[libribook.com] Traumatic Scar Tissue Management 1st Edition

• Paresthesia – 47%
• Arm/shoulder swelling – 25%
• Phantom sensations – 19%
• Allodynia – 15%.
Chronic pain related to breast cancer was significantly associated with poorer
health-related quality of life (HRQOL) and higher medicine consumption.
Chronic pain is 42% more prevalent in breast cancer survivors than in the
general population. Other sequelae prevalence factors include age (<70 years),
short education, being single (divorced, widowed, separated), radiotherapy, and
time since operation <10 years. Radiotherapy and younger age were significantly
associated with most sequelae (Peuckmann et al. 2009).
Although sequelae appears common, there remains a sizeable gap between
patient need and measures taken to provide or refer for appropriate rehabilitative
services (Cheville et al. 2008, 2009, Schmitz et al. 2012). It is established that
the likelihood of referral is lower among minorities and the socioeconomically
disadvantaged – a noted access to care disparity among not only cancer survivors
but in the population at large.
There is a growing body of evidence which supports that rehabilitative and
exercise intervention result in better outcomes when adverse treatment effects
are identified and treated early on (Box et al. 2002, Stout Gergich et al. 2008,
Torres Lacomba et al. 2010, Springer et al. 2010, Schmitz et al. 2010, Gerber et
al. 2011).
Further, the 60% side-effect incidence (Schmitz et al. 2012) is likely an
underestimate, given that several common sequelae of particular relevance to
manual therapies were not measured in the study, such as bone health, arthralgias
and chemotherapy-induced peripheral neuropathy (Schmitz et al. 2012). If
impairments are commonly observable and if cost-effective rehabilitative
treatment has been shown to reduce morbidity and comorbidities, then it is
reasonable that the service provision, referral and accessibility gaps are
satisfactorily addressed.
Schmitz et al. (2012) note the broad spectrum term – rehabilitation; although MT
is not specifically identified, when we scan the list of sequelae, with the
exception of infection, every single issue noted falls squarely within our scope of
practice. Clinical experience and supportive evidence affirms that MT can