Implementation of structured physical activity in the pediatric stem cell transplantation

Area of Science:

• Pediatric Hematology/Oncology
• Sports Medicine
• Rehabilitation

Background:

• Peripheral blood stem cell transplantation (PBSCT) is a critical yet taxing treatment for pediatric hemato-oncological diseases.
• Evidence supporting the benefits of sports therapy in adult PBSCT is available, but its application in children remains under-investigated.
• There is a need to evaluate the feasibility and impact of integrating sports activities into pediatric PBSCT protocols.

Purpose of the Study:

• To investigate the integration of sports activity into the treatment of children and adolescents undergoing PBSCT.
• To assess the physiological adaptations and quality of life outcomes in pediatric patients participating in a sports therapy program during PBSCT.
• To gather insights into patient acceptance and requirements for sports activities within the PBSCT setting.

Main Methods:

• A 2-step case-control study involving 23 pediatric patients undergoing PBSCT.
• An intervention group (n=13) engaged in cycle ergometer training and sports equipment activities during the isolation phase.
• A control group (n=10) did not receive sports therapy. Physiological data and quality of life were assessed using questionnaires and guided interviews.

Main Results:

• Patients in the intervention group trained an average of 25 minutes at 0.6 watt/kg on a cycle ergometer.
• The majority of patients avoided significant loss of muscular power.
• Quality of life showed a positive trend, and fatigue symptoms improved, though not statistically significant.
• Interviews indicated general acceptance of physical activity during PBSCT, with suggestions for improved equipment quality and tailored training programs.

Conclusions:

• Supportive sports therapy is feasible within pediatric PBSCT, even with initial patient skepticism regarding the added burden.
• The program demonstrated potential in mitigating muscle power loss and improving patient-reported outcomes like quality of life and fatigue.
• Recommendations include enhancing equipment quality and flexibility, and individualizing training to accommodate diverse patient conditions.