Physical Activity and Rehabilitation in Life-threatening Illness

This book is a comprehensive summary of the recommendations for best practice, and current evidence, for physical activity and rehabilitation of functional deficits in individuals with end-stage diseases. While advances in technology have afforded us the opportunity to live longer lives, it has also demanded an expansion of focus of medical interventions towards palliative care to enhance the quality of life. Exercise and healthcare professionals must strive to broaden their perspectives to provide for the unique needs of these individuals, and to successfully engage with them, to achieve the most positive outcomes throughout the entire continuum of care. Healthcare providers play a critical role in advocating for care to allow individuals to remain physically active for as long as possible, even in the face of declining health. Finally, due to the increasing and progressively emergent healthcare utilization required by these individuals, a significant cost burden is experienced by healthcare systems, patients, families, and payers. There is evidence of substantial protective effects of physical activity, prevention, safety, and rehabilitative procedures to reduce hospital readmissions, reduce length of stay, and assist in avoiding unwarranted or unnecessary diagnostic tests or procedures. Physical activity has been proven to have a substantial impact and protective effects on virtually all medical conditions. During curative management, but especially during transitional phases to palliative care, other strategies need enhanced consideration to complement the existing plan of care and help to improve patient's quality of life. Ideally, physical medicine would be at the forefront of allowing individuals to live their best life until the very end. Physical Activity and Rehabilitation in Life-threatening Illness is key reading for academics and policy makers in physical activity, international exercise, wellness and rehabilitation, and related disciplines, as well as research-focused clinicians in settings where patients with advanced illness are frequently encountered.

Amy J. Litterini PT, DPT is an Associate Clinical Professor in the Doctor of Physical Therapy Program at the University of New England in Portland, Maine, USA. Her clinical career has focused on adult rehabilitation, with an interest in advanced cancer survivorship. She is a certified patient navigator by the Harold P. Freeman Patient Navigation Institute and a certified hospice volunteer with Compassus Hospice. Amy served in governance positions in the American Physical Therapy Association's Academy of Oncologic Physical Therapy and the Oncologic Specialty Council of the American Board of Physical Therapy Specialists. Christopher Wilson PT, DPT, DScPT is an Assistant Professor in the Physical Therapy Program in the School of Health Sciences at Oakland University, Rochester, MI, USA and the Residency Program Director for the Beaumont Health Oncology Residency, Troy, MI, USA. He is the Vice President of the Academy of Oncologic Physical Therapy of the American Physical Therapy Association and served as the Hospice Palliative Care Coordinator for the oncology subgroup of the World Confederation for Physical Therapy (now World Physiotherapy).

PART I Core Concepts in Life-threatening Illness 1 1 Palliative Care for Adults 3 CHRISTOPHER WILSON AND AMY LITTERINI 2 Palliative Care Philosophy for Children and Adolescents 21 KENDRA D. KOCH 3 Exercise, Activity in Cancer and Chronic Disease 34 JEANNETTE Q. LEE 4 Role of Therapists and Palliative Care Models 46 CHRISTOPHER WILSON AND AMY LITTERINI 5 Caregivers in Patient- and Family-Centered Care 61 AMY LITTERINI AND CHRISTOPHER WILSON 6 Integration with the Interdisciplinary Care Team 75 CHRISTOPHER WILSON AND AMY LITTERINI 7 Communication Strategies 96 CHRISTOPHER WILSON AND AMY LITTERINI PART II Diagnoses and Conditions in Life-threatening Illness 111 8 Diseases of the Heart 113 AMY LITTERINI AND CHRISTOPHER WILSON 9 Malignant Neoplasms 119 AMY LITTERINI AND CHRISTOPHER WILSON 10 Accidents and Unintentional Injuries 134 AMY LITTERINI AND CHRISTOPHER WILSON 11 Respiratory Diseases 140 AMY LITTERINI AND CHRISTOPHER WILSON 12 Cerebrovascular Diseases: Acute and Chronic Stroke 151 AMY LITTERINI AND CHRISTOPHER WILSON 13 Progressive Neurological Diseases 159 AMY LITTERINI AND CHRISTOPHER WILSON 14 Diabetes 173 AMY LITTERINI AND CHRISTOPHER WILSON 15 Kidney Disease 181 AMY LITTERINI AND CHRISTOPHER WILSON 16 Substance Use Disorder, Intentional Self-Harm, Gun Violence, and HIV/AIDS 187 AMY LITTERINI AND CHRISTOPHER WILSON PART III Outcome Measures and Interventions 209 17 Management of Conditions and Symptoms 211 AMY LITTERINI AND CHRISTOPHER WILSON 18 Measuring and Quantifying Outcomes 249 AMY LITTERINI AND CHRISTOPHER WILSON Contents xi 19 Therapists' Interventions among Practice Settings 261 CHRISTOPHER WILSON AND AMY LITTERINI 20 Safe Patient Handling and Mobility 275 CHRISTOPHER WILSON AND AMY LITTERINI PART IV Policy, Research, and Education 293 21 Education on Palliative and End-of-Life Care 295 CHRISTOPHER WILSON AND AMY LITTERINI 22 Policy Issues and Clinical Documentation 306 CHRISTOPHER WILSON AND AMY LITTERINI 23 The Future of Physical Activity, Rehabilitation, and End-of-Life Care 322 CHRISTOPHER WILSON AND AMY LITTERINI Afterword 337 RICHARD BRIGGS