Palliative care patients may benefit from occupational therapy (OT) and physical therapy (PT) intervention. Rehabilitation specialists are skilled at working with patients to set realistic and meaningful functional goals. Further study on rehabilitation treatment to improve quality of life among patients in palliative care is needed.

Objective: To analyze the relationship between platelet counts, the intensities of physical therapies (PT) and occupational therapies (OT) services received, and the frequency of bleeding complications in children undergoing hematopoietic stem cell transplants (HSCT) during a period of severe thrombocytopenia. Design: Retrospective review study Setting: Tertiary care hospital Participants: Children (age <18) hospitalized for HSCT in 2010 and 2011 who received PT and OT services while markedly thrombocytopenic (platelets≤50K/mcL). Interventions: None Main Outcome Measures: Intensities of PT and OT interventions, the patients’ platelet counts on specific therapy days and any bleeding events (minor or major) that occurred during or briefly following rehabilitation interventions. Results: Sixty-two patients (accounting for sixty-three HSCTs) met the criteria for analysis. Fifty-six of these patients (fifty-seven HSCTs) underwent PT and/or OT while markedly thrombocytopenic. There was no correlation between the platelet count and the intensity of rehabilitation interventions. There were no major bleeding events. There was no association between minor bleeding and intensities of PT or OT interventions and no association between minor bleeding events and platelet counts. Only 5 minor bleeding events occurred during or following moderate or intensive therapy out of 346 PT and OT sessions (1.5%). Conclusion: The results of our study suggest that bleeding complications during or following mobilization and supervised exercise during PT and OT in children with severe thrombocytopenia undergoing HSCT are minor and relatively rare. These are encouraging results for both patients and rehabilitation specialists treating this population who is at high risk for developing immobility related complications.

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