1 Therapy services for Spinal Cord Compression (SCC) Caroline Belchamber 2004

2 Facts Oncology Physiotherapist 18 hours funded by the Physiotherapy department No dedicated rehabilitation Occupational therapist

3 The role of the therapist To prevent chest infections To maintain optimum function and ability within disease limitations To maintain mobility and prevent contractures through exercise To advise carers on posture, safe handling and moving Holistic approach to lifestyle management

4 Realistic goal setting to meet functional expectations Wheelchair mobility Ambulation Self-care Transfer abilities Learning to live with advanced cancer Learning to live with a disability

5 Therapeutic treatment Increases muscle strength Improves balance, posture and co-ordination Improves comfort through the reduction of pain and stiffness Improves ventilation through positioning Provides psychological support Provides education and support to carers and staff

6 Observations Southampton Hospital Velindre NHS Trust Rehabilitation Wheelchairs Gym Funding

7 Literature review The need for rehabilitation to be an integral part of palliative care is widely recognised in the literature (Cheville 2001, Hopkins 2000, NCHSPCS 2000) Kirshblum et al (2001) advocate that patients should participate in a structured programme of rehabilitation in a specialist in-patient rehabilitation facility where they would act as proactive members of their rehabilitation team. In spite of a relatively poor prognosis for patient’s with scc healthcare professionals contend that intensive rehabilitation is important to maximise the patient’s functional abilities and QOL (Yoshioka 1994)

8 Conclusion The Therapy services aim to provide a holistic approach through collaboration with the multi-disciplinary team to enable people with scc to set realistic goals so allowing them to come to terms with their advanced cancer and disability.

9 References Cheville A. Rehabilitation of patients with advanced cancer. Cancer 2001; 92 (suppl 4): 1039-1048 Hopkins K F, Tookman A J. Rehabilitation and specialist palliative care. Int J Palliat Nurs 2000; 6: 123-130 Kirshblum S, O’Dell MW, Ho C, Barr K. Rehabilitation of persons with central nervous system tumours. Cancer 2001; 92 (suppl 4): 1029-1038 National Council for Hospice and Specialist Palliative Care Services. Fulfilling lives: rehabilitation in palliative care. London: NCHSPCS, 2000. Yoshioka H. rehabilitation for the terminal cancer patient. Am J Phys Med Rehabil 1994; 73: 199-206