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What is Physiotherapy?

Physiotherapy can be defined as the use of physical and therapeutic modalities to increase the range of movement and strength, to decrease pain and to improve the function and lifestyle of patients. The phrase physical and therapeutic modalities refers to such things as exercises, pain relief, and electrotherapy, which are all tools that may be used by physiotherapists in the treatment of the physical symptoms of disease, injury and surgery. 

Physiotherapy and Cancer of the Vagina

Physiotherapists are a vital part of the team of professionals dedicated to the effective treatment and management of gynaecological cancer. The role that physiotherapy plays in this team is to ensure that patients are physically prepared for surgery, and to assist them during recovery from surgery. Physiotherapists also educate patients about some of the possible physical side effects of gynaecological surgery (such as lymphoedema), and how these side effects may be prevented and managed.

Physiotherapists are usually consulted at each stage of gynaecological cancer treatment. Their intervention in the treatment process comes in two main forms: acute (surgical, usually at the time of diagnosis); and non-acute (when patients are admitted for other reasons, such as chemotherapy and radiation therapy).

Acute Physiotherapy 

As has been mentioned above, the term acute physiotherapy refers to intervention at the time of surgery. There are four main stages to acute physiotherapy treatment.

A pre-operative visit usually takes place between the patient and physiotherapist. The purpose of this visit is to explain to patients the need for physiotherapy and the results it will produce. This pre-operative consultation will involve the physiotherapists teaching patients a number of exercises and techniques to assist them during their preparation for and recovery from surgery. These exercises may include such things as circulatory exercises (to prevent DVT blood clots); deep breathing techniques (to prevent pneumonia); care of limbs if the lymphatic system is to be disturbed; and mobility (how best to move around with an abdominal wound).

Post-operative physiotherapy involves a continuation of the techniques and principles introduced during the pre-operative preparation. Treatment at this stage involves good team work between the physiotherapists, nursing staff and doctors. Patients are encouraged to achieve realistic goals, and to take their recovery 'one day at a time'.

At this stage, patients usually meet with their physiotherapist to discuss a home exercise routine. Also discussed here will be the practicalities of putting this plan into action, and whether or not assistance can or should be provided by family members and community nursing services.

Further contact is encouraged if needed. For example, once a patient has returned home after surgery, she may experience problems with activities to do with lifting, abdominal exercise, care of a lymphatic limb, toileting, etc. If these problems arise, consultation with a physiotherapist can often solve them.

Non-Acute Physiotherapy. 

Non-acute physiotherapy treatment usually occurs after the patient has been involved in acute physiotherapy. In relation to gynaecological cancer, most patients will receive non-acute physiotherapy treatment when they are receiving chemotherapy or radiation therapy. The areas of concern to physiotherapists during this type of non-acute care include:

How can Physiotherapists Help Patients?

There are a number of techniques used by physiotherapists to assist patients during acute and non-acute treatment and care. These techniques will vary according to factors such as the individual patient's capabilities; the nature of her condition; and her normal activity levels. As such, it is not possible to provide a 'standard' prescription for physiotherapy treatment of gynaecological cancer over the internet. However, below are a number of general techniques that are often used by physiotherapists as part of the treatment and management of gynaecological cancer patients.

Exercises that may help to improve the mobility of a patient include moving around the bed, moving in and out of bed, bed to chair transfers, walking, and toileting. Physiotherapists also discuss and examine the need for aids to perform such functions as walking and toileting. 

These activities are aimed at increasing a patient's endurance. The physiotherapist will develop, with the patient, a rehabilitation programme, which sets realistic goals for the patient during recovery, with or without the consultation of the patient's family.

If surgery results in the development of a respiratory infection, then an appropriate physiotherapy regime targeting the chest will be developed. Often, this will involve a consultation with the patient's carer and/or family, as their assistance may be required.

If a patient should develop lymphoedema as a result of surgery, a physiotherapist qualified and experienced in dealing with lymphoedema should be consulted, or patients should attend a lymphoedema clinic. Extensive assessment of the condition is required, and there is usually a need for compression bandaging.

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