The Effectiveness of Incorporating a Play-based Intervention to Improve Functional Mobility for a Child with Relapsed Acute Lymphoblastic Leukaemia

A Case Report

Paula Vercher, You Jou Hung, Mansoo Ko

Research output: Contribution to journalArticle

Abstract

Background and Purpose: Acute lymphoblastic leukaemia (ALL) is one of the most common forms of cancer seen in children, accounting for one-fourth of all childhood cancers. These children typically present with decreased functional mobility, weakened lower extremity muscle strength and reduced exercise endurance and interests because of disease progressions and chemotherapy treatments. The purpose of this case report was to examine the effectiveness of incorporating a play-based physical therapy (PT) intervention programme to improve functional mobility for an inpatient with relapsed ALL undergoing chemotherapy. Case Description: The patient was a 3-year-old male admitted to the hospital for relapsed ALL. He was diagnosed approximately 1year earlier for which he had undergone chemotherapy and was later considered in remission at that time. When the patient relapsed, he underwent another round of chemotherapy and was waiting for a bone marrow transplant during his treatment during the course of this case report. For PT intervention, therapeutic exercises were incorporated into play to strengthen his lower extremity strength and muscle endurance. Functional activities were also incorporated into play to improve his aerobic capacity and overall quality of life. Multi-attribute health status classification system (HUI3) utility scores, 6-minute walk test distance (6MWT), lower extremity (LE) strength, transfer and tolerated treatment time were assessed to identify the effect of a PT intervention. Outcomes: Despite experiencing fatigue, the patient completed most of the treatments incorporated into play. After 5weeks of PT intervention, the participant improved on HUI3 (pre: 0.72 and post: 0.92), 6MWT (pre: 156ft and post: 489ft), LE strength (squat), transfer (sit to stand) and tolerated treatment time (pre: 16minutes and post: 44minutes). Discussion: This case report suggests that incorporating a play-based PT intervention programme could be physically tolerable and functionally beneficial for a young child with relapsed ALL undergoing inpatient chemotherapy.

Original languageEnglish (US)
JournalPhysiotherapy Research International
DOIs
StateAccepted/In press - 2016
Externally publishedYes

Fingerprint

Physical therapy
chemotherapy
Chemotherapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Muscle
cancer
muscle
Durability
Lower Extremity
Drug Therapy
Therapeutics
Transplants
health status
quality of life
fatigue
Muscle Strength
bone
Bone
Inpatients
leukaemia

Keywords

  • Acute lymphoblastic leukaemia (ALL)
  • Physical therapy
  • Relapsed

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

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title = "The Effectiveness of Incorporating a Play-based Intervention to Improve Functional Mobility for a Child with Relapsed Acute Lymphoblastic Leukaemia: A Case Report",
abstract = "Background and Purpose: Acute lymphoblastic leukaemia (ALL) is one of the most common forms of cancer seen in children, accounting for one-fourth of all childhood cancers. These children typically present with decreased functional mobility, weakened lower extremity muscle strength and reduced exercise endurance and interests because of disease progressions and chemotherapy treatments. The purpose of this case report was to examine the effectiveness of incorporating a play-based physical therapy (PT) intervention programme to improve functional mobility for an inpatient with relapsed ALL undergoing chemotherapy. Case Description: The patient was a 3-year-old male admitted to the hospital for relapsed ALL. He was diagnosed approximately 1year earlier for which he had undergone chemotherapy and was later considered in remission at that time. When the patient relapsed, he underwent another round of chemotherapy and was waiting for a bone marrow transplant during his treatment during the course of this case report. For PT intervention, therapeutic exercises were incorporated into play to strengthen his lower extremity strength and muscle endurance. Functional activities were also incorporated into play to improve his aerobic capacity and overall quality of life. Multi-attribute health status classification system (HUI3) utility scores, 6-minute walk test distance (6MWT), lower extremity (LE) strength, transfer and tolerated treatment time were assessed to identify the effect of a PT intervention. Outcomes: Despite experiencing fatigue, the patient completed most of the treatments incorporated into play. After 5weeks of PT intervention, the participant improved on HUI3 (pre: 0.72 and post: 0.92), 6MWT (pre: 156ft and post: 489ft), LE strength (squat), transfer (sit to stand) and tolerated treatment time (pre: 16minutes and post: 44minutes). Discussion: This case report suggests that incorporating a play-based PT intervention programme could be physically tolerable and functionally beneficial for a young child with relapsed ALL undergoing inpatient chemotherapy.",
keywords = "Acute lymphoblastic leukaemia (ALL), Physical therapy, Relapsed",
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