**12. Conclusion**

To implement an adequate sensory-motor and functional recovery program the patient needs to reach an acceptable walking ability. The ability to walk is the key to any human movement, despite the fact the human movements are not limited to bipedal locomotion; bipedal loco‐ motion is a fundamental part of daily life and is a prominent target of public health physical

The human gait is a complex combination of concerted movements; objective monitoring of walking evolution, using pedometer and accelerometer technologies, offers an opportunity to

Available studies in literature have used a variety of objective parameters based on instru‐

In order to get a better walking performance, two integrate procedures may be implemented: **1.** normalization of the foot-ground reaction forces using customized viscoelastic orthotics to control vertical and shear forces on the foot during the stance phase with no need for

**2.** use of the microgravitary system S.P.A.D (Corpo53, Italy) that determine the sensorymotor and functional recovery of the posture during the walking activity in combination to the development of proprioceptive information trasmitted from the periphery to the

After a period of unconditioning typical of the acute phase of cancer, it is necessary to learn again the correct body schema and achieve the complete recovery of postural control through spinal rehabilitation with floating platforms in tridimensional space and visual feedback. It is important to attempt correction of such postural abnormalities early in the rehabilitation

For example, breast cancer patients may develop chronic post-surgical pain following breast cancer treatment (Macrae, 2001) and, thus, adopt specific protective postures resulting in muscle spasm and muscle imbalances (Cheville & Tchou, 2007). Growing evidence is being produced in support for the use of Progressive Resistive Exercise training in head and neck cancer patients, in order to manage shoulder dysfunction and pain secondary to spinal accessory nerve damage. The importance of correcting posture and scapular stability prior to

The system I-Moove is equipped with a balancing platform with helical movement which allow the continuous realignment of the subsystems of the body in order to maintain an optimal posture as well as the use of a traction force. It also provides a real-time visual feedback

The inclusive approach entails therapeutic techniques implemented by physical therapists to improve the quality of life, including: EMG Biofeedback, home therapy-related imagery with Riablo-System (coRehab Italy), music therapy, play therapy, virtual reality- and exercise. The

process in order to prevent further dysfunctional patterns of movement. [145]

resistance exercise has been documented by McNeely et al (2004).

that allows physicians to monitor the correction. [146]

**11.3. Quality of life improvement**

formulate guidelines and recommendations for cancer patients.

ments that have been previously validated.

the obligatory use of athletic shoes;

cortical central system.

activity guidelines.

88 Updates on Cancer Treatment

The management of cancer pain with a planning of a complex rehabilitation program, in the context of a comprehensive treatment, encompasses nutritional support, multimodal training, correction of lifestyle, as well as use of advanced physical energies. Therefore, for the purposes of the optimal management of cancer pain, it is essential to identify the pathogenetic features and the clinical characteristics of pain, in order to tailor the different treatment modalities in rehabilitation. Terminal patients should have access to rehabilitation services and be encour‐ aged to remain functional and independent.

Clinical experience suggests that the application of the fundamental principles of rehabilitation medicine is likely to improve the care of patients with cancer.

A specialist in the identification, evaluation, and rehabilitation of neuromuscular, musculos‐ keletal, and functional disorders associated with cancer and its treatment should aim to the restoration and maintenance of function and quality of life.

Too often physicians tend to limit the treatment of pain in cancer patients to a pharmacological approach, tailored according to the severity of the symptoms as per the guidelines of the OMS.

A global and complex rehabilitation program may decrease the need for pharmacological medications and the occurrence of related side effects.

While oncologists are responsible for prolonging survival and nurses and counselors for optimizing comfort, the physical therapists play a major role in optimizing functions in patients suffering from cancer pain.

Physiatrist and physical therapists should thus be part of the team taking care of the integrated cancer management in primary, secondary and tertiary care, with a particular role being played with regard to cancer pain.

Molecular mechanisms in pain perception will direct mechanism-based drug therapy pre‐ scription in palliative care, whereas understanding of pain pathogenesis will direct physical therapy treatment, allowing proper decision-making and efficient treatment delivery in patients with cancer pain.

Despite being unquestionable that the primary goal in cancer patients management should be to prolong the overall survival, treatment of cancer pain is important in order to preserve daily functions and quality of life.

The development of an evidence-based body of knowledge will ensure that patients receive appropriate rehabilitation interventions in cancer pain.

Future research should, thus, focus on a better understanding of the role of rehabilitation and on defining appropriate interventions for this patient population.
