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PM R. 2017 Sep;9(9S2):S415-S428. doi: 10.1016/j.pmrj.2017.08.403.

A Focused Review of Safety Considerations in Cancer Rehabilitation.

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Department of Physical Medicine and Rehabilitation, Hofstra Northwell School of Medicine, Hempstead, NY; Long Island Jewish Medical Center, Manhasset, NY(∗).
Department of Rehabilitation Medicine, Northwell-Glen Cove Hospital, Glen Cove, NY(†).
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA; Spaulding Rehabilitation Hospital Network, Boston, MA; Massachusetts General Hospital, Boston, MA; Physiatry, Brigham and Women's Hospital, Boston, MA(‡).
Department of Physical Therapy, Wingate University, Wingate, NC(§).
Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD; Office of Strategic Research, Department of Rehabilitation Medicine, Clinical Center, National Institutes of Health, MSC 1604, 10 Center Dr, Bethesda, MD 20892-1604(‖). Electronic address:


Cancer and its treatments introduce various adverse effects that may affect survivors' physical, cognitive and psychological functioning. Frequently both tolerance to activity and exercise are affected as well. Rehabilitation providers should have substantive knowledge about the effect of cancer progression and common side effects associated with antineoplastic treatment to safely integrate rehabilitation interventions. Rehabilitation may mitigate loss of function and disability; however, these patients are among the most medically complex that providers treat. This report provides a focused review that synthesizes the current evidence regarding disease progression and oncology-directed treatment side effects within the context of safety considerations for rehabilitation interventions throughout the continuum of cancer care. Descriptive information regarding the evidence for precautions and contraindications is provided so that rehabilitation providers can promote a safe plan of rehabilitation care. It is incumbent upon but also challenging for rehabilitation providers to stay up to date on the many advances in cancer treatment, and there are many gaps in the literature regarding safety issues. Although further research is needed to inform care, this review provides clinicians with a framework to assess patients with the goal of safely initiating rehabilitation interventions.

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