Table 1.

Evidence-Based Physical Rehabilitation Interventions for Prevalent Impairments

Impairment	PT and/or OT Treatments	Assistive Devices	Orthotics and Compression Garments
Shoulder contracture	Topical or deep heat prior to mobilization, Codman’s exercises, manual techniques (eg, distraction), gentle PROM with progression to AAROM & AROM; education regarding the need for continued daily mobilization, instruction in daily HEP	Canes for AAROM activities, overhead pulleys for home use	Dynamic splints
Lymphedema	MLD, fibrous release techniques, multilayer short-stretch bandaging, remedial exercise, skin care, strategies to minimize lymphatic load, weight management, caregiver instruction in MLD and bandaging, primary preventive strategies for cellulitis	Schneider packs/pads for fibrolysis; donning and doffing aids	Compression garment, alternative nocturnal compression device
Aerobic deconditioning	Interval aerobic training ± oxygen support with PRN adaptations for bony instability, pain, neurogenic weakness, contractures; education in the rationale for interval conditioning; instruction in perceived exertion scale for self monitoring; support and guidance in establishing long-term OP program	Cane or quad cane as needed, adaptation of aerobic equipment as needed	NA
Upper extremity motor deficits
Proximal	Progressive resistive exercise to residual shoulder stabilizing muscles, core strengthening activities; ADL deconstruction and provision with compensatory strategies; education in strategies for tone reduction PRN	Dressing, bathing, and grooming assistive devices, nonslip mat	Balanced forearm orthotic, sling for painful subluxation
Distal	ADL deconstruction and provision with compensatory strategies, PROM as needed with progression to AAROM and AROM; education in strategies for tone reduction PRN	Built up eating utensils; nonslip mat; dressing, bathing, and grooming assistive devices	Universal cuff, wrist extension orthotic with lock, nocturnal resting splints

NOTE. The five categories of intervention consist of PT, OT, assistive devices for mobility, assistive devices for ADL performance, and orthotics and compression garments.

Abbreviations: PT, physical therapy; OT, occupational therapy; PROM, passive range of motion; AAROM, active assistive range of motion; AROM, active range of motion; HEP, home exercise program; MLD, manual lymphatic drainage; OP, outpatient program; NA, not applicable; ADL, activities of daily living; PRN, as needed.