Introduction
As survival rates of childhood cancers increase in the last decades,
short- and long-term adverse effects of oncologic diseases and
treatments have resulted in diminished physical activity and motor
performance of patients and survivors.1-8 Children and
adolescents with oncologic diagnoses demonstrate reduced strength,
balance and functional mobility4-6,9 with self-report
of cancer-related fatigue9 when compared to control
norms or healthy peers. During hospitalizations for cancer-related care,
less than half of children mobilized 3-5 days a week and 18% less than
3 days per week in a retrospective study.10 Levels of
physical activity, including number of strides and activity intensity,
were significantly lower during inpatient stays compared to that at home
in pediatric patients with oncologic diagnoses in another
study.11
Physical exercise training interventions have been demonstrated to
improve cardiopulmonary fitness, muscle strength, and flexibility for
children with cancer.12,13 Reduced fatigue and
improved physical function are among other potential benefits of
exercise for patients with childhood cancer.12,14 In a
meta-analysis study, incorporation of exercise training during cancer
treatment significantly improves children’s functional mobility and
their ability to participate in activities of daily living (ADLs)
without affecting the risk of mortality or relapse.7For patients who experience functional deficits during a hospitalization
due to adverse effects of treatment or disease, intensive therapies
supported by an admission to inpatient rehabilitation may promote their
functional progress. Patients on inpatient rehabilitation may receive
physical therapy (PT), occupational therapy (OT), speech therapy (ST),
and several other services addressing their neurocognitive,
psychological, recreational, educational and/or vocational needs.
Children and adolescents with cancer diagnoses undergoing inpatient
rehabilitation demonstrate significant functional gains in domains of
self-care, mobility, and cognition.15
While pediatric patients with functional deficits may benefit from
intensive therapies during inpatient stays, cancer treatment plans or
medical care related to disease or treatment complications may prevent
patients from transferring to the inpatient rehabilitation unit safely.
This retrospective study evaluates a pilot program named Short-term
Pediatric Rehabilitation Intensive Therapy (SPRINT), which provides
intensive therapies for pediatric patients hospitalized on the
hematology-oncology (Hem-Onc) and bone marrow transplant (BMT) units at
a regional tertiary pediatric hospital. This evaluation of SPRINT
includes an assessment of functional outcomes of participants, adverse
events associated with the program, as well as measures of patients’
fatigue, sadness, nervousness, and pain by parents and patients at the
start and end of SPRINT.