Laura Sisola Gilchrist

Saint Catherine University · Department of Physical Therapy

This document was drafted by interdisciplinary experts informed by the evidence and guided by their extensive lymphedema clinical experience at the 2023 American Cancer Society (ACS) Lymphedema Summit: Forward Momentum: Future Steps in Lymphedema Management hosted by the ACS, Lymphology Association of North America, and the Washington School of Med...

Breast cancer-related lymphedema (BCRL) remains a challenging condition impacting function and quality of life. Complete decongestive therapy (CDT) is the current standard of care, necessitating a comprehensive review of its impact. This paper presents a systematic review (SR) of SRs on CDT’s efficacy in BCRL, and the components of manual lymph dra...

Objective Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy and among the most common malignancies in young adults and requires a unique pattern of healthcare utilization including an acute/emergent presentation and an intensive initial 8 months of therapy followed by two years of outpatient treatment. The COVID-19 pandemic...

Background B‐lineage acute lymphoblastic leukemia (B‐ALL) is the most common malignancy of childhood. With the introduction of novel cellular therapies, cost of care is a critical component and the financial burden experienced by patients and society requires evaluation. Aims This study aims to assess the utilization and cost of care for chimeric...

Objective Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy and requires a unique pattern of healthcare utilization including an acute/emergent presentation and an intensive initial 8 months of therapy followed by two years of outpatient treatment. The COVID-19 pandemic caused massive global disruptions in healthcare use an...

BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood. With the introduction of novel cellular therapies, cost of care is a critical component and financial toxicity experienced by patients and society requires evaluation. This study aims to assess the total cost of CAR-T therapy for pediatric ALL patients with c...

Objective: To investigate the temporal trends and factors associated with outpatient rehabilitation utilization and costs for pediatric acute lymphoblastic leukemia (ALL). Design: De-identified, administrative claims data and longitudinal health information on patients representing a mixture of ages, ethnicities, and geographical regions across...

Objective: The objective of this study was to examine the relationship between adverse events (AEs) and critical events (CEs) during and following rehabilitation in cancer patients post hemopoietic stem cell transplant (HSCT) or bone marrow transplant (BMT) and to identify if particular lab values are associated with increased risk of AEs or CEs....

Background Participation in exercise improves function, restores fitness, and enhances quality of life in survivors of breast cancer. There is robust evidence regarding resistance and aerobic training for women at risk for and with breast cancer–related lymphedema; however, the effect of yoga on impairments and functional outcomes has not been well...

PurposeThe aim was to identify the impact of the (a) components of breast cancer–related lymphedema (BCRL) educational content, (b) modes of education, and (c) timing of education on arm volume, quality of life, function, complications associated with BCRL, adherence to interventions, and knowledge acquisition in individuals diagnosed with breast c...

PURPOSE Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. Five-year survival is approaching 90%. In efforts to further improve outcomes, it is critical to consider the cost of ALL care. MATERIALS AND METHODS Commercial insurance data from OptumLabs Data Warehouse were used to identify patients with ALL, age 1-30 years, di...

Introduction: Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood, with a current incidence of 3,000 cases annually. Incremental alterations in treatment over time have resulted in overall survival rates that now exceed 90%. Although minor differences exist between ALL treatment protocols from different cooperative groups,...

This systematic review provides a high-quality synthesis of the empirical evidence regarding chemotherapy-induced peripheral neuropathy (CIPN) characteristics and patterns described in studies of children who received neurotoxic chemotherapy to treat cancer. PubMed, CINAHL, PsycINFO, and Embase were searched for articles published 2009 - 2019, yiel...

Purpose A work group from the American Physical Therapy Association Academy of Oncologic Physical Therapy developed and published a clinical practice guideline (CPG) to aid clinicians in identifying interventions for individuals with breast cancer–related lymphedema (BCRL). This guideline reviewed the evidence for risk mitigation and volume reducti...

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is commonly experienced by children receiving neurotoxic chemotherapy. No validated pediatric CIPN patient-reported outcome (PRO) measures exist. Purpose: To test sensitivity, internal consistency reliability, content and convergent validity, and feasibility of the Pediatric Chemotherapy...

Background Breast cancer–related lymphedema (BCRL) is a sequela of cancer treatment that can impact quality of life. Interventions to address this impairment should be tailored for each lymphedema stage throughout the trajectory of care, from diagnosis of cancer throughout survivorship. Methods Studies were included in this clinical practice guide...

A work group from the American Physical Therapy Association (APTA) Academy of Oncologic Physical Therapy developed a clinical practice guideline to aid clinicians in identifying interventions for people with breast cancer-related lymphedema, targeting volume reduction, beginning at breast cancer diagnosis and continuing through cancer treatments an...

Objective: To review assessment and management approaches for chemotherapy-induced peripheral neuropathy-related physical function deficits. Data sources: Peer-reviewed articles from PubMed, Ovid MEDLINE, CINAHL PsycINFO, SPORTDiscus, Scopus, and key studies' reference lists. Conclusion: Brief clinical tests (eg, gait, Timed Up and Go) can scr...

Purpose: The purpose of this study was to evaluate the impact of switching patients being treated for acute lymphoblastic leukemia (ALL) from vincristine to bortezomib. Patients and methods: A total of 20 patients with ALL were switched from vincristine to bortezomib (1.3 mg/m/dose) because of worsening neuropathy despite physical therapy interv...

In May of 2018, the National Cancer Policy Forum (NCPF) of the National Academies of Sciences, Engineering, and Medicine (formerly the Institute of Medicine) released a report titled: Long-Term Survivorship Care After Cancer Treatment: Proceedings of Workshop. NCPF published reports have historically played a significant role in driving policy and...

Peripheral neuropathy is a well recognised treatment-related toxicity in children with cancer, associated with exposure to neurotoxic chemotherapy agents. Acute damage can occur in sensory, motor, or autonomic neurons, with symptoms that are rarely life threatening, but often severe enough to interfere with function during therapy and after treatme...

Background The Oncology Section of the APTA recently published a clinical practice guideline (CPG) for diagnosing secondary upper-quadrant lymphedema (SUQL) related to cancer. Application of any CPGs may be challenging depending upon clinical setting, patient population, and clinical expertise. Purpose The purpose of this article is to assist the...

Purpose: To describe the incidence and short-term recovery of balance control in children and adolescents receiving neurotoxic treatment for noncentral nervous system cancers and to investigate the association of chemotherapy-induced peripheral neuropathy and balance control. Methods: Sixty-five children and adolescents diagnosed with leukemia,...

Background Pain is one of the most common complaints in individuals with cancer and can occur at any point during the course of cancer treatment. Purpose To identify outcome measures for assessing pain and to evaluate their psychometric properties and relevance to adults with a diagnosis of cancer. Methods Three electronic databases (CINAHL, MEDL...

Background Childhood cancers and subsequent treatments can leave survivors with impairments that may lead to decreased physical performance. Rehabilitation can be an important component of promoting improved physical function in children and adolescents undergoing treatment for cancer. Objective To review and synthesize evidence for nonsurgical, n...

Secondary upper-quadrant lymphedema (SUQL) is a complication of cancer treatments that may impact a large number of cancer survivors. To identify lymphedema early, it is important to determine which diagnostic tools yield the best accuracy so that early intervention can minimize impairments and potentially reduce the cost of disease management whil...

Introduction The Oncology Section of APTA developed a clinical practice guideline to aid the clinician in diagnosing secondary upper-quadrant cancer-related lymphedema. Methods Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care cl...

The Oncology Section of the American Physical Therapy Association (APTA) developed a clinical practice guideline to aid the clinician in diagnosing secondary upper quadrant cancer-related lymphedema. Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist an...

Background Pediatric patients being treated for cancer often have low blood counts, yet physical therapy (PT) intervention and activity during treatment are thought to be important. The current practice at one institution is to modify PT interventions based on symptoms rather than relying on complete blood cell (CBC) counts. Purpose This study inv...

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent side effect of pediatric cancer treatment. The presentation of CIPN, trajectory and completeness of recovery over the first 6 months postchemotherapy, and the influence of patient and treatment characteristics on recovery are described. Patients and methods: Sixty-seven chi...

No abstract is available for this article.

The health care delivery system in the United States is challenged to meet the needs of a growing population of cancer survivors. A pressing need is to optimize overall function and reduce disability in these individuals. Functional impairments and disability impact a majority of patients during and after disease treatment. Rehabilitation health ca...

Purpose: Children treated with vincristine often develop chemotherapy-induced peripheral neuropathy (CIPN), but effects of CIPN on gait have not been reported. Methods: Gait variables of 52 children/adolescents treated for non-central nervous system cancers with CIPN were compared with an age- and sex-matched control group. Gait data were collec...

Background: Children with cancer identify fatigue as a pervasive symptom, which increases during the corticosteroid pulse in acute lymphoblastic leukemia (ALL) maintenance. The FitBit(®) is a fitness tracker that downloads activity measurements to the Internet in real time. In this feasibility study, we explored if children who received daily FitB...

It is widely understood that people treated for cancer often feel much better before their therapy begins than they do when it has concluded. Novelist Wilfred Sheed wrote of his cancer experience in his memoir, In Love With Daylight: A Memoir of Recovery [1].

Survivors of childhood cancer may experience persistent symptoms, including fatigue, sleep disturbance, and balance impairment. Yoga is a complementary therapy that improves fatigue, sleep, and quality of life in adult cancer survivors. Using a one group, repeated measures design, we evaluated the feasibility of a yoga program and assessed if cance...

Background: Pain is one of the most commonly reported impairments after breast cancer treatment affecting anywhere from 16-73% of breast cancer survivors Despite the high reported incidence of pain from cancer and its treatments, the ability to evaluate cancer pain continues to be difficult due to the complexity of the disease and the subjective e...

Background: Pain is one of the most commonly reported impair- ments after breast cancer treatment affecting anywhere from 16% to 73% of breast cancer survivors. Despite the high reported inci- dence of pain from cancer and its treatments, the ability to evalu- ate cancer pain continues to be difficult due to the complexity of the disease and the su...

Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer treatment in children; however, measurement of CIPN has been hampered by limitations in available tools, which may impact prevalence estimates. The purpose of this study was to assess the relative ability of the Common Terminology Criteria (CTCAE) rating process to...

Background: Neurotoxicity is a common side-effect of cancer treatment, but no scales have been validated for the pediatric population. The objective of this study was to test the reliability and validity of the pediatric modified-Total Neuropathy Scale (ped-mTNS) to measure chemotherapy-induced peripheral neuropathy in school-aged children. Metho...

Chemotherapy forms the backbone of treatment for many types of pediatric cancers, but a main side effect of treatment is chemotherapy-induced peripheral neuropathy (CIPN). Damage to the peripheral nervous system by chemotherapeutic agents can occur at the axon, cell body, or myelin level, and the mechanism of damage differs based on the specific ch...

Chemotherapeutic agents are the primary treatment of many solid (breast, bone, brain, and lung) and hematological malignancies (leukemia, lymphoma, and multiple myeloma). Because these drugs are not specific for cancer cells, healthy, rapidly dividing cells can also be damaged by chemotherapeutic agents, and such damage manifests itself in the form...

Diabetic Peripheral Neuropathy (DPN) is a complication of diabetes experienced by more than 30% of all diabetic patients. It causes decreased sensation, proprioception, reflexes, and strength in the lower extremities, leading to balance dysfunction. The purpose of this study was to assess the effectiveness of interventions used by physical therapis...

Adult survivors of childhood lower-extremity sarcoma are largely physically inactive, a behavior which potentially compounds their health burden. Altering this behavior requires understanding those factors that contribute to their physical inactivity. Therefore, this investigation sought to identify factors associated with inactivity in this subpop...

Cancer rehabilitation is an important part of survivorship as a distinct phase of treatment. Although cancer rehabilitation may involve many disciplines, this article specifically covers evidence-based treatment in physical and occupational therapy. Patients may need physical and occupational therapy services for a variety of cancer-related or canc...

Young adult survivors of childhood brain tumors (BTs) may have late effects that compromise physical performance and everyday task participation. The objective of this study was to evaluate muscle strength, fitness, physical performance, and task participation among adult survivors of childhood BTs. In-home evaluations and interviews were conducted...

Although the incidence of cancer in the United States is high, improvements in early diagnosis and treatment have significantly increased survival rates in recent years. Many survivors of cancer experience lasting, adverse effects caused by either their disease or its treatment. Physical therapy interventions, both established and new, often can re...

The aim of this study was to develop and test the feasibility of a chemotherapy-induced peripheral neuropathy (CIPN) measurement, the ped-mTNS, for use in school-aged children. After adapting an established adult measure (modified-Total Neuropathy Scale), the ped-mTNS was administered one time to 20 children ages 5-18 who were undergoing, or had re...

ABSTRACT &NA; This article is the second in a 2-part series written by the Research Committee of the Oncology Section, APTA that introduces the various aspects of rehabilitation research and the need to address quality of life issues in cancer survivors. Part I: (1) provided justification for physical therapy research, (2) encouraged the reader to...

To determine whether ATP and P2X3 receptors contribute to bone-cancer pain in a mouse model, immunohistochemical techniques were used to identify whether changes in the labeling of P2X3 receptors on epidermal nerve fibers (ENFs) occurred during tumor development. C3H mice were injected with osteolytic fibrosarcoma cells in and around the calcaneus...

This is a two part series written by the Research Committee of the Oncology Section of the APTA that introduces the various aspects of rehabilitation research and the need to address quality of life issues in all survivors of a cancer diagnosis. Part I will provide justification for physical therapy research, prompt the reader to generate the resea...

Octopamine, a biogenic amine analogous to norepinephrine, plays an important role in the orchestration and modulation of invertebrate behavior. In the leech, the behavioral actions of octopamine have been demonstrated; however, identification of octopaminergic neurons had not been determined by using immunohistochemical techniques. Thus, we used an...

Although the medicinal leech is a well-studied system in which many neurons and circuits have been identified with precision, descriptions of the distributions of some of the major biogenic amines, such as dopamine (DA) and octopamine (OA), have yet to be completed. In the European medicinal leech Hirudo medicinalis and the American medicinal leech...

It is well established that neural networks respond to a wide variety of modulatory substances by which they can become reconfigured, yet few studies have examined the effects of neurotransmitter mixtures on such networks. In a previous study of the medicinal leech using triple intracellular recordings, we found that stimulation of identified mecha...

Octopamine (OA), a biogenic amine similar to norepinephrine, has profound and well-documented actions on the nervous systems of invertebrates. In the insect, Manduca sexta, we examined the developmental plasticity of OA synthesis, studied its endocrine regulation, and observed previously undescribed OA-immunoreactive (ir) neurons. We found that lev...

Possible interactions between octopamine-immunoreactive (IR) and serotonergic neurons in the CNS of the medicinal leech were investigated. Simultaneous intracellular recordings of serotonin-containing neurons (either the Retzius neuron or cell 21) and the dorsolateral octopamine-IR (DLO) neuron demonstrated that both sets of neurons are coactive at...

Thesis (Ph. D.)--University of Minnesota, 1996. Includes bibliographical references.