INTEGRATIVE FRAMEWORK OF PHYSIOTHERAPY TO MANAGE CANCER CACHEXIA USING METABOLOMICS AND PERSONALIZED NUTRITION
Cancer cachexia, a multidimensional, complex metabolic syndrome of involuntary weight loss, muscle wasting, and systemic inflammation, continues to threaten cancer therapy outcomes and survival and quality of life. Traditional physiotherapy and nutrition care often employ nonindividualized methods, disregarding metabolic heterogeneity at the individual level. This study introduces a novel Integrative Physiotherapy Framework (IPF) that integrates metabolomicsguided phenotyping with personalized rehabilitation and nutritional programs to enhance metabolic resilience in cancer cachexia patients. Metabolic signatures defining impaired energy flux, mitochondrial perturbation, and inflammatory dysregulation were defined through untargeted plasma and skeletal muscle metabolomic profiling. These evidence-based individualized physiotherapy treatment regimens consist of resistance and aerobic exercise with omega-3 fatty acid-fortified dietary preparations, branchedchain amino acids, and antiinflammatory plant phytochemicals. In a 12week pilot cohort, the IPF elicited striking increases in lean body mass, muscle strength, and fatigue indices, as well as normalization of important metabolites like lactate, kynurenine, and βhydroxybutyrate. The results show that modulation of individual metabolic phenotypes by physiotherapy-facilitated metabolic modulation can reduce cachexia onset and restore functional capacity. By incorporating metabolomic understanding into clinical rehabilitation, the paradigm provides a precision-medicine treatment model for oncology physiotherapy, integrating molecular science and functional rehabilitation in a synthesis of supportive cancer care that redefines supportive cancer care.