Associate Professor of Physical Therapy WVU, United States
Research Objectives: To proactively and objectively determine physical function impairments in persons throughout the autologous stem cell transplant (auto-SCT) process
Setting: Academic medical center in rural Appalachia
Participants: All patients (n=88) being evaluated for, and subsequently undergoing auto-SCT are referred for 3 physical therapy evaluations.
Interventions: Key components of physical function (balance, endurance, muscular strength and power) are assessed by oncologic-trained physical therapists at three key time points. Following evaluation, patients are instructed in a home exercise program of strengthening and progressive walking to be performed throughout the acute transplant period.
Main Outcome Measures: 2-Minute Walk Test, Timed Up-and-Go, 5 times sit-to-stand, and isometric handgrip. Individual performance at baseline (pre-transplant), 30- & 180-days post-transplant is compared to age- and sex-matched healthy norms.
Results: A total of 88 patients have been evaluated using this model over 3 years. More than 70% performed below healthy norms for endurance, gait speed, and muscular strength/power at pre-transplant baseline. Most elements of function declined further at 30 days, with incomplete recovery at 180 days. However, many patients remained below norms throughout the post-transplant period.
Conclusions: By systematically assessing patients early in the auto-SCT process, this prospective surveillance model has identified deficits in physical function that were previously unrecognized. Most patients enter the auto-SCT program already impaired and get worse due to intensive chemotherapy and/or induction radiation as well as any acute auto-SCT medical complications. Using standardized objective measures with norm referencing, the degree of impairment can be quantified. Future work will determine triggers for physical rehabilitation referrals as well as identifying interventions that will most effectively minimize impairments and facilitate full functional recovery.
Author(s) Disclosures: none
Learning Objectives:
describe typical limitations in physical function associated with autologous hematopoeitic stem cell transplantaion
describe a prospective model to assess physical function prior to, early and late in recovery from transplantation
describe possible ways to integrate standardized physical performance testing into the pathway of a hematopoeitic stem cell transplantation program
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.jpg "Anne Swisher, PT, DPT, FAPTA photo")