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Community-based outpatient cancer rehabilitation services for women with gynecologic cancer: acceptability and impact on patient-reported outcomes

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Women with gynecologic cancers often experience functional impairments impacting quality of life. Physical and occupational therapy (PT/OT) treat functional impairment; however, the acceptability and impact of these services for women with gynecologic cancer are unknown.


We reviewed rehabilitation charts of women with gynecologic cancer who received PT/OT (i.e., patients) in 2019 and completed patient-reported outcome measures (PROMs) selected by their therapist at intake (pre) and discharge (post). We calculated descriptive statistics for patient, rehabilitation, and acceptability (0–10) data. For PROM data, we used paired samples t-tests to evaluate pre-post change, and then calculated effect size (Hedge’s g) and the proportion who achieved a minimal detectable change (MDC).


PT/OT patients (N = 84) were 64.63 ± 11.04 years old with predominant diagnoses of ovarian (41.7%) or endometrial (32.1%) cancer. They attended a median of 13 sessions (IQR = 8.0–19.0). Sessions were predominantly PT (86%) vs. OT (14%). Median acceptability was 10 (IQR = 9.8–10.0). Pre-post improvement was observed for each of the 17 PROMs used by therapists. Significant improvement (p < .05) was observed for four PROMs: the Patient-Specific Functional Scale (M∆ = 2.93 ± 2.31, g = 1.47, 71% achieved MDC), the Lower Extremity Functional Scale (M∆ = 12.88 ± 12.31, g = 0.61, 60% achieved MDC), the Lymphedema Life Impact Scale (M∆ = 20.50 ± 20.61, g = 1.18, 58% achieved MDC), and the Modified Fatigue Impact Scale (M∆ = 6.55 ± 9.69, g = 0.33, 7% achieved MDC).


PT/OT was acceptable and improved patient-reported outcomes for women with gynecologic cancers. Future research is needed to establish gynecologic-specific guidelines for referral and PT/OT practice.

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Data and materials are available upon request to the corresponding author.

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We would like to thank the patients who participated in the therapy, Stacye Mayo for manuscript review, Tiffany Croteau for her administrative support, and Select Medical leadership and therapists in the following divisions/markets: Baylor Scott & White Institute for Rehabilitation, SSM Health Physical Therapy, Banner Physical Therapy, NovaCare Rehabilitation, and KORT Physical Therapy.

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Authors and Affiliations



Authors Wood, Pergolotti, Kendig, Leiser, and Buckley conceptualized the study. Dr. Wood led data extraction, analysis, and initial manuscript preparation with support from Bartram, Hidde, Kendig, and Pergolotti. All authors reviewed and advised on the study and manuscript at each stage.

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Correspondence to Kelley C. Wood.

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This study was approved by the University of Southern Maine Institutional Review Board for the protection of human subjects (IRB #: 20–08-1521).

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Competing interests

Authors Wood, Pergolotti, and Kendig receive salaries from Select Medical. Author Bertram receives a salary from Baylor Scott and White Institute for Rehabilitation. The remaining authors have no relevant financial or non-financial interested to disclose. The content is solely the responsibility of the authors and does not necessarily represent the official views of Select Medical or Baylor Scott and White Institute for Rehabilitation.

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Wood, K.C., Bertram, J., Kendig, T. et al. Community-based outpatient cancer rehabilitation services for women with gynecologic cancer: acceptability and impact on patient-reported outcomes. Support Care Cancer 30, 8089–8099 (2022).

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