Occupational therapy rehabilitation for sarcoma patients following limb salvage surgery: a scoping review.
McKenzie C., Barker K.
Introduction: Sarcomas are rare cancers of bone and soft tissue, and limb salvage surgery is the standard treatment followed by multidisciplinary rehabilitation. The scoping review aimed to summarize the evidence for occupational therapy intervention for adult sarcoma patients following limb salvage surgery. Methods: A review of the literature using a scoping framework was undertaken starting with a systematic database search, followed by an analysis of the literature. The literature was described using a numerical analysis, and the following headings; (a) rehabilitation, (b) activity limitations and participation restrictions, (c) functional outcomes. Findings: Seventeen articles met the review criteria, papers were diverse in study location, type, population, methods and outcomes used. Following limb salvage surgery patients experience functional deficits, activity limitations and participation restrictions in life roles and loss of previous identity. Prehabilitation can influence functional outcomes. Functional activity was found to plateau at 4-12 months following limb salvage surgery, with some patients identifying a need for further rehabilitation. Conclusion: The review identified limited evidence guiding occupational therapy practice for sarcoma patients following limb salvage surgery. Further research is needed to demonstrate the effectiveness of occupational therapy intervention in the early and late stages of rehabilitation and develop evidence based guidelines. Implications for rehabilitation Sarcoma patients experience activity limitations and participation restrictions in activities of daily living, work and leisure following limb salvage surgery. Prehabilitation and early intervention can influence functional outcomes. Functional ability may plateau at 4-12 months following limb salvage surgery. Some groups of patients will benefit from late rehabilitation to maximize their rehabilitation potential.