Abstract

Introduction: The number of cancer survivors is increasing and the need for multidisciplinary cancer rehabilitation centers is on the rise. The Cancer Rehabilitation and Cachexia Clinic at the McGill University Health Centre, aims to provide personalized, multidisciplinary care by introducing the concept of three patient streams based on symptom progression: restorative, supportive and cachexia. Patients at this clinic are seen by five cancer care specialists whose goal is to improve quality of life while restoring or maintaining their functional abilities. The present study evaluated the functional outcomes of the patients who participated in the multidisciplinary cancer rehabilitation clinic in 2014.
Objectives: To evaluate the functional improvement in the hand grip strength, six minute walk test, sit to stand test and the single leg stand test, of patients who took part in the interdisciplinary cancer rehabilitation clinic.
Methods: 115 patients with cancer were referred to the Cancer Rehabilitation and Cachexia Clinic from January to December 2014. Physical functional was assessed at baseline visits, follow-up visits and at the end evaluation, by performing the had-grip strength test, 6 minute walk-test, sit-to-stand test, and single leg stand test. The data was analysed for each dependent variable to determine if any baseline differences existed among the three program streams (restorative stream, supportive stream, cachexia stream) and to measure if the patients improved their functional status pre-post rehabilitation after completing the respective assigned streams.
Results: There were 48 patients assigned in the cachexia stream, 28 patients in the restorative and 39 in the supportive stream. The most predominant type of cancer was lung cancer. At baseline, the cachexia stream had significantly lower weight, BMI and higher WBC compared to the restorative stream. At baseline, patients in the supportive stream had a significant higher percentile HGS when compared to the cachexia stream (p<0.05). Although not statistically significant, all three streams slightly improved their hand-grip strength while being part of the program.
Conclusion: Overall function of the groups did not show improvement based upon the 6MWT and HGS. However, the supportive stream did show improvement in their percentile HGS. Thus, the interdisciplinary rehabilitation services demonstrated only mild improvements in the supportive but no measureable differences in the restorative or cachexic patient groups.