Physiotherapy in Palliative Care (Under medical supervision)

Physiotherapy provides good physical function and maximises comfort for the cancer warriors. The goal of therapy is to improve quality of life of patients and provide symptom control utilising specific exercise techniques and modalities.

Active participation from both the patient and the caregiver is important for improvement in condition.

Disclaimer: Information on this page is for education and awareness only. It should not be used as a prescription or otherwise.  There are more specific exercises for other conditions like lymphoedema, abdominal exercises, etc. For more questions and a better understanding, please consult your doctor or physiotherapist. 

Often patient will have difficulty in expelling out the secretions. Regular steam inhalation moistens the airways and decrease the viscosity of the secretions, thereby helping the patient in expelling secretions with lesser effort. Use of devices like Incentive spirometer, flutter and acapella valve devices can also assist in secretion removal. Your physiotherapist can guide you in efficiently using these devices.  

Regular turning is important to prevent bed sores in prolonged bed stays. Caregivers should turn the patient every 2 hourly during the daytime to minimise the chances of bed sore. Turning should be in Log roll manner i.e. keeping the shoulder and pelvic girdle in the same plane while turning the patient. For this, the knees of the patient should be bent first, and then, by supporting the shoulder and pelvis, patient should be turned.

Gentle, slow and rhythmic- ROM (Range of motion) exercises for all joints, helps in: 

#Minimising joint contractures,

#Maintain joint and tissue mobility and 

#Assist in blood circulation

Self pacing and energy conservation techniques can also help in symptom management. Usage of assistive walking aids like stick or walker will also help in prevention of fall. Avoid forward bending and squatting, if your cancer care requires it to be avoided 

Patients with bony lesions requires adequate bracing and support to perform daily activities. Wearing these braces in proper manner is also important. Caregivers can learn these techniques from physiotherapist.

 With advancing age and/or disease progression, the bed rest time increases, and because of this the muscles gradually became weak; often known as disuse atrophy. The next few breathing and limb exercises can slow this progression.

With relaxed neck and shoulder muscles, patient is instructed to inhale as deeply as possible from nostrils, hold the breath for two seconds and exhale from mouth with pursed lips. Repetitions- 1 to 2 breathing exercise in 5 to 10 mins 

Using a thick towel roll beneath the knee, patient is instructed to press the towel roll on the bed, without holding the breath. Hold for 5 seconds and release. 

Repetitions-5 repetitions two times daily 

Using a thin towel roll beneath the ankle, patient is instructed to press the towel roll on the bed, without holding the breath.  

Hold for 5 seconds and release. 

Repetitions-5 repetitions two times daily.