Neuro oncology conditions

Physiotherapy plays a crucial role in the rehabilitation and supportive care of patients with neuro-oncology conditions—those involving tumors of the brain, spinal cord, or peripheral nerves. The primary goals are to maintain or improve function, reduce complications, and enhance quality of life. Treatment varies based on tumor type, location, severity, and stage of disease (pre- or post-operative, during or after radiation/chemotherapy, etc.).

Key Physiotherapy Approaches in Neuro-Oncology:

1. Prehabilitation (Before Surgery or Treatment)

  • Goals: Improve baseline fitness and function to better tolerate treatment.

  • Interventions:

    • Education

    • Strengthening exercises

    • Breathing exercises

    • Functional mobility training

2. Post-Surgical Rehabilitation

  • Common Issues: Weakness, fatigue, balance problems, coordination deficits, spasticity, mobility issues.

  • Treatment Focus:

    • Neuro-rehabilitation techniques: e.g., Bobath, PNF (Proprioceptive Neuromuscular Facilitation)

    • Gait retraining: With or without assistive devices

    • Balance and proprioception exercises

    • Functional mobility training: Bed mobility, transfers, stair training

    • Strengthening and endurance exercises

3. During Radiation/Chemotherapy

  • Considerations: Fatigue, immunosuppression, neuropathy, and deconditioning.

  • Goals:

    • Maintain activity level

    • Minimize side effects like fatigue and deconditioning

    • Manage pain

  • Interventions:

    • Graded aerobic exercise

    • Light resistance training

    • Energy conservation education

    • Neuropathic pain management (e.g., TENS, desensitization techniques)

4. Managing Neurological Impairments

Depending on tumor location and effects, the following may be addressed:

  • Hemiparesis or limb weakness

  • Spasticity management: Stretching, positioning, splinting, and modalities like cryotherapy

  • Coordination problems: Task-specific and sensory-motor retraining

  • Cognitive and perceptual issues: Often in collaboration with occupational therapists

  • Communication and swallowing difficulties: Refer to speech and language therapy

5. Palliative and Supportive Care

  • Goals: Comfort, mobility, and independence

  • Focus Areas:

    • Pain relief (modalities, positioning)

    • Family and caregiver training

    • Mobility aids and environmental adaptation

    • Breathing exercises if respiratory function is impaired

6. Psychosocial and Quality of Life Support

  • Fatigue management: Pacing, rest strategies

  • Mood and motivation: Support through activity-based therapy

  • Community reintegration: Social and vocational goals

Multidisciplinary Coordination

Physiotherapists work closely with:

  • Neurosurgeons

  • Oncologists

  • Occupational therapists

  • Speech therapists

  • Psychologists

  • Palliative care teams