title: Multidisciplinary rehabilitation in women following breast cancer treatment: a randomized controlled trial.
abstract: OBJECTIVE
  To assess the effectiveness of a multidisciplinary ambulatory rehabilitation programme for women following definitive breast cancer treatment in an Australian community cohort.
  
  
  METHODS
  Eighty-five women in the community randomized to a treatment group (n = 43) for individualized high-intensity programme, or a control group (n = 42) comprising usual activity. The primary outcome Depression Anxiety Stress Scale (DASS) scale measured restriction in participation. Secondary measures included Perceived Impact Problem Profile (PIPP) and Cancer Rehabilitation Evaluation System Short-Form (CARES-SF); and Functional Independence Measure (FIM) motor subscale for activity limitation. Assessments were at baseline and 4 months.
  
  
  RESULTS
  Intention-to-treat analysis of data showed a significant difference between both groups in DASS Depression scores (p = 0.006) (moderate effect size, r > 0.3), PIPP Mobility (p = 0.05) and Participation (p = 0.04) scales, and CARES-SF Global score (p = 0.02) (small effect size, r < 0.3). The treatment group, compared with control group, showed significant improvement in the DASS Depression scores: 22/42 (52.4%) vs 12/37 (32.4%) (p = 0.02). No difference between groups was noted in the FIM scale.
  
  
  CONCLUSIONS
  Rehabilitation can benefit participation in breast cancer survivors. Evidence for specific rehabilitation interventions is needed. Integrated cancer programmes allow opportunities to evaluate patients in various settings, but require outcome research to develop service models for survivorship issues.
authors.affiliation: Department of Rehabilitation Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia. fary.khan@mh.org.au
authors.forename: Fary
authors.initials: F
authors.lastname: Khan
authors.forename: Bhasker
authors.initials: B
authors.lastname: Amatya
authors.forename: Julie F
authors.initials: JF
authors.lastname: Pallant
authors.forename: Ishani
authors.initials: I
authors.lastname: Rajapaksa
authors.forename: Caroline
authors.initials: C
authors.lastname: Brand
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology; D001943:Breast Neoplasms / Q000523:psychology / Q000534:rehabilitation*; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010348:Patient Care Team; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome