Abstract
Objective
To analyze the relation between platelet counts, intensities of physical therapy (PT)
and occupational therapy (OT) services received, and frequencies of bleeding complications
in children undergoing hematopoietic stem cell transplant (HSCT) during a period of
severe thrombocytopenia.
Design
Retrospective review study.
Setting
Tertiary care hospital.
Participants
Children (N=63; age, <18y) hospitalized for HSCT in 2010 and 2011 who received PT
and OT services while markedly thrombocytopenic (platelet count, ≤50K/mcL).
Interventions
Not applicable.
Main Outcome Measures
Intensities of PT and OT interventions, patients' platelet counts on specific therapy
days, and any bleeding events (minor or major) that occurred during or shortly after
rehabilitation interventions.
Results
Sixty-two patients (accounting for 63 HSCTs) met the criteria for analysis. Fifty-six
of these patients (57 HSCTs) underwent PT and/or OT while markedly thrombocytopenic.
There was no correlation between platelet counts and intensities of rehabilitation
interventions. There were no major bleeding events. There was no association between
minor bleeding events and intensities of PT or OT interventions and no association
between minor bleeding events and platelet counts. Only 5 minor bleeding events occurred
during or after moderate or intensive therapy out of 346 PT and OT sessions (1.5%).
Conclusions
The results of our study suggest that bleeding complications during or after mobilization
and supervised exercise during PT and OT in children with severe thrombocytopenia
undergoing HSCT are minor and relatively rare. These are encouraging results for both
patients and rehabilitation specialists treating this population who is at high risk
of developing immobility-related complications.
Keywords
List of abbreviations:
CI (confidence interval), HSCT (hematopoietic stem cell transplant), OR (odds ratio), OT (occupational therapy), PT (physical therapy)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 11, 2017
Footnotes
Supported in part by the National Institutes of Health/National Cancer Institute Cancer Center Support Grant (grant no. P30 CA008748).
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
