Cancer rehabilitation aims to enable patients to maximize their physical, social, psychological, and vocational functions within the limits that arise during the course of the disease and its treatment. According to recent domestic studies, most patients report one or more physical problems during or after cancer treatment. This review presents the latest updates on cancer-related rehabilitation issues. Cancer rehabilitation in Korea still faces various barriers, including a lack of awareness, problems with the healthcare delivery system, and high costs, and recognizing the need for rehabilitation during cancer treatment varies among patients and even physicians. Hence, an appropriate cooperative referral system for cancer rehabilitation requires improvement. We herein review the current status of and barriers to cancer rehabilitation in South Korea to resolve the issues of domestic cancer rehabilitation.

Citations

• Use of Pulmonary Rehabilitation for Lung Cancer Patients in Korea: Analysis of the National Health Insurance Service Database
  Sang Hun Kim, Cho Hui Hong, Jong-Hwa Jeong, Jinmi Kim, Jeong Su Cho, Jin A Yoon, Jung Seop Eom, Byeong Ju Lee, Myung Hun Jang, Myung-Jun Shin, Yong Beom Shin
  Journal of Korean Medical Science.2025;[Epub]     CrossRef
• Factors associated with sedentary behavior among community-dwelling breast cancer survivors aged 50 years or older
  Jae Hyeon Park, Jung Soo Lee, Hyung Seok Nam, Yeo Hyung Kim
  Scientific Reports.2024;[Epub]     CrossRef

Objective
To evaluate the efficacy and safety of Daewoong botulinum toxin type A (NABOTA) after its launch in South Korea.
Methods
This prospective, multicenter, open-label phase IV clinical trial included 222 patients with stroke. All patients visited the clinic at baseline and at weeks 4, 8, and 12 after injection of upto 360 units of NABOTA into the wrist, elbow, and finger flexor muscles at the first visit. The primary outcome was the change in Modified Ashworth Scale (MAS) score for the wrist flexor muscles between baseline and week 4. The secondary outcomes were the changes in MAS, Disability Assessment Scale (DAS), and Caregiver Burden Scale (CBS) scores between baseline and each visit, and the Global Assessment Scale (GAS) score at week 12.
Results
There was a statistically significant decrease in the MAS score for the wrist flexors between baseline and week 4 (-0.97±0.66, p<0.001). Compared with baseline, the MAS, DAS and CBS scores improved significantly during the study period. The GAS was rated as very good or good by 86.8% of physicians and by 60.0% of patients (or caregivers). The incidence of adverse events was 14.4%, which is smaller than that in a previous trial.
Conclusion
NABOTA showed considerable efficacy and safety in the management of upper limb spasticity in stroke patients.

Objective
To investigate the clinical usefulness of diffusion tensor imaging (DTI) and tractography in the prediction of outcomes after traumatic cervical spinal cord injury (SCI) and to assess whether the predictability is different between DTI and tractography administered before and after surgery.
Methods
Sixty-one subjects with traumatic cervical SCI were randomly assigned to preop or postop groups and received DTI accordingly. Among the patients who had DTI before surgery, we assigned 10 patients who had received repeated DTI examinations at 8 weeks after injury to the follow-up group. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained from DTI, and imaginary fiber and crossing fiber numbers were calculated from the tractography. Neurological status and functional status were assessed at 4 and 8 weeks after SCI.
Results
The neurologic and functional statuses of both groups improved after 4 weeks. Out of the initial 61 patients who were enrolled in the study, the failure rate of DTI image analysis was significantly higher in the postop group (n=17, 41.5%) than in the preop group (n=6, 20%). The FA values and fiber numbers in the preop group tended to be higher than those in the postop group, whereas ADC values were lower in the preop group. When comparing the tractographic findings in the follow-up group, imaginary fiber numbers at the C6 and C7 levels and crossing fiber numbers from the C3 to C6 levels were significantly decreased after surgery. Several DTI and tractographic parameters (especially the ADC value at the C4 level and imaginary fiber numbers at the C6 level) showed significant correlations with neurologic and functional statuses in both the preop and postop groups. These findings were most prominent when DTI and physical examination were simultaneously performed.
Conclusion
Preoperative DTI and tractography demonstrated better FA and ADC values with lower interpretation failure rates than those obtained after surgery, whereas postoperative data significantly reflected the patient’s clinical state at the time of evaluation. Therefore, DTI and tractography could be useful in predicting clinical outcomes after traumatic cervical SCI and should be interpreted separately before and after spine surgery.

Citations

• Quantitative Magnetic Resonance Identifies Recovery from Spinal Cord Injury after Bioactive Implants
  DIANA OSORIO-LONDOÑO, AXAYÁCATL MORALES-GUADARRAMA, ROBERTO OLAYO-GONZÁLEZ, ERNESTO ROLDAN-VALADEZ
  Archives of Medical Research.2024; 55(5): 103012.     CrossRef

Objective
To demonstrate the sonoanatomy of the medial antebrachial cutaneous nerve (MACN) in the elbow region using high-resolution ultrasonography (HRUS) to identify areas at a high risk of MACN injury.
Methods
A total of 44 arms were included in the study. In the supine position, the participants’ arms were abducted 45° with the elbow fully extended. The MACN was visualized in the transverse view. The anterior branch of the MACN (ABMACN), posterior branch of the MACN (PBMACN), and location of the branching sites were determined. The distance between the ABMACN and superficial veins, including the basilic vein (BV) and median cubital veins (MCV) was measured. For the PBMACN, the distance to the ulnar nerve (UN) and to BV were measured.
Results
The MACN was subdivided into 2.18±1.00 branches, including ABMACN and PBMACN. The ABMACN and PBMACN were subdivided into 1.60±0.78 and 1.07±0.25 branches, respectively. The branching point of the MACN was 8.40±2.42 cm proximal to the interepicondylar line (IEL). We demonstrated that the ABMACN is located close to the BV and MCV in the elbow region, and the PBMACN was located approximately 1 cm and 0.8 cm anterior to the UN and posterior to the BV at the IEL level, respectively.
Conclusion
Considering the location of the MACN, including ABMACN and PBMACN, clinicians can perform invasive procedures around the elbow region more carefully to lower the risk of MACN injury.

Citations

• Ultrasonographic differential diagnosis of medial elbow pain
  Min Jeong Cho, Jee Won Chai, Dong Hyun Kim, Hyo Jin Kim, Jiwoon Seo
  Ultrasonography.2024; 43(5): 299.     CrossRef

Objective
To compare the biomechanical properties of the glenohumeral joint capsule between adhesive capsulitis (AC) after breast cancer surgery and idiopathic AC and demonstrate the effects of hydrodilatation (HD) with corticosteroid injection for AC after breast cancer surgery.
Methods
Twenty-three prospective patients with AC after breast cancer surgery (BC group) and 44 retrospective patients with idiopathic AC without breast cancer (CON group) underwent HD with corticosteroid injection and home exercise training. We compared their biomechanical characteristics (capsular capacity, maximal pressure, and capsular stiffness). In the BC group, the passive range of motion (ROM) of the affected shoulder and a questionnaire (Shoulder Pain and Disability Index [SPADI]) were evaluated at baseline and 2 and 4 weeks after treatment.
Results
The BC group showed higher biomechanical characteristics (maximal pressure and capsular stiffness) than did the CON group. The mean maximal pressure and capsular stiffness were 519.67±120.90 mmHg and 19.69±10.58 mmHg/mL in the BC group and 424.78±104.42 mmHg and 11.55±7.77 mmHg/mL in the CON group (p=0.002 and p=0.001, respectively). And, the BC group showed significant improvements in all ROMs (abduction, flexion, and external rotation) and the SPADI pain and disability sub-scores following the treatment.
Conclusion
The glenohumeral joint capsular stiffness was greater in the patients with AC after breast cancer surgery than in those with idiopathic AC. HD with corticosteroid injection was effective in treating AC after breast cancer surgery.

Citations

• An update on rehabilitative treatment of shoulder disease after breast cancer care
  P. E. Ferrara, D. M. Gatto, S. Codazza, P. Zordan, G. Stefinlongo, M. Ariani, D. Coraci, G. Ronconi
  MUSCULOSKELETAL SURGERY.2024; 108(1): 31.     CrossRef
• Effects of Intra-Articular Triamcinolone Injection on Adhesive Capsulitis after Breast Cancer Surgery
  Sungwon Kim, Sunwoo Kim, Jong Geol Do, Ji Hye Hwang
  Diagnostics.2024; 14(14): 1464.     CrossRef

Objective
To analyze the effects of lymphovenous anastomosis (LVA) surgery after 1 year using the elastic index (EI) and volume.
Methods
This study was a retrospective study of 41 patients, with lymphedema, who underwent LVA surgery between July 2018 and June 2020. Limb circumference, used to determine the volume of the limb with lymphedema, and EI, which reflects tissue stiffness and measured using ultrasonography were measured for each patient before and 1 year after LVA surgery. To examine the effect of LVA, differences in the preoperative and 1-year postoperative volumes and EIs were analyzed using the Wilcoxon signed-rank test.
Results
The mean volume and EI of the dominant site in upper-extremity lymphedema were 2,309.4 cm³ and 1.4, respectively, preoperatively and 2,237.1 cm³ and 0.9, respectively, at 1 year postoperatively. The mean volume and EI difference of the dominant site 1 year after surgery was -16.6 cm³ (p=0.22) and -0.5 (p<0.001). The mean volume and EI of dominant site in lower-extremity lymphedema were 6,137.0 cm³ and 1.2, respectively, preoperatively, and 5,832.6 cm³ and 1.1, respectively, at 1 year postoperatively. The mean volume and EI difference of the dominant site 1 year postoperatively were -320.9 cm³ (p=0.04) and -0.2 (p=0.09), respectively.
Conclusion
LVA surgery is more effective in reducing pressure than in reducing volume, which may be helpful in preventing the progression of lymphedema.

Objective
To assess the accuracies and validities of popular smart bands for heart rate (HR) measurement in cardiovascular disease (CVD) patients during a graded exercise test (GXT).
Methods
Seventy-eight patients were randomly assigned to wear two different smart bands out of three possible choices: Samsung Galaxy Fit 2, Xiaomi Mi Band 5, or Partron PWB-250 on each wrist. A 12-lead exercise electrocardiogram (ECG) and patch-type single-lead ECG were used to assess the comparative HR accuracy of the smart bands. The HR was recorded during the GXT using the modified Bruce protocol.
Results
The concordance correlation coefficients (r_c) were calculated to provide a measure of agreement between each device and the ECG. In all conditions, the Mi Band 5 and Galaxy Fit 2’ correlations were r_c>0.90, while the PWB-250 correlation was r_c=0.58 at rest. When evaluating the accuracy according to the magnitude of HR, all smart bands performed well (r_c>0.90) when the HR was below 100 but accuracy tended to decrease with higher HR values.
Conclusion
This study showed that the three smart bands had a high level of accuracy for HR measurements during low-intensity exercise. However, during moderate-intensity and high-intensity exercise, all the three smart bands performed less accurately. Further studies are needed to find a more optimal smart band for HR measurement that can be used for precise HR monitoring during formal cardiac rehabilitation exercise training, including at high and maximal intensity (Clinical Trial Registration No. cris.nih.go.kr/KCT0007036).

Citations

• The Accessibility and Effect of Cardiac Rehabilitation in COVID-19 Pandemic Era
  Chul Kim, Jun Hyeong Song, Seung Hyoun Kim
  Annals of Rehabilitation Medicine.2024; 48(4): 249.     CrossRef
• An Evaluation of the Effect of App-Based Exercise Prescription Using Reinforcement Learning on Satisfaction and Exercise Intensity: Randomized Crossover Trial
  Cailbhe Doherty, Rory Lambe, Ben O’Grady, Diarmuid O’Reilly-Morgan, Barry Smyth, Aonghus Lawlor, Neil Hurley, Elias Tragos
  JMIR mHealth and uHealth.2024; 12: e49443.     CrossRef
• Women’s Involvement in Steady Exercise (WISE): Study Protocol for a Randomized Controlled Trial
  Irene Ferrando-Terradez, Lirios Dueñas, Ivana Parčina, Nemanja Ćopić, Svetlana Petronijević, Gianfranco Beltrami, Fabio Pezzoni, Constanza San Martín-Valenzuela, Maarten Gijssel, Stefano Moliterni, Panagiotis Papageorgiou, Yelko Rodríguez-Carrasco
  Healthcare.2023; 11(9): 1279.     CrossRef