Is there any role for physical therapy in chronic GvHD?

Area of Science:

• Hematopoietic Cell Transplantation
• Immunology
• Rehabilitation Medicine

Background:

• Chronic graft-versus-host disease (GvHD) is a significant cause of mortality post-hematopoietic cell transplantation (HCT).
• The role and specific impact of physical therapy (PT) interventions on GvHD outcomes remain incompletely understood, representing a literature gap.

Purpose of the Study:

• To systematically review the existing literature on the effectiveness and safety of physical therapy (PT) interventions for patients with chronic GvHD.
• To identify the types of PT interventions with the strongest evidence base for improving GvHD outcomes.

Main Methods:

• A comprehensive electronic literature search was conducted across 13 databases (1994-2016).
• Studies were assessed for quality using the JADAD scoring method.
• Only PT interventions directly relevant to GvHD were included, excluding those for general transplantation recovery.

Main Results:

• A total of 3 studies met the selection criteria from an initial search of 4775 articles.
• Moderately high evidence supports the effectiveness of supervised PT interventions.
• Moderate evidence supports the effectiveness of self-administered exercise programs.

Conclusions:

• Physical therapy is a safe intervention for GvHD patients, though it remains understudied.
• Limited randomized controlled trial evidence exists for most PT interventions in GvHD.
• Further well-designed clinical trials are urgently needed to evaluate focused PT interventions, particularly for musculoskeletal GvHD.