Abstract
Simple SummaryChildren: adolescents, and young adults who are affected by hematological malignancies and who are undergoing intensive phases of cancer treatment including hematopoietic stem cell transplantation, experience diminished functional ability. This study was aimed at assessing if osteopathic treatment and evaluation can be used when an 11-week precision-based exercise program is run inside the hospital. Our results support that osteopathy plus precision-based intervention could be a desirable support in the clinical prise en charge of these children and adolescents. Osteopathy is a safe method for the evaluation of clinical conditions and requires strong multidisciplinary synergy between pediatricians and exercise physiologists.Children: adolescents, and young who are adults affected with hematological malignancies (CAYA-H) and who are undergoing intensive phases of cancer treatment, including hematopoietic stem cell transplantation (HSCT), experience diminished functional ability. This study was aimed at assessing the feasibility, efficacy, safety, and satisfaction of an osteopathic intervention in CAYA-H attending an 11-week precision-based exercise program (PEx). All of the participants were given 4–10 treatments according to the prescription ordered by the sports medicine doctor in charge of the PEx, and the following outcomes were assessed: (1) spinal column range of motion (ROM) by palpation; (2) lower and upper limb joints ROM by a goniometer; (3) orthostatic posture by plumb line assessment; (4) chest and abdomen mobility by inspection and palpation; (5) cranial-sacral rhythmic impulse (CRI) by palpation; and (6) adverse effects. Goal attainment scaling (GAS) was used to identify the accomplishment of a desired clinical result. Moreover, HSCT patients who were affected with graft-versus-host disease and/or osteonecrosis had their joints assessed in terms of ROM as tools to monitor the effectiveness of immunosuppressive treatment. A total of 231 CAYA-H were identified, and 104 participated in the study (age 10.66 ± 4.51 yrs; 43% F). PEx plus osteopathy reached positive GAS scores by improving the ROMs of the spinal column and/or limbs (81% and 78%, respectively), chest and abdomen mobility (82%), and CRI (76%). Only minor reversible adverse effects were noticed during the study. Together, our data seem to initiate a new course where osteopathy could be useful in evaluating structural edges due to the clinical history of each CAYA-H. Given the contributions that were obtained by the GAS scores, osteopathic treatment seems to reveal interesting potential that can be targeted in the future.
Highlights
According to the European Society of Paediatric Oncology’s (SIOPE) perspective, there are nearly 500,000 European children, adolescents, and young adults with hematological malignancies (CAYA-H) today
Eighty-one (35%) CAYA-H did not participate in the study, the main reason for which was due to logistical reasons
150 CAYA-H were recruited and 24 (16%) dropped out (
Summary
According to the European Society of Paediatric Oncology’s (SIOPE) perspective, there are nearly 500,000 European children, adolescents, and young adults with hematological malignancies (CAYA-H) today. Exercise capacity is reduced at the beginning of treatment, after being offtherapy for one year, and even after 15 years of follow-up [9,10,11,12]. A recent review suggested that the effects of PEx for childhood cancer participants are not yet convincing due to the small numbers of participants and insufficient study designs, the first results show some positive effects on physical fitness in the intervention groups compared to the control groups [18]. There were positive intervention effects in terms of body composition, flexibility, cardiorespiratory fitness, muscle strength, and health-related quality of life (cancer-related items). In the last 2 years, new studies on large cohorts of CAYA-H showed how supervised in-hospital PEx for children with cancer are safe and play a cardio-protective role as well as improve exercise capacity [19,20]
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