Physical Therapy Commons^™

The Use Of Tens To Help Manage Post-Mastectomy Pain, Alyssa B. Carey, Amanda Giarratano, Verena Gorgi, Lauren Vera

Oncology Rehabilitation in Practice

Transcutaneous electrical nerve stimulation (TENS) has been demonstrated to be an effective non-pharmacological adjunct for postoperative pain management in thoracic surgeries. However, few studies have examined its benefits in managing post-mastectomy pain. This study found that TENS provided positive effects on postoperative pain control, which were associated with improved physical and psychological outcomes. Overall, TENS appears to be a safe and effective modality for managing acute postmastectomy pain.

Whole-Body Vibration As An Adjunctive Modality For Radiation-Induced Fibrosis In Breast Cancer Rehabilitation: A Physical Therapist’S Perspective, Carla Steinberg

Oncology Rehabilitation in Practice

No abstract provided.

Occupational Therapy Interventions For Pediatric Patients With Cancer And Avascular Necrosis: A Case Report, Lucy Weathers, Sandra Murphy, Michael Neel, Raul Riberio

Oncology Rehabilitation in Practice

Background: Avascular necrosis (AVN) is a rare disease that can be caused by cancer treatment. AVN can affect multiple joints, which can disrupt one’s ability to perform daily activities. Rehabilitation services, including occupational therapy (OT) and physical therapy, are used to improve a patient’s quality of life through skilled conservative interventions that improve daily task engagement. Occupational therapists are trained to address functional deficits experienced by pediatric patients with cancer and may play a key role in treating patients who have AVN. This case report describes the role of OT in addressing self-care for a patient experiencing early multifocal AVN. …

Individualized Aerobic Exercise Prescription As Part Of A Comprehensive Physical Therapy Treatment During Systemic Chemotherapy: A Case Report, Veronica Griesemer

Oncology Rehabilitation in Practice

Background: Cardiovascular disease (CVD) is commonly seen in cancer survivors. Multiple treatment modalities for breast cancer can cause cardiotoxicity during or even decades after treatment. Aerobic exercise has been well documented to treat non-cancer-related CVD; however, research regarding optimal dosing within the cancer population is needed. This case report discusses the examination, evaluation, and treatment of a patient with breast cancer receiving potentially cardiotoxic chemotherapy.

Case Description: This patient presented with decreased cardiorespiratory fitness, elevated heart rate, and shortness of breath when climbing the stairs after completing systemic chemotherapies doxorubicin and cyclophosphamide. She was preparing to start paclitaxel treatments and …

The Relationship Between Fatigue And Quality Of Life For Patients Participating In A Cancer Survivor Program, Madge Suzanne Tinsley, Marie Vazquez Morgan, Elizabeth Disbrow, Carol Crooms

Oncology Rehabilitation in Practice

Introduction: The purpose of this chart review was to examine differences in fatigue and quality of life following cancer treatment based on gender, race, age, cancer type, and referral for rehabilitation services.

Methods: Ninety-one patient charts were reviewed for demographic variables, cancer type, rehabilitation referral, and baseline scores on the Brief Fatigue Inventory (BFI) and Reintegration to Normal Life Index (RNLI). Group differences were analyzed using the Mann–Whitney U test, and correlations between fatigue and quality of life were assessed using Pearson’s correlation (p < 0.05).

Results: Participants included 65 females (71%) and 26 males (29%), with 73% identifying as Black, 26% …

Impact Of Lymphedema Treatment Act Implementation On Lymphedema Therapists’ Compression Garment Practices, Sarah Stolker, Karla T. Washington, Kimberly Karr, Andrew Amari, Kyle A. Pitzer

Oncology Rehabilitation in Practice

Purpose: Lymphedema management requires routine use of compression garments to stabilize limb volume and diminish infection risk. The 2024 Lymphedema Treatment Act (LTA) established Medicare coverage for these essential medical supplies. However, this legislation introduced structural challenges to clinical workflows for lymphedema therapists, who traditionally perform measuring, ordering, and fitting. This study evaluated contemporary practices in compression garment fitting, procurement, compensation patterns, and policy-driven impacts on therapist workload and stress.

Methods: A cross-sectional exploratory survey of US lymphedema therapists evaluated the impact of the LTA on clinical workflows. The survey assessed weekly time spent on garment-related tasks, workflow changes since …

Demonstrating Competence In Oncology Rehabilitation: Credentials, Clinical Preparation, And Professional Trust, Christopher M. Wilson

Oncology Rehabilitation in Practice

Every rehabilitation professional will inevitably provide care for people living with and beyond cancer across acute care, outpatient settings, inpatient settings, and home care and within the community. Yet, many clinicians report feeling underprepared or unqualified to address the complex effects of cancer and its treatments. Continuing education, mentorship, and clinical experience remain important routes to professional development, but advanced credentials can offer a structured pathway for developing knowledge and skills and an external recognition of this preparation. This perspective discusses the potential value of specialization or board certification for rehabilitation professionals and other pathways for skill and knowledge attainment …

Editor's Message: About This Issue, Bryan A. Spinelli

Oncology Rehabilitation in Practice

In this issue, we are pleased to publish the President’s Message, two research reports, two case studies, a research round-up, and a clinical perspective. In the President’s Message, Dr. Wilson discusses the role that advanced credentials and mentorship can play in enhancing professional development and fostering interprofessional trust.

Cover And Front Matter, Volume 3, Issue 3

Oncology Rehabilitation in Practice

No abstract provided.

Integrating Oncology Into Entry-Level Physical Therapist Curricula, Shana Harrington, Christopher M. Wilson, Morgan Zaranec, Lori Boright

Oncology Rehabilitation in Practice

Print issue available for $25.

Background: Cancer and its treatments commonly result in adverse effects that impair function, well-being, and quality of life, necessitating access to skilled physical therapists (PTs). Although oncology is an essential component of physical therapist practice, entry-level education in cancer rehabilitation has historically been limited. In 2025, the Essential Competencies for Physical Therapy Entry-Level Education in Oncology were developed through a mixed-methods, modified Delphi process, establishing 19 competencies across six domains and defining minimum expectations for new graduates. To support translation of these competencies into academic curricula, a practical implementation resource was needed.

Purpose: To …

Interprofessional Palliative Care: Implementation Of What Matters Most, Nicole Moran, Madeleine A. Keppel, Madison E. Markey, Alicia Naccarato, Kristen Cumming, Lori Boright

Oncology Rehabilitation in Practice

Palliative care (PC) is defined as specialized care plans for people with serious, life-limiting illnesses, emphasizing comfort care and management of complex symptoms. Rehabilitation professionals such as physical and occupational therapists have unique skills and perspectives towards managing and contributing to this population though are often under-represented on interprofessional palliative care teams. The Guide to What Matters (The Guide) was created upon recognition of the need for an increased presence of rehabilitation services in PC.

Severe Chemotherapy-Induced Peripheral Neuropathy Presenting With Paraplegic Symptoms: A Rehabilitation Case Report, Cecilia Hammond, Elizabeth Campione

Oncology Rehabilitation in Practice

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is characterized by sensory and/or motor symptoms in distal extremities starting within 24 hours of receiving chemotherapy and can potentially last for years. Management of CIPN may include medication (i.e. Duloxetine) and physical therapy (PT). The purpose of this case report is to describe the rehabilitation process and adjustments to the plan of care for a patient with severe CIPN. This case underscores the importance of a proper diagnosis and the need for research to develop evidence-based guidelines for PT interventions for non-ambulatory patients with severe CIPN.

Case description: The patient was a 53-year-old female …

Recurring Axillary Web Syndrome (Aws) Following A Strenuous Increase In Upper Extremity Strengthening Exercise: A Case Report, David Locke, Linda Koehler

Oncology Rehabilitation in Practice

Background: Axillary web syndrome (AWS) refers to cords presenting in the axilla, upper extremity, and lateral chest wall after breast cancer surgery with axillary lymph node dissection. This unique case demonstrates the onset of AWS 2 weeks post-operatively with recurrence at 4 and 21 months, following rapid progression in upper extremity strengthening exercise.

Case Description: A 33-year-old athletic woman with invasive ductal carcinoma underwent a left mastectomy with sentinel node biopsy (6 nodes removed). Cord development occurred at 2 weeks after surgery. She sought physiotherapy consisting of AWS education, myofascial pin-and-stretch techniques applied to the cord in end-range abduction, a …

Clinical Management Of A Patient With Lipo-Lymphedema Using Adjustable Compression Wraps: A Case Report, Candace Alexander, Claire Davies, Martha Monroe

Oncology Rehabilitation in Practice

Background: Lipo-lymphedema indicates the presence of lipedema and lymphedema. Compression is used to achieve volume reduction and assist with long-term management. Adjustable compression wraps (ACWs) have been used in lymphedema care to replace traditional compression bandaging and facilitate patient self-care.

Case Description: This patient reported issues with bilateral leg edema for more than 35 years. She reported poor experiences with compression garments and had tried self-management with a compression pump only. She was referred for lymphedema care when her malfunctioning compression pump enabled her edema to worsen.

Assessment and Treatment: Lipedema may have been present for many years …

Physical Therapy Management Of An Adult Patient Diagnosed With Spindle Cell Rhabdomyosarcoma: A Case Report, Jennifer Carrano

Oncology Rehabilitation in Practice

Background: Rhabdomyosarcoma (RMS) is a rare soft tissue sarcoma that primarily affects children and adolescents. Adult RMS is uncommon and associated with poorer prognosis and limited evidence to guide rehabilitation.

Case Description: A 29-year-old male presented with right facial pain, hearing loss, tinnitus, and right facial and tongue paresthesia. Imaging and biopsy revealed spindle cell RMS of the right masticator space. He had no cancer-related family history, did not smoke, and used alcohol occasionally. Treatment included neoadjuvant chemotherapy, major oncologic resection with scapular free flap reconstruction, and adjuvant radiation. He was referred to outpatient physical therapy with trismus, restricted …

Navigating Care In Cancer: Aligning Rehabilitation And Exercise To Support Patients, Christopher M. Wilson

Oncology Rehabilitation in Practice

The growing evidence base supporting both exercise oncology and cancer rehabilitation highlights their complementary roles across the cancer continuum. Research consistently demonstrates that physical activity improves physical function, fatigue, quality of life, and survival, while rehabilitation addresses impairments and restores participation in meaningful activities. Despite these advances, current care models often lack coordination, resulting in fragmented services, inappropriate referrals, and missed opportunities for optimal patient outcomes. Some individuals are directed to exercise programs without adequate screening for underlying impairments, while others may receive rehabilitation services when supervised, independent or community-based activity would suffice.

To address these gaps, there is a …

Editorial Board Message: About This Issue, Bryan A. Spinelli

Oncology Rehabilitation in Practice

Bryan Spinelli provides a summary of the contents of the issue.

Cover And Front Matter, Volume 3, Issue 1

Oncology Rehabilitation in Practice

Cover and front matter, Volume 3, Issue 1

Thriving Through Treatment: A Senior Physical Therapist’S Perspective On Mindset In Cancer Care, Christine C. Masterson

Oncology Rehabilitation in Practice

Mindset plays a pivotal role in the cancer care continuum, influencing not only emotional well-being but also treatment adherence and physical recovery. Drawing on clinical experience as a senior physical therapist at Memorial Sloan Kettering Cancer Center, this Perspective explores how a thriving, wellness-oriented mindset can enhance outcomes for individuals facing cancer. Through case examples and evidence-based discussion, the article highlights how personal resilience, social support, and compassionate care foster post-traumatic growth, reduce complications, and improve engagement in rehabilitation. Physical therapists are uniquely positioned to lead this mindset shift, blending technical skill with emotional insight to empower patients. Cultivating a …

The Role Of Psilocybin In End-Of-Life Care: Evidence, Mechanisms, And Guidelines, Mackenzie E. Unsworth, Mary Lou Galantino, Robert Sandoval

Oncology Rehabilitation in Practice

This article aims to provide a brief overview of the evidence and mechanisms for psilocybin use in EOL care. Additionally, this article will provide guidelines for clinicians to assess patient use and integrate psilocybin into their clinical practice with respect to its current legal status.

Tissue Quality In Early Stages Of Breast Cancer-Related Lymphedema: A Pilot Study, Tyler Almquist, Gabrielle Schroeder, Ian Villegas, David A. Doubblestein

Oncology Rehabilitation in Practice

Introduction: Breast cancer-related lymphedema (BCRL) is a chronic condition associated with breast cancer treatments. Tissue quality assessment, commonly performed using the pitting edema test, can also be quantified with digital tissue tonometry. However, the role of tonometry in early-stage BCRL — classified as Stages 0 and I by the International Society of Lymphology (ISL) — remains unclear.

Purpose: This pilot study aimed to assess the utility of tonometry in early-stage BCRL by evaluating tissue resistance (N), volume (ml), and circumference (cm) in healthy individuals and those with ISL Stage 0 and I lymphedema.

Methods: A convenience sample of females …

Dynamic Overhead Body-Weight Support Improves Walking Performance Following Icu Admission For Allogeneic Hematopoietic Stem Cell Transplantation: A Case Study, Hillary M. Jacobson, Carolyn Miller, Renee Mckenzie, Bryan Wittmeyer, Andrew Ray

Oncology Rehabilitation in Practice

Background: Non-Hodgkin lymphoma is a commonly treated with allogeneic hematopoietic stem cell transplant (allo-HSCT), leading to severe weakness and impaired function. Dynamic body weight support systems (DBWS) are a promising rehabilitation tool for enhancing early mobilization in deconditioned patients.

Purpose: Evaluate the integration of DBWS into the rehabilitation plan of a patient recovering from a prolonged ICU stay post-allo HSCT, focusing on mobility and functional recovery.

Case Description: A 55-year-old male, two years post-allo HSCT for cutaneous T-cell lymphoma, was hospitalized for 14 weeks due to respiratory distress from pneumonia and lung GVHD, resulting in severe deconditioning. DBWS was introduced …

Finding A Certified Lymphedema Therapist: Access To Lymphedema Treatment In Minnesota, Emma M. Tsai, Linda Koehler

Oncology Rehabilitation in Practice

Introduction

Lymphedema is a progressive disease that leads to chronic swelling. Lymphedema treatment includes complete decongestive therapy (CDT) provided by a certified lymphedema therapist (CLT). Locating CLTs can be difficult for patients and providers. Our aims were to 1) describe a method for assessing accessibility of lymphedema treatment in a specific region, and 2) apply this method to a specific region (Minnesota) to describe the lymphedema care in that region.

Methods

This cross-sectional study searched therapist directories on websites related to lymphedema and lymphatic diseases (e.g. lymphedema training programs, professional associations) to assess the current distribution of CLTs in Minnesota. …

Artificial Intelligence And The Future Of Oncology Rehabilitation, Christopher M. Wilson

Oncology Rehabilitation in Practice

While the promise of AI in oncology rehabilitation is remarkable, successful adoption requires balance between enthusiasm and realism. These technologies must be thoughtfully integrated into existing workflows with safeguards for data privacy, accuracy, and clinician oversight. The goal is not to replace clinical judgment or the human connection at the heart of rehabilitation, but to amplify and augment them—restoring time, focus, and compassion to the clinical encounter. With deliberate implementation and continuous evaluation, AI can become a trusted partner in advancing the quality, accessibility, and humanity of oncology rehabilitation practice.

Editorial Board Message, Bryan A. Spinelli

Oncology Rehabilitation in Practice

With the release of this issue, we would like to announce that Oncology Rehabilitation in Practice have adopted a new publication schedule. Oncology Rehabilitation in Practice will continue to publish 2 issues each calendar year with issues now being released in May and November. The rationale for this change was that our previous publication schedule coincided with the release of the October and April issues of Rehabilitation Oncology, an official publication of APTA Oncology that is a peer-reviewed, indexed resource for advancing oncologic physical therapy practice and cancer rehabilitation. We hope this change will limit the challenges that clinicians …

Cover And Front Matter, Volume 2, Issue 2

Oncology Rehabilitation in Practice

No abstract provided.

Vision For The Future Of Oncology Physical Therapy: Apta Oncology’S Strategic Plan, Christopher M. Wilson, Emily Compagner

Oncology Rehabilitation in Practice

This article summarizes the 2024-27 strategic plan of the Academy of Oncologic Physical Therapy. The strategic plan consists of five strategic pillars — advocacy, engagement, education, collaboration, and research. Although the strategic plan is slated for another review in 2027, the 2024-27 strategic plan sets forth the key initiatives to advance the field of cancer physical therapy and oncology rehabilitation. This piece summarizes some key initiatives and how the academy and the profession will aim to achieve the APTA and APTA Oncology visions. For the full 2024-27 strategic plan of APTA Oncology, visit www.oncologypt.org.

Axillary Web Syndrome (Aws) In Absence Of Breast Cancer History Or Surgery: A Case Report, David B. Locke, Linda Koehler

Oncology Rehabilitation in Practice

Background: Axillary web syndrome (AWS) is a complication of breast cancer surgery with axillary lymph node removal. Cords are found within 2 weeks post-surgery in the axillary area of the operated side, and many extend down the arm or into the lateral chest wall. The purpose of this report is to present a unique case of idiopathic AWS, and to increase awareness of non-cancer related AWS in the medical community.

Case Description: A 39-year-old healthy female presented to physiotherapy with a 2-week history of a palpable tight cord in her left axilla without history of cancer or surgery. She sought …

The Therapeutic Effects Of A High-Velocity Resistance Training Intervention For Chemotherapy-Induced Polyneuropathy, Mariah Gleeson, Lori Boright, Elise C. Brown, Deborah Doherty

Oncology Rehabilitation in Practice

Purpose: Chemotherapy-induced polyneuropathy, also referred to as chemotherapy-induced peripheral neuropathy (CIPN), is a dose-dependent, neurotoxicity from known neuropathic agents (e.g., taxanes, platinums, and vinca alkaloids) causing damage to the peripheral nervous system. CIPN can present as sensory, motor, or autonomic symptoms, such as muscle weakness and balance impairments. Currently, there are no treatment or prevention methods for CIPN. The purpose of this case series was to assess the therapeutic effects of a high velocity resistance training (HVRT), or power training, in women diagnosed and treated for cancer, who presented with CIPN by measuring balance, functional performance, neuropathy, quality of life …

Importance Of Objective Assessment To Determine Physical Function In Persons Undergoing Autologous Hematopoietic Stem Cell Transplantation, Anne Swisher

Oncology Rehabilitation in Practice

No abstract provided.