A Pilot Study of Virtual Rehabilitation After Hematopoietic Cell Transplantation
Emory University
Summary
Chronic GVHD (cGVHD) is a major cause of illness in patients who undergo hematopoietic transplantation (HCT). GVHD can affect any organ in the body, can require several years of treatment, and can impact the quality of life (QoL). Physical activity and exercise have been shown to enhance fitness and improve QoL in chronic illnesses including GVHD, however, patients often have barriers to attending sessions including distance, risk of infection, and physical therapists' lack of experience with pediatric patients. The team's goal is to assess whether a virtual rehabilitation program in children post-HCT (including children with chronic GVHD) is feasible and whether its implementation will improve physical functioning and QoL. Patients between the ages of 8 and 23 years who are at least one hundred days post-HCT will be eligible for participation. Patients will have an assessment by a pediatric physical therapist at the time of study entry, at the end of the rehabilitation program, and approximately 3 months later. They will be supplied with some exercise equipment (such as dumbbells and resistance bands). Patients will have twice weekly half-hour one-on-one online sessions with the physical therapist for 12 weeks. Patients will be recruited through the bone marrow transplant clinic.
Description
Physical rehabilitation is an important, but often inadequately addressed, component of comprehensive cGVHD care. Physical activity and exercise have been shown to enhance fitness and improve QoL, including in patients with chronic diseases. Studies in patients undergoing HCT (including patients with GVHD) show the positive impact of exercise on QoL including improved endurance, muscular strength, functional capacity, perceptions of fatigue, and emotional, and social well-being. Evidence supports that the most effective intervention is supervised participation, followed by self-administered ex…
Eligibility
- Age range
- 8–23 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Recipients between the ages of 8 and 23 years ≥100 days post allogeneic HCT. * Patients 8-14 years old should have a caregiver willing to assist with the implementation of the exercises during the session * Patients should have access to devices and a reliable internet connection. * Patients should be cleared for exercise by their physician * Patients are eligible to participate regardless of underlying diagnosis, preparative regimen, or graft source. Exclusion Criteria: * Any physical impediment to exercise as evaluated by the treating physician. * Non-English-speakin…
Interventions
- BehavioralVirtual exercise and rehabilitation program
Participants will have two 30-minute sessions per week for 12 weeks. The program will focus on aerobic exercises and stretching exercises. When applicable, stretching exercises will focus on areas of contractures, and joints with limited range of motion (ROM). Sessions will be completed by a team of Physical Therapists using the established telemedicine platform at Children's Healthcare of Atlanta, as used routinely in the blood and marrow transplant clinic for clinical care (Epic). Adherence to the program will be encouraged during monthly standard clinic visits.
Location
- Children's Healthcare of AtlantaAtlanta, Georgia