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Rossi F, Botti S, Morri M, Asaftei S, Bertin D, Breggiè S, Casalaz R, Cervo M, Ciullini P, Coppo M, Cornelli A, Esposito M, Ferrarese M, Ghetti M, Longo L, Naretto G, Orsini N, Panzeri D, Pellegrini C, Peranzoni M, Perna A, Petit N, Picone F, Pittorru G, Raffa D, Recchiuti V, Rizzato L, Sarzana M, Sensi R, Fagioli F, Ricci F. The Italian Consensus Conference on the role of rehabilitation for children and adolescents with leukemia, central nervous system tumors, and bone cancer, part 2: general principles for the rehabilitation treatment of motor function impairments. Pediatr Hematol Oncol 2024; 41:346-366. [PMID: 38984654 DOI: 10.1080/08880018.2024.2353360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 07/11/2024]
Abstract
In Italy, 1400 children and 800 adolescents are diagnosed with cancer every year. About 80% of them can be cured but are at high risk of experiencing severe side effects, many of which respond to rehabilitation treatment. Due to the paucity of literature on this topic, the Italian Association of Pediatric Hematology and Oncology organized a Consensus Conference on the role of rehabilitation of motor impairments in children/adolescents affected by leukemia, central nervous system tumors, and bone cancer to state recommendations to improve clinical practice. This paper includes the consensus on the rehabilitation of children and adolescents with these cancers.
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Affiliation(s)
- Francesca Rossi
- Rehabilitation Service, Public Health and Pediatric Sciences Department, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Stefano Botti
- Haematology Unit, Oncology and Advanced Technology Department, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Mattia Morri
- Nursing, Technical and Rehabilitation Assistance Service, IRCCS Rizzoli Orthopedic Institute, Bologna, Italy
| | - Sebastian Asaftei
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Daniele Bertin
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Simona Breggiè
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roberto Casalaz
- Paediatric Oncohematology, Unit Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Marta Cervo
- Functional Rehabilitation Unit, A.O.U. Meyer, Florence, Italy
| | - Paola Ciullini
- Functional Rehabilitation Unit, A.O.U. Meyer, Florence, Italy
| | - Monica Coppo
- Health Professions of Rehabilitation Sciences Masters Degree, Clinical and Biological Sciences Department, University of Turin, Turin, Italy
| | - Annalisa Cornelli
- Pediatric Oncology Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Miriana Ferrarese
- Health Professions of Rehabilitation Sciences Masters Degree, Clinical and Biological Sciences Department, University of Turin, Turin, Italy
| | - Marina Ghetti
- Pediatric Hematology Department, A.O.U. Policlinico Umberto I-Rome, Rome, Italy
| | - Lucia Longo
- Health Professions of Rehabilitation Sciences Masters Degree, Clinical and Biological Sciences Department, University of Turin, Turin, Italy
| | - Gabriella Naretto
- Rehabilitation, Department of Pediatric Orthopedics Unit A.O.U. Città della Salute e della Scienza, Regina Margherita Children's Hospital, Turin, Italy
| | - Nicoletta Orsini
- Physical Therapy and Rehabilitation Department, Children's Hospital Giannina Gaslini, Genoa, Italy
| | - Daniele Panzeri
- Neuro-oncological Rehabilitation Unit, Scientific Institute, IRCCS E. Medea, Lecco, Italy
| | - Chiara Pellegrini
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Michela Peranzoni
- Department of Physiotherapy, Hospital of Bolzano, Health Trust, Bolzano, Italy
| | - Antonella Perna
- Medical Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, University Hospital St. Orsola-Malpighi, Bologna, Italy
| | - Nadine Petit
- Pediatric Hematology Department, A.O.U. Policlinico Umberto I-Rome, Rome, Italy
| | - Fabiola Picone
- Functional Rehabilitation Unit, A.O.U. Meyer, Florence, Italy
| | - Gianna Pittorru
- Medical Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, University Hospital St. Orsola-Malpighi, Bologna, Italy
| | - Debora Raffa
- Nursing, Technical and Rehabilitation Assistance Service, IRCCS Rizzoli Orthopedic Institute, Bologna, Italy
| | - Veronica Recchiuti
- Physical Therapy Neuroscience Department and Functional Rehabilitation, Children's Hospital Bambino Gesù, Rome, Italy
| | - Lucia Rizzato
- Complex Operative Unit of Orthopaedic Rehabilitation, AO of Padua, Padua, Italy
| | - Marina Sarzana
- Pediatric Immunohematology Unit and Stem Cell Program, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Raffaella Sensi
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Franca Fagioli
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Federica Ricci
- Division of Child Neurology and Psychiatry A.O.U. Città della Salute e della Scienza, Regina Margherita Children's Hospital, Turin, Italy
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Nielsen KA, George CLS, Gilchrist LS. Association Between Laboratory Values and Adverse Events in Adults Post-Hematopoietic Stem Cell Transplant During and After Rehabilitation. Arch Phys Med Rehabil 2023; 104:1425-1431. [PMID: 36958648 DOI: 10.1016/j.apmr.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 02/02/2023] [Accepted: 03/05/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVE The objective of this study was to examine the relationship between adverse events (AEs) and critical events (CEs) during and after rehabilitation in cancer patients post-hemopoietic stem cell transplant (HSCT) or bone marrow transplant (BMT) and to identify whether particular laboratory values are associated with increased risk of AEs or CEs. DESIGN A retrospective chart review (2012-2017) of hospitalized patients ages 18-75 years who received a diagnosis of cancer and BMT or HSCT receiving rehabilitation services SETTING: Urban Midwest tertiary, research and academic hospital. PARTICIPANTS In total, 99 hospitalized adults with HSCT or BMT participated in 300 rehabilitation sessions. INTERVENTIONS Physical or occupational therapy using a symptom-based approach in which patient symptoms were monitored and therapy was adjusted in real time MAIN OUTCOME MEASURES: Incidence of AEs or CEs occurring during or within 48 hours of rehabilitation. RESULTS A total of 300 rehabilitation sessions were carried out where 99.7% had 1 or more laboratory values outside reference range. In only 3.3% of therapy sessions an AE occurred during or within 2 hours of rehabilitation. Within 48 hours postrehabilitation, AEs occurred in 22.3% and CEs in 4%. No laboratory value was significantly associated with increased risk of AEs or CEs during rehabilitation. A hemoglobin <8.0 g/dL conferred an increased risk of AEs (odds ratio [OR], 2.85-6.89) depending on timeframe analyzed and overall risk of CE (OR, 3.75). Lower hemoglobin levels (<7.5 g/dL and <7.0 g/dL) did not increase this risk. Low platelets (<25 k/μL) increased the risk of AEs on day 1, 2 and overall (OR, 2.5-2.72) and overall risk of CEs (OR, 6.62). CONCLUSIONS Our research demonstrates a low rate of AEs and CEs during or within 2 hours of rehabilitation but supports the need to monitor patients when hemoglobin is <8 g/dL or platelets are <25 k/μL due to the increased risk of events.
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Affiliation(s)
- Kelli A Nielsen
- Department of Physical Therapy, St Catherine University, St. Paul, MN; Department of Rehabilitation Services, M Health Fairview, Minneapolis, MN.
| | - Caroline L S George
- Department of Pediatrics, Division of Pediatric Critical Care, University of Minnesota, Minneapolis, MN
| | - Laura S Gilchrist
- Department of Physical Therapy, St Catherine University, St. Paul, MN
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Sparrow J, Dagen H, Harris A, Schwartzberg S, Weathers L, Kibby M, Harman JL, Jacola LM. Occupational Therapy: An Essential Component of Support for Young Children With Cancer. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:211-217. [PMID: 35929023 DOI: 10.1177/15394492221115060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We established a multidisciplinary early childhood clinic to support infants and toddlers receiving cancer treatment. The access to occupational therapy (OT) in this population is unknown. To describe the access to OT for infants and toddlers with cancer. We retrospectively reviewed medical records to determine the frequency and characteristics of children with cancer who were referred to OT. Demographic data, medical information, and frequency of referrals were extracted from September 2015 to September 2018. Of the 134 patients, 112 (83.6%) received an OT evaluation: 88.4% were referred for hospital-based OT services; 42.0% were recommended for services upon returning home. Between-group comparisons revealed significant differences in referrals for home- or community-based OT services based on age and disease. OT is crucial to treatment plans that address the developmental needs of young pediatric oncology patients during hospitalization and thereafter. Recommendations for monitoring this vulnerable population are provided.
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Affiliation(s)
| | - Hannah Dagen
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | | | | | - Lucy Weathers
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Megan Kibby
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | | | - Lisa M Jacola
- St. Jude Children's Research Hospital, Memphis, TN, USA
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Tanner L, Gilchrist L, Hooke MC, Sencer S. Comment on: Development of a comprehensive pediatric oncology rehabilitation program. Pediatr Blood Cancer 2020; 67:e28148. [PMID: 31867819 DOI: 10.1002/pbc.28148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 12/11/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Lynn Tanner
- Children's Minnesota, Minneapolis, Minnesota
| | - Laura Gilchrist
- Children's Minnesota, Minneapolis, Minnesota.,Doctor of Physical Therapy Program, St. Catherine University, Minneapolis, Minnesota
| | - Mary C Hooke
- Children's Minnesota, Minneapolis, Minnesota.,School of Nursing, University of Minnesota, Minneapolis, Minnesota
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