September 2026 Pediatric Lecture Series: The Physiatrists Role in Management of Lower Extremity Osteosarcoma-Session Recording

Video Transcription

Video Summary

Dr. Debbie Cassidy presented a physiatrist’s approach to caring for children and adolescents with lower-extremity osteosarcoma. She reviewed key disease features and the general treatment sequence: biopsy and staging, induction chemotherapy, surgical local control, recovery, and resumed chemotherapy. Understanding this timeline—and the specific reconstruction and postoperative restrictions—is essential for planning safe rehabilitation.<br /><br />Rehabilitation should begin as early as diagnosis when possible. Prehabilitation can address baseline impairments, strength, endurance, safe mobility, fatigue management, and family education. Physiatrists can also coordinate referrals to therapy, pain services, psychosocial support, and prosthetics. After surgery, priorities include wound healing, infection and edema control, pain management, contracture prevention, and safe mobility, while enabling chemotherapy to resume. Plans must be individualized for limb-sparing surgery or amputation and follow the surgical team’s weight-bearing, range-of-motion, and activity precautions.<br /><br />Cassidy recommended using the DEETS framework—preventive, restorative, supportive, and palliative care—to align interventions with treatment phase and prognosis. A rehabilitation roadmap can help patients and families understand goals and expectations throughout care.<br /><br />Guidelines support physiatry assessment for surgical patients and structured, supervised aerobic and resistance exercise to address cancer-related fatigue. Energy conservation and adaptive strategies can also help. Mirror therapy may be considered for phantom limb pain, although evidence is limited. Research comparing limb-sparing surgery and amputation shows mixed functional results, while quality of life appears broadly comparable.<br /><br />The central message: provide safe, coordinated rehabilitation throughout the cancer-care continuum, and recognize that education and care coordination are valuable parts of the physiatrist’s role.

Keywords

osteosarcoma

physiatry

rehabilitation

prehabilitation

limb-sparing surgery

amputation

chemotherapy

postoperative care

mirror therapy

cancer-related fatigue