Safety and Feasibility of Rehabilitation Interventions in Children Undergoing Hematopoietic Stem Cell Transplant With Thrombocytopenia.
Katarzyna Ibanez, Noel Espiritu, Regine L Souverain and 6 others
PMID 28807693WHAT IT FOUND
Supervised PT and OT appear safe for children undergoing stem cell transplant with low platelets.
No major bleeding occurred, and minor bleeding was rare. However, therapy was often declined or withheld, so frequent attempts are needed to ensure patients receive adequate rehabilitation.
Key findings
01No major bleeding complications related to therapy interventions occurred, and only five episodes of minor bleeding were noted out of 346 total sessions.
02There was no correlation between the intensity of the intervention and the platelet count in either age group.
03Therapy sessions were attempted and completed on 36% and 18% of the days when platelet count was ≤50K/mcL, respectively, with 23% declined and 24% withheld.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Retrospective design means the exact platelet count at the time of therapy was unknown; recorded counts likely overestimated actual levels during sessions. The study was underpowered to detect differences in bleeding rates due to only five minor bleeding events. Data were collected from a single institution, limiting generalizability to other settings or unsupervised exercise programs. Information on session duration and quality was not collected, preventing comparison to therapy provided elsewhere. Bleeding risk is influenced by factors other than platelet count, such as infection, fever, coagulopathy, and medications, which were not fully accounted for in the analysis.
Declared interests
The authors certify that no party having a direct interest in the results has or will confer a benefit on them or their associated organizations. The study was supported by the NIH.
The easy way to misread this
Do not assume that a specific platelet count threshold dictates safe therapy intensity. The study found no correlation between platelet count and therapy intensity, and decisions were guided by overall medical status. Additionally, the safety findings apply only to supervised therapy, not to independent exercise programs.