April 13, 2021
Christopher Wilson, PT, DPT, DScPT, an assistant professor in Oakland University’s Physical Therapy program, is co-author of a new book that aims to help physical therapists and other health professionals improve quality of life for those living with chronic, degenerative or end-stage illness.
The book, titled “Physical Activity and Rehabilitation in Life-threatening Illness,” was also co-authored by Amy Litterini, PT, DPT, associate clinical professor in the Doctor of Physical Therapy program at the University of New England (Maine), with contributions from other experts in the field. It highlights best practices for caring for a population with a markedly high need for rehabilitation services.
“When most people think of physical therapy and rehabilitation, it’s to make someone better or fix a problem like low back pain or stroke,” said Wilson. “But there’s a huge population of folks with life-limiting or chronic diseases such as late-stage cancer or an advancing disease process, and rehabilitation professionals need to know how to work with these patients.”
He continued, “There’s a lot of research showing evidence of exercise reducing cancer recurrence, decreasing obesity and reducing someone’s pain. I think we are doing that pretty well in the general population, but with chronically or terminally ill patients, it’s more complicated and usually takes a higher level of expertise, which is why the book is aimed at health care providers and researchers in this area of practice.”
The book also seeks to increase awareness among other health care disciplines and the general public that rehabilitation can benefit every patient, regardless of their disease progression and ability level.
“In my career, I’ve noticed that not everyone understands that rehabilitation is safe for people with chronic or life-threatening illness,” Wilson explained. “When I talk to patients, I tell them that physical therapy is not a choice between two extremes, but more like a dimmer switch that can be turned up or down based on the patient’s individual needs.”
According to the Centers for Disease Control and Prevention, 60 percent of adults in the U.S. have a chronic disease; 40 percent have two or more. Chronic diseases are among the leading causes of death and disability, and leading drivers of the nation’s $3.8 trillion in annual health care costs, the CDC reports. To counteract these trends, the book advocates changing the way care providers deal with the chronically ill – namely by addressing health issues proactively and treating rehabilitation as an ongoing process, instead of a one-time fix.
“When I started in this profession, patients got a bout of physical therapy, and the thinking was that if I did my job right I’ll never see them again because they’re going to stay healthy,” Wilson explained. “But that’s not how it goes, especially with this population. They’re going to have re-injury or re-exacerbation and they’ll need a physical therapist for life – an ongoing relationship just like with a medical doctor or a dentist.”
He added, “When you go to the dentist, you still get your checkup even if you’re not having any pain. The dentist might catch a cavity and fix it before it turns into a rotted tooth. We should apply that same thinking when caring for the movement system of the body. A long-term, proactive approach can increase quality of life for patients and decrease health care costs by reducing hospital stays and medical procedures.”
Wilson also noted the importance of the entire care team working together to support the physical and psychosocial needs of patients. The book dedicates a chapter to explaining the roles of medical doctor, palliative care nurse and physical therapist, along with social worker, spiritual adviser and other professionals.
“The purpose of our textbook is improving a person’s quality of life, and physical function is just one component of that,” said Wilson. “For individuals who are facing a chronic and life-threatening illness, there can be a lot of anxiety and feelings of being out of control. It’s a very fear-inducing and disruptive experience that requires support from a multidisciplinary team to help manage all these issues.”
Published by Routledge, the 380-page volume is organized into four sections and 23 chapters co-written by Wilson and Litterini, with select chapters by Jeannette Lee, associate professor at the University of California, San Francisco and Kendra Koch, researcher at the University of Texas, Austin. OU Doctor of Physical Therapy student Danielle Black served as line editor, providing support on grammar, punctuation and writing style. The foreword was written by Richard Briggs, a leading expert in palliative care and hospice for the past 30 years.
In addition to his role in OU’s Physical Therapy program, Wilson is an OU alumnus, having earned a Bachelor of Science in Health Science and a Master of Physical Therapy from Oakland. After receiving his Doctor of Physical Therapy from the University of St. Augustine (Florida), he started his career as a physical therapist at Beaumont Hospital, Troy, where he has practiced since 2001. He is currently the Residency Program Director for the Beaumont Health Oncology Residency and Vice President of the American Physical Therapy Association’s Academy of Oncologic Physical Therapy. He also has served as the Hospice Palliative Care Coordinator for the oncology subgroup of the World Confederation for Physical Therapy (now World Physiotherapy).
To learn more about the book, view the publisher’s web page.