Advancing  Cancer Survivorship Care 

Locating and rating stiffness impairments following cancer

Denise Stewart
Occupational Therapist
Located in Monterey, USA
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AdVANCING CANCER SURVIVORSHIP CARE CONFERENCE 2024

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BIO

ABSTRACT

Denise Stewart is an Occupational Therapist trained at the University of Queensland, Australia. Her career has transitioned from providing rehabilitation for people with severe and chronic conditions in the public hospital setting to managing chronic injuries and conditions in the private sector: at the workplace and in lymphedema clinics. For the last 30 years, Denise has pioneered rehabilitation services for less-known physical impairments experienced by people after breast cancer.
Her latest work involves creating educational resources, to empower women and health professionals with knowledge about the assessment and treatment options for common physical issues that follow cancer surgery and radiotherapy.
Denise enjoys using various technologies to facilitate learning: face-to-face upper-body impairment workshops, the International Breast Cancer Rehabilitation Summit, online training for oncology manual therapy, and her Breast Cancer Rehabilitation YouTube channel.


Clinicians and exercise professionals must develop oncology scar evaluation tools for various cancers to better guide and evaluate the effectiveness of manual therapy interventions and specific exercises. Oncology scarring and radiation fibrosis are recognized as impairments that can cause pain, restrictions in the range of movement, and peripheral nerve damage.
Statistically significant results in shoulder abduction range and breast scar severity have been reported when myofascial treatments are used on breast cancer patients. While specific exercise therapy (mobilization and stretching) targeting the affected area is more widely
recommended for use by people following cancer treatments. Current standardized oncology scar questionnaires gather information on patient satisfaction, quality of life, and the frequency of scar-related symptoms. However, these patient-rated questionnaires fail to identify scar features to guide myofascial and scar treatments, and specific safe exercise. Myofascial
Adhesions in Patients after Breast Cancer (MAP-BC) is the only reliable and valid oncology-specific evaluation tool for health professionals to evaluate a range of scar features systematically. Scar locations within three soft-tissue layers and palpation and rating of the scar /adhesion will be presented. MAP-BC’s unique feature of using limb positioning to evaluate scar
stiffness/elasticity, positional limitations, and an adapted method will be discussed. The MAP-BC experience can guide health and exercise professionals to develop new scar severity evaluation tools for clinical use and research.


Locating and rating stiffness impairments following cancer

Denise Stewart
Occupational Therapist
Located in Monterey, USA
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Locating and rating stiffness impairments following cancer

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