Physical and Occupational Therapy for Bone Marrow Transplant Patients
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: UNC Lineberger Comprehensive Cancer Center
Disqualifiers: No BMT admission history
No Placebo Group
Approved in 3 Jurisdictions
Trial Summary
What is the purpose of this trial?This is a single-site, non-randomized, observational study designed to evaluate the impact of adding physical and occupational therapy consultation upon inpatient admission for a bone marrow transplantation (BMT). The purpose of this study is to investigate whether consultation with physical and occupational therapists as part of the general admission order set for patients scheduled for bone marrow transplant will result in reduced complications, morbidity, length of inpatient stay, 30-day readmission, and 90-day mortality. Baseline data collection will be used to determine eligibility. This study will be partially retrospective (pre-implementation of physical and occupational therapy consultation order) and partially prospective.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment Physical and Occupational Therapy for Bone Marrow Transplant Patients?
Research shows that occupational therapy can help manage psychosocial and environmental problems in cancer patients, and physical therapy is linked to improved mobility in patients with orthopedic issues. These findings suggest that similar therapies could be beneficial for bone marrow transplant patients by addressing both physical and emotional needs.
12345Is physical and occupational therapy safe for bone marrow transplant patients?
Research shows that physical and occupational therapy is generally safe for bone marrow transplant patients, though some studies have looked at specific risks like bleeding in children with low platelet counts.
678910How does physical and occupational therapy differ from other treatments for bone marrow transplant patients?
Physical and occupational therapy for bone marrow transplant patients is unique because it focuses on improving quality of life and functional capacity through personalized rehabilitation, addressing complex musculoskeletal issues that arise post-transplant. Unlike standard drug treatments, this therapy involves a tailored approach to help patients regain strength and mobility, which is not universally standardized but is crucial for their recovery.
1011121314Eligibility Criteria
This trial is for adults aged 18 or older who are admitted for a bone marrow transplant (BMT) and have not had an inpatient BMT before. It's designed to see if adding physical and occupational therapy right from the start can help reduce complications and improve recovery.Inclusion Criteria
I have undergone a bone marrow transplant.
I am 18 years or older and planning to undergo bone marrow transplantation.
Exclusion Criteria
I have never been hospitalized for a bone marrow transplant.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
1-2 weeks
Baseline Data Collection
Baseline data collection will be used to determine eligibility for the study
1 day
Intervention
Physical and occupational therapy consultation upon inpatient admission for bone marrow transplantation
During inpatient stay
Follow-up
Participants are monitored for complications, morbidity, length of inpatient stay, 30-day readmission, and 90-day mortality
Up to 90 days
Participant Groups
The study tests whether early consultation with physical and occupational therapists can decrease problems, shorten hospital stays, lower chances of coming back to the hospital within 30 days, and reduce deaths within 90 days after a BMT.
1Treatment groups
Experimental Treatment
Group I: physical and occupational therapyExperimental Treatment1 Intervention
Physical and occupational therapy consultation might be used to provide targeted prehabilitation interventions.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Lineberger Comphrehensive Cancer Center at University of North Carolina at Chapel HillChapel Hill, NC
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Who Is Running the Clinical Trial?
UNC Lineberger Comprehensive Cancer CenterLead Sponsor
References
Identification and management of psychosocial and environmental problems of children with cancer. [2012]An occupational therapist working as a rehabilitation specialist on the hematology-oncology team for pediatric malignancy identified and sought solutions for problems encountered among 49 pediatric oncology patients and their families. The occupational therapist's role as "CARE (CAncer REhabilitation) counselor" involved working with the patient, family, and team members to meet needs and provide services other than direct medical treatment. A variety of environmental needs and psychosocial problems were identified and managed. Prospective interaction from the time of diagnosis, resulting in 63 percent solution of all problems, was more effective than intervention initiated at other stages of illness.
Occupational Therapy Interventions for Adults With Cancer. [2017]This Evidence Connection describes a case report of a man with non-Hodgkin's lymphoma who underwent an allogenic stem cell transplant. The occupational therapy assessment and treatment processes for an outpatient rehabilitation setting are described. Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Project.
Understanding Patient Experience with Outpatient Cancer Rehabilitation Care. [2023]Understanding patient experience is key to optimize access and quality of outpatient cancer rehabilitation (physical or occupational therapy, PT/OT) services.
Older Adults with Cancer: A Randomized Controlled Trial of Occupational and Physical Therapy. [2021]The impact of occupational therapy (OT) and physical therapy (PT) on functional outcomes in older adults with cancer is unknown.
Relationship between duration of therapy services in a comprehensive rehabilitation program and mobility at discharge in patients with orthopedic problems. [2022]The purpose of this study was to examine the relationship between duration of physical therapy and occupational therapy and mobility at the time of discharge from a comprehensive rehabilitation program in a group of patients with orthopedic diagnoses.
Association Between Laboratory Values and Adverse Events in Adults Post-Hematopoietic Stem Cell Transplant During and After Rehabilitation. [2023]The objective of this study was to examine the relationship between adverse events (AEs) and critical events (CEs) during and after rehabilitation in cancer patients post-hemopoietic stem cell transplant (HSCT) or bone marrow transplant (BMT) and to identify whether particular laboratory values are associated with increased risk of AEs or CEs.
Safety and Feasibility of Rehabilitation Interventions in Children Undergoing Hematopoietic Stem Cell Transplant With Thrombocytopenia. [2020]To analyze the relation between platelet counts, intensities of physical therapy (PT) and occupational therapy (OT) services received, and frequencies of bleeding complications in children undergoing hematopoietic stem cell transplant (HSCT) during a period of severe thrombocytopenia.
Improving Occupational Performance in Pediatric Hematopoietic Cell Transplant Recipients. [2022]There is a critical gap in the literature regarding the efficacy of occupational therapy interventions for pediatric hematopoietic cell transplantation (HCT) patients.
Return to primary service among bone marrow transplant rehabilitation inpatients: an index for predicting outcomes. [2021]To assess rehabilitation inpatient risk of return to primary (RTP) service in patients with bone marrow transplant (BMT).
Physical therapy pathway and protocol for patients undergoing hematopoietic stem cell transplantation: Recommendations from The Eastern Mediterranean Blood and Marrow Transplantation (EMBMT) Group. [2020]Patients undergoing hematopoietic stem cell transplantation (HSCT) are often referred for physical therapy (PT) to help improve their quality of life. However, to our knowledge there is no clear PT pathway to guide therapists and patients before, during, and after HSCT.
Role of Physical Therapy before and after Hematopoietic Stem Cell Transplantation: White Paper Report. [2020]Hematopoietic stem cell transplantation (HSCT) patients can suffer from various musculoskeletal problems resulting in long-term functional incapacity. Physical therapy (PT), as a part of the healthcare team, has been historically advocated for regaining functional capacity and improving quality of life post-HSCT. Because of the nature of this condition and the burden of post-transplant complications, this patient group requires a unique approach toward their rehabilitation that takes into account their complex musculoskeletal presentation ranging from fascia, muscle, tendons, bones, and ligaments. However, to our knowledge there is no universal standardized PT protocol or pathway to help guide rehab specialists to achieve optimal gains for this patient group, and anecdotal evidence suggests that these patients do not always receive the PT care they require. Hence, in collaboration with the Transplant Complications Working Party of the European Society for Blood and Marrow Transplantation, the Survivorship Special Interest Group of the American Society of Blood and Marrow Transplantation, and the Quality of Life Committee of the Eastern Mediterranean Blood and Marrow Transplantation, herein the Physical Therapy Association for Graft Versus Host Disease provides a brief review on role of PT in mitigating musculoskeletal complications in HSCT patients and makes evidence-based recommendations for incorporation of PT into routine HSCT care.
A longitudinal multidimensional rehabilitation program for patients undergoing allogeneic blood and marrow transplantation (CaRE-4-alloBMT): Protocol for a phase II feasibility pilot randomized controlled trial. [2023]Allogeneic blood and marrow transplantation (alloBMT) is a curative treatment for blood cancers associated with various treatment-related adverse events and morbidities. Current rehabilitation programs are limited for patients undergoing alloBMT and research is urgently needed to test the acceptability and effectiveness of these programs. In response, we developed a 6-month multidimensional longitudinal rehabilitation program that spans from pre transplant to 3 months post transplant discharge (CaRE-4-alloBMT).
Two-year adjustment of bone marrow transplant survivors. [2022]Very little systematic analysis exists on the psychological and emotional factors involved in bone marrow transplantation, either during or after treatment. However, recent published findings, contrary to earlier anecdotal and case study evidence, indicate that bone marrow transplant survivors appear to be functioning adequately on a variety of 'quality of life' variables. The purpose of the present study was to compare bone marrow transplant survivors to a matched sample of patients undergoing maintenance chemotherapy in four areas of function; physical health, including symptoms and physician visits; personal functioning, emphasizing ability to care for self; psychological functioning; and role functioning, including employment and sexual difficulties. Our data reveal that the bone marrow transplant patients were experiencing greater difficulties than the maintenance chemotherapy patients in several areas. For example, the bone marrow transplant patients had experienced greater disruption of vocational functioning and reported more sexual difficulties. However, in spite of more objective difficulties, bone marrow transplant patients, compared to maintenance chemotherapy patients, viewed themselves as equally healthy and reported similarly low levels of psychological distress. The findings are discussed in the context of necessary future research on bone marrow transplant survivors.
Physical therapy for patients after bone marrow transplantation. [2019]The purpose of this article is to provide an overview of bone marrow transplantation (BMT) as it relates to the practice of physical therapy based on experiences at a cancer research center. This overview includes information on the diseases treated with BMT, patient treatment regimens during hospitalization, and complications commonly encountered. Physical therapy guidelines are suggested for the evaluation of and therapeutic intervention for patients after BMT.