17 YEARS EXPERIENCE WITH SPORT GROUPS IN CANCER AFTER-CARE WITH MAMMA-CA-PATIENTS - A MODEL OF COMMUNITY BASED REHABILITATION

17 YEARS EXPERIENCE WITH SPORT GROUPS IN CANCER AFTER-CARE WITH MAMMA-CA-PATIENTS - A MODEL OF COMMUNITY BASED REHABILITATION

Schule. K. (German Sport University of Cologne.
Institute for Rehabilitation and Sport for the Disabled)

Introduction

Whereas some retrospective examinations concemin Q protective effects of sports activities on cancer have been published (Paffenbarger et af. 1987, Lee et al. 1991, Thune et al. 1997), there are only a few statements about movement and sport in rehabilitation of cancer-patients. The aim of every rehabilitation is the increase of quality of life. An optimal integration in the social surroundings is part of the same. Movement and sport activities make a contribution to this quality because they influ* ence its three main aspects in psychological, psychic and social spheres.

Aim

The aim of this paper is to report on a 17 years lasting experience with specific reha-sport groups and their organizations. For more than 17 years the first sport group for women with breast cancer had been founded in Cologne. Meanwhile, there are about 500 sport groups with typical characteristics of self-help groups all over Germany. As far as we know there are not too many groups of this nature in Europe. however there are a few in Beglium and Norway, This contribution should be a stimulation to found such groups in further European countries.

We are introducing the "Kulner Konsens" worked out in 1991, a curriculum which had been confirmed by all German Sport Federations in 1997, for the education of sports assistants for such groups. Its contents are:

Medical bases

Psychological aspects of oncological diseases

Specific knowledge of physical exercise

Organization of sport group for cancer after-care

in the sense of a "community based rehabilitation"

Selected results

Physiological parameters

Despite the reduction of radical mastectomy " today one preferes breast preservation - still 60 - 70% of the women have trouble with the limitation of mobility of the arm- shoulder-region-Although we are not content with the objective improvements, the women have learnt to live with their handicap so that still existing limitations of mobility will touch them less. Thus the activities of daily living increase.

Psychosodal effects

First of all we have to mention pain. anxiety and depression. In all of these sections we are successfull. We can report this for many other rehabilitation sports-groups, too. And these aims should always be acnieved by a welt measured and well organized sportstherapy or by an appropriate rehabilitation sports'programme at the place of residence (community-place).

This is also valid for the social communication and interaction which can be supported by the sports programmes and wich have a tendency against isolation.

Conclusion

In the rehabilitation of cancer patients there are deficiencies in physical and psycho-social care which must be recognized. Referring to breast cancer, special sport programs (gymnastics, moderate endurance training, games, etc.) have stood the test as a community program. There is no doubt that favourable psychosocial circumstances have a positive influence on overcoming the disease in the sense of social support. Apart from this, these activities are also influencing the weakened immune system (Ldtzerich, Peters 1997)-

In summary, because of the advantages stated above, further sport groups should be initiated in every European country. This would greatly contribute to a possible reduction of expenditures spent on health care in general.

in Germany exists about 500 special sports groups for this clients. In some other European countries as in Belgium, Norway, Poland and Switzerland they started similiar programmes in the last 5 years The most problem is to interest medical doctors and physiotherapists for such interventions wich are orientated to bio-psycho-social signs.

To win more renabilitees for these programmes it is nessessary to improve more and effective cooperations between several clinics, rehabilitation" and self-help services, in sense of networking.

References:

1. Paffenbarger RS, Hyde RT, Wing AL: Physical activity and incidence of cancer in divers populations: a preliminary report. Am J Clin Nutr45: 312-317.1987

2. Lee I. Paffenbarger RS, Hsieh CC: Physical activity and risk of developing colo-rectal cancer among college alumni. J Nat Cancer Inst 83:1324-1329,1991 Lotzerich H, Peters С: Krebs und Sport, Sport & Buch StrauU. Kuln 1997

3. Thune I, Brenn T., Lund E., Gaard M.: Physical activity and the risk of breast cancer. New Engi J Mod 336- 1269-1275, 1997


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Schule, K. 17 years experience with sport groups in cancer after-care with mamma-ca-patients - a model of community based rehabilitation // Открытый мир : Науч.-практ. семинар по адапт. двигат. активности. - М., б. г. - С. 10-12.