Palliative care (PC) and best Supportive Care are complex areas to promote and advance. Many people need and benefit from them, therefore education, spreading knowledge and existence of interdisciplinary teams (IDT) are required to ensure best quality of life.
Nowadays only 15% of Countries have Hospice and Palliative Care (HPC) integrated inside their national health system. Among those countries, few offer physical therapies.
Complementary and other non-pharmacological strategies used alongside traditional analgesic approach aims to help patients in maintaining and improving functionality in order to obtain at the same time psychological benefits.
Physical therapies (PT) are part of a no pharmacological approach, including several different techniques applied by physical therapists (PTs) with the purpose not only to manage the symptoms but also to improve Quality Of Life (QOL) of patients receiving pain rehabilitation and palliative care. It allows PTs to be part of an IDT and being active part of the holistic care of the patient.
Linking PC with physical rehabilitation or physical exercise (PE), the aim was to critically evaluate the evidence for the effectiveness, benefits and weaknesses of PT (exercise) in end-of-life care.
Due to the results obtained and the strength of the evidence, the author suggests a first protocol involving an IDT to best fit the evidence.
A systematic review has been conducted, screening and reviewing the most recent studies published and related to this topic. More than 10 among databases and journals has been investigated to answer the aim.
Eight studies fitted for the analysis discussing the role of physical therapy intervention in palliative care setting. The quality of the studies was done following QASP/CASP checklists.
Improvements (p ≤ 0.01) were observed in physical performance, fatigue, and overall quality-of-life scores. A first physical exercise programme is suggested.
An holistic biopsychosocial intervention (Total Pain concept) is the key for those people with complex and life-threatening illnesses. Not only for patients but also for the caregivers underlying the importance of a IDT. PTs play an important role inside a team focusing their intervention in improving functionality and QOL turning to physical and functional dimensions of care.
Around 75% of the population will need PC therefore it is indispensable to start offering i) the best services, ii) where patients want, iii) taking the best decisions (right care, right place, right time).
PT/PE plan has to be tailor-made and based on the general prospective evolution of the patient, in his capability to recover his functionality and his desire to take part to the rehabilitation programme.
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