Gabriella Kourie unpacks the concept of prehabilitation: consulting an oncology trained rehabilitation therapist at the time.
The concept of rehabilitation has been used in discussion, for years, with regards to people who have needed it in various situations. A sport injury, medical condition or surgical procedure may result in a patient needing rehabilitation to help them recover and restore their functions and abilities to what they were before their injury or disability.
Being an oncology patient should be no different. Just as the patient who comes in for surgery to repair a broken bone will need rehabilitation after medical intervention to improve their quality of life; there are many areas of function that are disturbed by oncology treatments and the same interventions should be offered to oncology patients.
There has been a recent shift in discussion with regards to rehabilitation in terms of the ‘just-right timing’ to intervene with therapy. It has been made evident that patients with increased fitness and healthier lifestyle choices, recover and heal faster from interventions, such as chemotherapy, radiation and, most prominently, oncology surgery. The ability to regain function and continue with life normally is more attainable for these patients.
For some people this is a way of life but for others, insight and guidelines into healthier and practical lifestyle choices are often needed to encourage these patients. In an ideal world, all oncology patients should be seen by a rehabilitation therapist at the time of their diagnosis. Thus, the concept of prehabilitation is brought to the table.
The concept of prehabilitation
Prehabilitation is important for all patients with a cancer diagnosis. It allows for early intervention and prevents secondary complications during and after primary cancer treatments. While the treating doctors are working hard to fight the disease, your oncology trained therapist can intervene to assist them with the overwhelming questions and uncertainty you face with your new diagnosis.
The aims of prehabiliation are to empower and educate cancer patients on their diagnosis and prescribe treatment in the hope that they will be better equipped to identify, deal with and overcome secondary implications caused by treatments, both physically and psychologically.
The process of prehabiliation allows your therapist to achieve three vital outcomes:
1. Baseline function
This refers to your level of capability before treatment starts. This broadly includes physical and psychological abilities to carry out personalised daily activities, expectations at work and tasks of leisure. Obtaining this before the onset of treatment can help your therapist plan the necessary rehabilitation intervention to ensure that you return to your baseline functions, in as many areas as possible, after treatment.
2. Improved functional tolerance
This refers to your ability to cope better with treatments due to increased awareness and purposeful participation in physical activities before they commence. For example, if you’re undergoing chemotherapy; insight into chemotherapy induced peripheral neuropathy (CIPN) and prescribed sensory training and muscle strengthening of the hands and feet can prolong the onset as well as help you cope with this side effect.
3. Improved functional recovery
This refers to the reduction in side effects that you will experience post treatment. For example, if you’re waiting for breast cancer surgery or radiation; with the implementation of stretching and low impact upper limb exercises, your ability to regain movement and function after surgery will be faster than a patient who remained idle in this time.
Aim for longevity
The goal of oncology treatment has to be looked at holistically and long-term. By implementing prehabiliation, your therapist is hoping to prevent secondary complications, not only during the various treatments but in the years to follow.
Prehabilitation can assist patients in implementing practical lifestyle changes as well as help patients to practice healthy habits that promote longevity.
MEET THE EXPERT – Gabriella Kourie
Gabriella Kourie is a qualified occupational therapist. She further trained and qualified as a PORi oncology and breast cancer rehabilitation therapist and is currently qualifying in Lymphoedema Assessment and Treatment.
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