at a tertiary care setting were prospectively collected per routine medical care. All orthopedic oncology patients who were seen in clinic and received electronic survey were included. All survey responses were submitted within one month of clinic appointment. IRB approval was obtained to retrospectively collect survey responses from 2015 to 2016. Basic demographic data along with survey category responses were collected and statistically analyzed.
RESULTS One hundred sixty-two patient surveys were collected. Average patient age was 54.4 years (SD = 16.2 years) and were comprised of 51.2% female and 48.4% male. 64.2% of patients were from in-state. Out of state residents were more likely to recommend both the practice and attending physician. The likelihood to recommend attending physician was positively associated with MD friendliness/courtesy (OR = 14.4, 95%CI: 2.5-84.3), MD confidence (OR = 48.2, 95%CI: 6.2-376.5), MD instructions follow-up care (OR = 2.5, 95%CI: 0.4-17.4), and sensitivity to needs (OR = 16.1, 95%CI: 1-262.5). Clinic operations performed well in the categories of courtesy of staff (76%) and cleanliness (75%) and less well in ease of getting on the phone (49%), information about delays (36%), and wait time (37%).
CONCLUSION Orthopedic specialties can utilize information from this study to improve care from the patient perspective. Future studies may be directed at how to improve these areas of care which are most valued by the patient.
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Affiliation(s)
- Alan T Blank
- Department of Orthopedic Surgery, Division of Oncology, Rush University Medical Center, Chicago, IL 61011, United States
| | - Sara Shaw
- Department of Orthopedics, University of Utah, Salt Lake City, UT 84122, United States
| | - Connor J Wakefield
- Department of Orthopedic Surgery, Division of Oncology, Rush University Medical Center, Chicago, IL 61011, United States
| | - Yue Zhang
- Department of Family & Preventive Medicine, University of Utah, Salt Lake City, UT 84108, United States
| | - Wei J Liu
- Scientific Computing and Image Institute, University of Utah, Salt Lake City, UT 84108, United States
| | - Kevin B Jones
- Department of Orthopedics, University of Utah, Salt Lake City, UT 84122, United States
| | - R Lor Randall
- Department of Orthopaedic Surgery, University of California-Davis Medical Center, Sacramento, CA 95817, United States
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Affiliation(s)
- Peter S Rose
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
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