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.