Inhalts- und Strukturanalyse von Bewegungsinterventionen in der onkologischen Rehabilitationskette unter besonderer Berücksichtigung der Rehabilitation und Nachsorge

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Introduction and Background: According to the Robert Koch Institute, the number of oncological diseases diagnosed has increased significantly in recent decades (2006: 426,800 & 2014: 476,210);; the forecast for 2020 is 519,000 new cases. The survival rates of people with cancer are becoming longer and longer (Robert Koch Institute, 2016). Cancer and its medical therapy have consequences and side effects that are a major limitation for patients. Medical side effects such as fatigue or chemotherapy-induced polyneuropathies can negatively influence the quality of life of patients not only in the acute phase of therapy but also years after the end of therapy. Especially important is the potential of exercise therapy for the targeted improvement of side effects and quality of life, which has been demonstrated in recent years through improved and more comprehensive study results. However, although the increasingly positive effects can be found in every phase of cancer, medical therapy and aftercare, there is no analysis of the scientific approaches of oncological exercise therapy within the rehabilitation pathway. The contents and structures in the individual sectors and the cross-sectoral cooperation should be analyzed. Methods: Within the present work, the contents and structures of exercise interventions in the rehabilitation pathway were examined. For this purpose, questionnaires of the same type and based on one another could be used in certified cancer centers, oncological rehabilitation clinics and cancer sports groups in Germany. The interface between two sectors was analyzed in order to check the state of information, the information and patient transfer and the cooperation between rehabilitation clinics and cancer sports groups on the topic of sport in cancer aftercare. With special consideration of the rehabilitation and aftercare sectors, the current scientific status of physical activity and exercise therapy was also recorded using the example of breast cancer and an overview was given of exercise therapy intervention studies in oncological rehabilitation clinics. A model project for a cross-sectoral approach to exercise therapy in the rehabilitation pathway was also presented. Results: Depending on the sector in the rehabilitation pathway, different contents and structures of oncological exercise interventions are shown. The certified cancer centers demonstrate a low level of implementation of the current scientific findings in the course of targeted exercise therapy and thus evidence-based care. In oncological rehabilitation clinics, on the other hand, exercise therapy plays a more important role. Nevertheless, with regard to the small number of RCT studies in rehabilitation clinics, there are gaps in the documentation of the studies, methodological differences and an insufficient review of the scientific approaches in rehabilitation clinics and in the daily life of patients. The results show that the cooperation between rehabilitation clinics and cancer sports groups has a high need for optimization and that exercise therapy must be optimized in post-cancer care. It should be emphasized that cancer sports groups offer only one option for exercise interventions, not for exercise therapy. There is a lack of standardized structures and contents for oncological exercise therapy and cross-sector cooperation in the rehabilitation pathway. Therefore, there are several approaches for optimizing the care for exercise therapy and the corresponding demands on future science and care. The model project on Oncological Training and Exercise Therapy (OTT) can represent the care for targeted exercise therapy in every sector within the rehabilitation pathway;; for this purpose, it is necessary to expand the approaches of this model throughout the country. Conclusion: The present analysis shows deficits in the current implementation of exercise interventions in certified cancer centers, oncological rehabilitation clinics and cancer sports groups within the rehabilitation pathway. There are gaps in cooperation on sports in cancer aftercare with a focus on rehabilitation and aftercare. With regard to the transfer of scientific findings into exercise therapy care for cancer patients, content and structures should be adapted in each sector and cross-sector networking should take place in the rehabilitation pathway. To this end, the important demands set out in this thesis should be addressed, definitions improved, and the rehabilitation pathway adapted into an exercise therapy pathway. The results show the need for optimization in sectoral care, but also for further research into targeted exercise therapy in oncology.
Original languageGerman
Place of PublicationKöln
PublisherDeutsche Sporthochschule Köln
Number of pages71
Publication statusPublished - 2020

ID: 5148589

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