Results
Between January 1, 2017 and October 10, 2018, 18 children and
adolescents, 50% female, between the ages of 1.9-17.8 years (median
4.78 years) participated in SPRINT program. Majority of patients live
>11 miles away from the facility, 38.9% with homes
>50 miles away. All patients had generalized muscle
weakness or deconditioning as a rehabilitation diagnosis, and 44.4%
carried an additional diagnosis of peripheral neuropathy (Table 1).
Leukemia, lymphoma, and CNS tumor consisted of the most common oncologic
diagnoses for SPRINT participants, and 10 participants received
chemotherapy while participating in SPRINT program (Table 2). During
their hospitalization prior to SPRINT course, 16 patients experienced
medical complications (Table 1), and 13 patients required ICU-level
care, ranging 3-25 ICU days with an average of 10.6 days. Hospital LOS
varied widely from 8 to 404 days, with a median of 68 days.
The change in PEDI caregiver assistance levels at the start and end
of-SPRINT was significant in all tasks under Self-Care and Mobility
domains (p = 0.001-0.048), demonstrating an overall reduction in
assistance needs of participants after completion of SPRINT (Table 3).
Functional expression was the only task under Social Function domain
that reached significance (t(6) = -2.83, p = 0.030).
All 18 patients received PT and OT in SPRINT. Average number of PT
sessions was 8.39 across SPRINT courses, which was 84% of planned PT
sessions, with overall average of 377 minutes of total PT minutes.
Average OT session number was 8.83, which was 88% of planned OT
sessions with an average of 467 total OT minutes. Only 7 patients
required ST as part of their SPRINT program, receiving an average of
7.14 sessions, which consisted of 88% of planned ST sessions for an
average total of 306.43 minutes.
Regarding barriers to therapy participation as documented in therapy
notes, either resulting in reduction of planned therapy minutes or
cancellation of entire sessions, 71% consisted of patients’ symptoms or
complaints (pain, fatigue, nausea or vomiting, general unwell feeling,
being asleep, irritability, and poor participation), 22% of patient
care (procedure, medication administration, care provider discussion,
diaper change/bathroom use), and 7% of unexpected transfer to ICU or
discharge from hospitalization before completion of the two-week SPRINT
course.
No adverse events related to SPRINT participation were identified for
all patients. At the end of hospitalizations after SPRINT completion, 9
patients were able to eventually discharge home, 6 patients transitioned
to inpatient rehabilitation for additional intensive therapies, 2 were
transferred to other acute care facilities closer to home, and 1 patient
died after an extraordinarily prolonged hospitalization due to infection
progression and neurologic deterioration with eventual withdrawal of
care.
Only 11 parents and 4 patients completed both pre- and post-SPRINT
questionnaires (Table 4). No significant difference between the pre- and
post-SPRINT questionnaire responses was documented; however, trends
toward reduced report of sadness by parent report and of tiredness by
self report were appreciated.