PHYSICAL THERAPIST CLINICAL PRACTICE GUIDELINE: EXERCISE PROGRAMS FOR ADULTS LIVING WITH OR BEYOND CANCER AND CARDIAC DYSFUNCTION, BONE METASTASES, CHEMOTHERAPY INDUCED PERIPHERAL NEUROPATHY, OR FATIGUE

This guideline was developed to assist physical therapists in supervising exercise interventions for adults living with or beyond cancer. Physical therapists may face clinical uncertainties while supervising exercise in this population, due to the complexity of the disease and its treatment, and/or associated health issues. The guideline describes recommendations related to the most commonly experienced uncertainties as indicated by physical therapists working in cancer care: cardiac damage/dysfunction, bone metastases, chemotherapy induced peripheral neuropathy (CIPN), and severe fatigue. The guideline was developed according to the guideline methodology of the Royal Dutch Society for Physical Therapy (KNGF). The project group performed a systematic literature search and evaluated the certainty of the retrieved evidence using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Subsequently, recommendations were formulated, after considering feasibility, acceptability, costs, values, and patient preferences. Implementation of this guideline will decrease clinical uncertainty among physical therapists and improve the quality of physical therapy care for people living with and beyond cancer.