Effect of early physical therapy on schoolchildren with hematological
cancer: a quasi-randomized controlled pilot study
Abstract
Background: Although the treatment for childhood hematological cancers
such as acute lymphoblastic leukemia (ALL) has improved, there are
problems involving a decrease in motor functional capacity and
health-related quality of life (HRQOL) during and after cancer
treatment. Physical therapy (PT) is expected to positively impact motor
functional capacity and HRQOL in patients, but the optimal time for
intervention is unknown. Procedure: This study evaluated the effect of
inpatient PT intervention in pediatric patients with hematological
cancer undergoing treatment at a single tertiary hospital. Participants
were assigned to two groups that started PT before or after initial
treatment (early PT or late PT, respectively). We evaluated the exercise
tolerance of participants using the six-minute walking distance (6MWD)
and differences in the HRQOL of participants and their mothers using the
Pediatric Quality of Life Inventory (PesdsQL) questionnaire at (1)
admission, (2) the end of initial treatment, and (3) discharge. Results:
Thirteen pediatric patients (61.5% ALL, aged 7–13 years) included.
Significant improvements were observed in PedsQL in the early PT cohort
but declined in the 6MWD and PedsQL in the late PT (all
p<0.025). The changes in PedsQL scores for the patients and
their mothers were similar. No adverse events related to PT during
treatment were identified. Conclusion: Early PT intervention is an
effective alternative to intensive rehabilitation care. Data suggest
that early rather than late-PT participation can result in significant
functional gains in locomotion and HRQOL in pediatric patients with
hematologic and oncologic conditions during hospitalization.