Cancer Rehabilitation Program

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An Evidence Based Approach
To Cancer Rehabilitation

WHAT THIS GUIDE INCLUDES

  • ​Shift Your Mindset: Education and Goal Setting
  • Increase Mobility to Improve Performance
  • Rebuild Muscle Strength
  • Improve Conditioning and Activity Tolerance

Introduction

Cancer is a disease that is often feared. After initial diagnosis there are a lot of unknowns and health professionals that guide you through this journey. Treatments can leave you exhausted, in pain, feeling sick and weak. One to One Wellness has developed this program to empower you throughout this journey.

Education, exercise, and mobility training are proven tools to enable you to regain control over your health. Your program will be designed to address your 4M’s of Health: Mindset, Mobility, Muscle, and Metabolism. Using these proven principles provides you with a safe method to improve your quality of life and empower you from diagnosis to post-treatment.

What is Cancer Rehabilitation?

Cancer Rehabilitation is an ongoing process from diagnosis to post-treatment. It is a program designed to help you better understand what is happening to your body and help you regain mobility and strength to be able to do the things you love. After cancer diagnosis, there are many aspects to health that come into consideration as treatments take a toll on our physical, psychological and social well-being. This program is designed to provide you with a safe method of maintaining or regaining your strength and mobility to help improve your quality of life throughout this entire journey.

Why Cancer Rehabilitation?

At the moment, there are few evidence-based resources to help active cancer patients and survivors in our community outside of our hospital system. After cancer treatment, continuing to work on your mobility, strength, and conditioning is very important. The long term and late effects of cancer treatments can be minimized and potentially prevented through a regular exercise program that includes two sessions of bone and muscle strength training per week and at least 22 minutes of moderate intensity (walking like you are late for work) exercise per day.

What Does the Evidence Show About the Impact of Exercise and Activity?

  • Increase Quality of Life
  • Improve Muscular Strength
  • Reduce Pain
  • Decrease Fatigue
  • Decrease Recurrence Rates, Risk of Second Primary
  • Cancers and Death by 50%
  • Decrease Cardiovascular Risks
  • Decrease Estrogen production in female breast cancer survivors
  • Decrease Estrogen side-effects in prostate cancer survivors

"

“People living with cancer can safely engage in
moderate amounts of exercise while on active
treatments or post completion of treatments”
 
"Exercise provides benefits in quality of life and muscular and aerobic fitness and does not cause harm”
 
“The potential benefits of exercise far exceed
the potential associated risk"

- Ontario Cancer Care Guidelines for Exercise

"

What are the components of the program?

We understand that there are symptoms such as pain, nausea, and fatigue that prevent people with cancer from participating in exercise which is why our program is designed around your individual needs and goals. The benefit of this type of individualized program is to determine your current activity level and slowly build your tolerance up over time to overcome these barriers.

YOUR SESSIONS INCLUDE:

Mindset and Education

Pain is one of the main barriers to people participating in an exercise program. Learning about pain helps people understand that not all pain has to be limiting and there is a difference between hurt and harm.
​

  • Active Cancer Pain vs. Pain from Active Cancer Treatments
  • Medication and Treatment side effects that include numbness/tingling, joint and muscle pain
  • Movements to help decrease pain sensitivity
  • Long term and Late side effects of treatments
  • How to pace your activities to better manage fatigue and pain
  • Why your pain may not be going away

Part of the treatment plan will be to set individualized goals using the SMART principle: Specific, Measurable, Attainable, Realistic, and Time Frame. This helps empower and motivate you in managing your health.

Mobility

Retraining your body to move is an important step to returning to the things you love. Gentle manual therapy and guided movement practices help prepare your body for the increase in demand of our day to day life. Listed below are techniques that your physiotherapist may be use to help you achieve your mobility goals:

  • Neurodynamic Mobilizations
  • Gentle Range of Motion
  • Graded Motor Imagery
  • Active-Assisted Range of Motion
  • Passive Range of Motion
  • Dermoneuromodulation (Specific Skin Stretching)
  • Gentle Joint Mobilizations

Retraining your body to move is an important step to returning to the things you love. Gentle manual therapy and guided movement practices help prepare your body for the increase in demand of our day to day life. Listed below are techniques that your physiotherapist may be use to help you achieve your mobility goals:
​

  • Somatic and Body Awareness Exercises
  • Self Neurodynamic Mobilizations
  • Functional Tasks (E.g., Sit to Stand)
  • Walking

The Arch and Flattening Exercise below is an example of a way to increase movement and body awareness. The awareness exercises learned throughout the program are meant to be mindful, effortless, and pain free.

Deep Breathing And Low Back Relaxation


1. Laying on your back with your knees bent and relaxed. Breathe in, allowing your stomach to expand and your back to relax and arch up. This should take 3-5 seconds. Do not hold your breath.

2. Breathe out, allowing your stomach to fall and your back flatten, gently contracting the abdominals. At the end of your expiration, add a small rolling back of the pelvis to flatten the back even more. This should take 3-5 seconds, do not hold your breath.

Muscle

The importance of muscle in the recovery process cannot be overstated. Muscle not only helps with recovery, but it stores and provides your body with essential nutrients to help combat the stress your body is going through. After your initial assessment, your physiotherapist will slowly introduce you to our semi-private training room. At One to One Wellness, we use a slow-motion strength training protocol that allows you to strengthen within and move beyond your current limits. This helps reduce the amount of force on your joints and makes our workouts very efficient. Our equipment is designed to be adjusted for every person’s size and available range of motion.

Metabolism

Necessary treatments such as chemotherapy, surgery, radiation, and medication can leave patients feeling fatigued, nauseated, weak, and ill. These are examples of barriers; things that make participating in our day-to-day activities and exercise program more difficult. This all happens due to the change in metabolic processes in our body (breaking things down and building things back up).

In order for activities to become easier and to reduce the impact of our barriers, we have to slowly build our muscle and our tolerance back to reduce the impact our barriers have on our recovery process. Techniques to help with this include Pacing and Graded Exposure.

Our therapists track your progress every session that you attend. The questionnaires you fill out throughout the program are to ensure your goals are being met and to provide consistent communication with your family physician. The Activity Diary below is a great way for you and your physiotherapist to keep track of your activity levels and compare them throughout the program.

About One to One Wellness Centre

One to One Wellness Centre is a multi-disciplinary clinic in the heart of downtown Halifax. For over 14 years we have offered individuals unique physiotherapy services. These include personalized one on one care and access to our training room for supervised resistance training with your physiotherapist. Our team has helped clients like you manage and overcome persistent pain and other chronic conditions by using the most recent scientific evidence-based treatments and understanding the value of therapeutic connection.


Phone: 902-425-3775           Website: www.121wellness.ca


Address:
1535 Dresden Row, Suite 210
Halifax, NS B3J 3T1

References


1) Bennett MI, Rayment C, Hjermstad M, Aass N, Caraceni A, Kaasa S. Prevalence and aetiology of neuropathic pain in cancer patients: a systematic review. Pain.2012; 153:359-65.
2) Segal R, Zwaal C, Green E, Tomasone J, Loblaw A, Ptrella T, et al. Exercise for people with cancer. Toronto (ON): Cancer Care Ontario; 2015 Jun 30. Program in Evidence-based Care Guideline No.: 19-5
3) Bowering JK, O’Connell N, Tabor, A, Catley MJ, Leake HB, Moselet LG, Stanton TR. The effects of graded motor imagery and its components on chronic pain: a systematic review and meta-analysis. Jour Pain. 2013; 14: 3-13.
4) Kumar SP, Saha S. Mechanism-based classification of pain for physical therapy management in palliative care: a clinical commentary. Ind Jour Pall Care. 2011; 17: 80-86.
5) Nijs J, Leysen L, Adriaenssens N, Ferrandiz MEA, Devoogdt N, Tassenoy A…Meeus M. . Pain following cancer treatment: guidelines for the clinical classification of predominant neuropathic, nociceptive and central sensitization pain. Acta Onco. 2016;55:659-63.
6) Butler D, Moseley L. Explain Pain. NOI Publications. 2003. Adelaide, Australia.
7 )Wolfe RR. The under appreciated role of muscle in health and disease. Amer Jour Clin Nutr. 2006; 84 : 475-82
8) McGuff D, Little J. Body by science. McGraw Hill Companies. 2009. USA.

Fax: 902-425-3774