Start of a table of contents

 

growing need to address functional changes following cancer treatments. 

27% decline in cancer death-- improve treatment and faster recognition

More long term related functional limitation and decline. 

	Surgery*	Chemotherapy	Radiation therapy	Hormone therapy	Immunotherapy
Cardiovascular 🧡		x**	x	x	x
Endocrine	x	x	x	x	x
Gastrointestinal	x	x	x		x
Neurological 🧠	x	x	x	x
Pulmonary	x	x	x
Fatigue🛏		x**		x***	x

*based on surgical involvement

** no increased RBC with Adjuvant CT, consider alternative to help moderate symptoms: plasma volume, increased Cardiac output, peripheral utilization (caution with over working heart, may limited intensity and had longer duration)

*** Muscle loss can be increased with 2 sets of 8-15 reps at 60% 1 rep max, helps with weight management

Common Reported Side affects and recommended exercises: 

All should be adjusted based type and stage of cancer, current cancer treatment, medical comorbidities 

Common Cancer stagine: 

TNM: Tumor size, Node involvement, Metastasis 

Anxiety	(3mod Aerobic + resistance )x12 weeks	Better with supervision
Altered bone metabolism	(3mod Resistance +  high 2-3 high impact)x52 weeks	Caution with osteoporosis Caution with metastasis Badk for joint health *** stay in normal ROM for form Limited usefulness
Chemotherapy-induced peripheral neuropathy	Aerobic + balance training	Mostly to limit impact on function and safety
Depression	(3mod Aerobic + resistance )x12 weeks	Dose Responsive up to 180 min/week
Altered cognition	--	No specific studies
Lymphedema	SLow progressive supervised resistive training	Exacerbation need MLD and compression
Falls	Endurance and strengthening	Multifactorial make difficult to define actual effective treatment
Nausea
Pain	Focused exercise to reestablish proper biomechanics
Altered sexual function	Limited general studies, Focused Pt has been shown with limited improvement (Pelvic floor) Improved mood or personal image has also been noted to improve.
Impaired sleep	(3mod Aerobic) 30 minutes x12 weeks	No specific studies, expect usual response with increased aerobic activity
Quality of life	(2-3mod Aerobic + 2-3 Mod resistance )x12 weeks	Combination is better Improved results with supervision
Fatigue	(3mod Aerobic + resistance ) 30 minx12 weeks	More results creatine increased intensity Linear response to 150 min/week
Physical Function	(3mod Aerobic +/- resistance )x12 weeks	Increased duration is key Focal changes need supervision

Types of Physical Exercises/expected functional changes:

Aerobic	Resistance	Flexibility
Activity Tolerance Improved sleep Mood management Perceived improved quality of life Appetite regulations	Weight management Increased bone density Joint protection Physical appearance	Range of motion Ligament and tendon protection Improved perception of function

Aquatherapy-- combo of aerobic and flexibility

Yoga - Resistance, aerobic and mental 

FITT guidelines

Main Article

Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker DS, Matthews CE, Ligibel JA, Gerber LH, Morris GS, Patel AV, Hue TF, Perna FM, Schmitz KH. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc. 2019 Nov;51(11):2375-2390. doi: 10.1249/MSS.0000000000002116. PMID: 31626055.

Link

https://pubmed.ncbi.nlm.nih.gov/31626055/

Dollar tree educational haul

 A recent trip to the dollar tree Looking for educational distractions for my kids. Sadly they are very little so entertainment is very important. Usually I look for books to read, coloring books. But I must say I was pleasantly surprised by the findings of this trip. 

This is the complete haul... I even found something for me. 

My favorite was probably the Sticker puzzle books. I only snagged two of them. because I thought they might be a little too intense for my kids based on age. However, they have been very good. from an educational standpoint there two ways to do this. 

the way we did it was to find the stickers in numerical order progressing through the entire sticker collection. Conversely, it can be done the opposite  way where you take the sticker and find the spot on the page.   Either way, as you can see at the end you get a beautiful picture. 

These bring back great memories for me.I remember doing them as a young child. 

 

Yes, you can see the images prior, however these give an opportunity to practice painting and create lovely water color like images with little set up and even less risk for a disastrous mess.  Separate brushes can be purchased.  

A newer version, and better for repeated use,  these come with a re-useable 'paint' brush. I've seen similar ones by Mellissa and Doug.

This works a little better for the limited attention span with my kids.  Each book has a variety of pictures and scenery making it easy to talk about eco-systems.

Haven't tried this one yet,  but lookint at the bright happy colors, I anticipate this will be a big hit. simple and quick activities. 

This  collection has been the biggest hit with my children. Stickers Education, my kids are in heaven! the pages are bright and happy, with simple instructions to follow.  We did find it easier to remove the sticker pages to make it easier to  complete.  

After completion of the activity, each page creates a beautiful page, you can see the efforts of my son. 

These were the awesome find! and have been used to help with color recognition at one age level, and spelling for another age level. We also found some foam stickers of different shapes and colors, however they were slightly difficult to remove the backing.  

#saralayway

Aqua Therapy for Common Neuro Conditions-- summary

 

Knowledge preface summary:

Aquatic therapy has been used intermittently for many years. It remains the main stay for various conditions: OA, LBP and other degenerative disease processes.  Common benefits from this form of exercise are:

    - decreased weight bearing on joints-- caused by buoyance varied based on water depth

    - increased ROM

    - thermoregulation

    - external hydrostatic pressure causes decreased peripheral joint swelling --> decreased post activity pain

    - increased pulmonary function

    - increased activity tolerance --> decreased energy demands while walking

    - increased cardio output--> central blood supply increased. 30% end diastolic pressure, noted a decreased HR. (frank-starling law) 

    -increased safety by decreased risk of falls

Some common concerns with this form of exercise:

    - accessibility

    - infection control

    - cost associated

    - limited protocols

    - social pressure

    -lack of weight bearing

This article reviews the impact of aquatic therapy on various common  neuro-conditions. 

POST CVA

    Older or more ill population seen after loss of blood flow (ischemic or hemorrhagic) to a specific area, impairments vary based on area of ischemia. 

    Hypothesis:

     Increased blood flow to vital organs may increase cerebral blood flow-- will this help increase rates of healing and recovery?

    Findings:

      Blood velocity in MCA of swimmers: 20% increased  

    Clinical implications: 

    increased activity tolerance: it is suggested that with the decreased energy demands with aqua therapy makes the energy demands equivalent to a non-CVA survivor there for there is improved distance and tolerance

    increased sensory input (Rood's Sensory Motor Training)

    increased parasympathetic output (temperature based)

    Results

            Same results as with land based treatment

CEREBRAL PALSY

     non-progressive brain injury seen with 4 subtypes. seen in the past in pediatrics, however, improvements in medicine have allowed increased life expectancy to adulthood. 

    hypothesis

    increased activity tolerance and motion, increased opportunity for activity because of decreased physical demand on caregivers(parents)

    Findings:

    increased vital capacity y 65% at 4 weeks, increased timed 0.5 mile, and floor to stand; however, no impact on walking, running and jumping (land based activities)

    Clinical implications

        noticeable benefits are seen, however, are not appreciated by caregivers, causing limited buy-in and thus decreased utilization.   

PARKINSONS DISEASE

      younger population, noted with progressive bradykinesia, altered posture and rigidity increased the risk of falls, depression and sleep alterations. 

    Pathogenesis: associated with altered heat shock proteins, decreased dopamine in the substantia nigra may worsen with elevated temperatures.

     Hypothesis:

        Temperature regulation in aqua therapy may result in longer lasting effects. 

    Findings:

            decreased risk of falls and improved balance

     Clinical implications:

             limited protocols limit results. The same benefits are noted with land-based  however the use of halliwick (aqua) and Balance and posture training(land) had better lasting results at 6 months. 

MULTIPLE SCLERORIS

    autoimmune disorder affecting the CNS resulting in scattered and random CNS lesions.  various presentations: progressive, relapsing-remitting, primary progressive, relapsing-progressive. increased incidence in warmer areas. 

    Hypothesis

       Temperature regulation may improve temperature regulation and decreased relapses and recurrence due to reported low tolerance to heat seen in 50-66% or affected population 

    findings:

    sensory and motor effects -- limited benefits to either 

    more cytokines and neurotropnis are seen with aquatherapy--significance unknown at this time. 

Clinical Implications:

    Aqua is the same as land, due to limited understanding of etiology

Common interventions

Halliwick

https://www.physio-pedia.com/The_Halliwick_Concept?utm_source=physiopedia&utm_medium=related_articles&utm_campaign=ongoing_internal

https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcTnfwA3H192Ewbasvj5b7T4-wnRMFQHm2DcSA&usqp=CAU

Ai chi

https://en.wikipedia.org/wiki/Ai_Chi

https://i0.wp.com/aichiplus.com/wp-content/uploads/2016/10/AiChi6to9-300x232.jpg?resize=606%2C469

Moving to the hotel

 So in an unexpected turn of events, the original plan fell apart. So now I find myself living in an a long term hotel with my two toddlers and one husband. Not ideal by any means.  But I am excited about our future home if we are patient enough to wait for it. 

While filled with anticipation and hope for my future home and work to design it, I have stumbled across the 'dollar tree DIY/ organization youtube channels which I have decided to attempt some of their ideas to help keep my sanity while living in this hotel. 

some of my favorites are:

@BargainBethany, 

@Glue guns and roses

@Doitonadime 

Sadly I have not had great luck at my dollar tree, with some other of their great finds,  but I do have hope and will show you the before and then the after photos. 

This is the drawer. It is my hope to find a plastic tote that can be used as a drawer separator for all our drawers since we are each limited to one drawer. 

This is our current toy shelf, yes it holds the toys, but to get one out they all must come out. I will be looking for something to diminish that 

The start of our book area. Unfortunately there are too many books causing them to fall over, My solution is to place velcro under to stabilize each divider.  

The bathroom shelves, while nice, are very shallow and the space is basically gone after the few bath supplies you see here. 

These are the trouble spots, we'll see what I find.