Poster Sessions - 2018 Research Day

Event Title

Impact of Early Functional Mobility Training on a 67-Year-Old Postsurgical Female with Abdominal Cancer: A Retrospective Case Report

Location

Hall of Governors

Start Date

4-6-2018 4:00 PM

End Date

4-6-2018 5:30 PM

Abstract

Background: Cancer continues to be a leading cause of mortality in the United States today, second only to heart disease in annual number of deaths due to the disease. A common treatment for malignant forms of abdominal cancer is surgical resection of the cancerous tissue. And while general guidelines for exercise interventions and other treatment strategies for individuals with cancer have been made available, a peer-reviewed, comprehensive clinical practice guideline, does not yet exist. Thus, due to the ever-increasing demand for high quality, cost effective cancer care, the current retrospective case report seeks to contribute to the eventual formulation of such a guideline with a focus on appropriate physical therapy outcome measures and interventions for postsurgical patients with abdominal cancer in the acute care setting.

Case Description: A 67-year-old Caucasian female was admitted to the hospital with invasive, moderately differentiated, gastric adenocarcinoma status post 4 previous cycles of FLOT therapy. Repeat imaging demonstrated a mass-like prominence at the GE junction compatible with known gastric cancer with no evidence of metastatic disease. The patient’s PMH is significant for breast cancer (1993) with subsequent bilateral mastectomy, hypertension, and osteoporosis. She is a retired teacher who currently lives with her husband in bi-level house, reports never being a smoker, no history of drug use and 12 oz./week of alcohol consumption. She reports being functionally independent prior to admission and now presents to physical therapy status post exploratory laparoscopy, total gastrectomy with en bloc splenectomy, Roux-en-Y esophagojejunostomy, needle catheter feeding jejunostomy, and left closed-tube thoracostomy. Therapeutic interventions throughout the patient’s plan of care focused primarily on functional mobility, including bed mobility, transfer training, gait training, ambulation tolerance, and functional balance training.

Outcomes: On the day of discharge, following an 8-day inpatient stay, the patient was independent and timely with all bed mobility and transfers and was capable of at least 500 ft of continuous, independent ambulation. Thus, the patient was deemed functionally independent and appropriate for discharge home with recommendation for continued therapy via Home Health PT.

Discussion: This care report describes possible interventions and outcome measures for the treatment of postsurgical patients with abdominal cancer in the acute care setting.

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Apr 6th, 4:00 PM Apr 6th, 5:30 PM

Impact of Early Functional Mobility Training on a 67-Year-Old Postsurgical Female with Abdominal Cancer: A Retrospective Case Report

Hall of Governors

Background: Cancer continues to be a leading cause of mortality in the United States today, second only to heart disease in annual number of deaths due to the disease. A common treatment for malignant forms of abdominal cancer is surgical resection of the cancerous tissue. And while general guidelines for exercise interventions and other treatment strategies for individuals with cancer have been made available, a peer-reviewed, comprehensive clinical practice guideline, does not yet exist. Thus, due to the ever-increasing demand for high quality, cost effective cancer care, the current retrospective case report seeks to contribute to the eventual formulation of such a guideline with a focus on appropriate physical therapy outcome measures and interventions for postsurgical patients with abdominal cancer in the acute care setting.

Case Description: A 67-year-old Caucasian female was admitted to the hospital with invasive, moderately differentiated, gastric adenocarcinoma status post 4 previous cycles of FLOT therapy. Repeat imaging demonstrated a mass-like prominence at the GE junction compatible with known gastric cancer with no evidence of metastatic disease. The patient’s PMH is significant for breast cancer (1993) with subsequent bilateral mastectomy, hypertension, and osteoporosis. She is a retired teacher who currently lives with her husband in bi-level house, reports never being a smoker, no history of drug use and 12 oz./week of alcohol consumption. She reports being functionally independent prior to admission and now presents to physical therapy status post exploratory laparoscopy, total gastrectomy with en bloc splenectomy, Roux-en-Y esophagojejunostomy, needle catheter feeding jejunostomy, and left closed-tube thoracostomy. Therapeutic interventions throughout the patient’s plan of care focused primarily on functional mobility, including bed mobility, transfer training, gait training, ambulation tolerance, and functional balance training.

Outcomes: On the day of discharge, following an 8-day inpatient stay, the patient was independent and timely with all bed mobility and transfers and was capable of at least 500 ft of continuous, independent ambulation. Thus, the patient was deemed functionally independent and appropriate for discharge home with recommendation for continued therapy via Home Health PT.

Discussion: This care report describes possible interventions and outcome measures for the treatment of postsurgical patients with abdominal cancer in the acute care setting.