Effect of an Inpatient Rehabilitation Program for Recovery of Deconditioning in Hematologic Cancer Patients After Chemotherapy

Abstract

ObjectiveTo investigate the effect of a rehabilitation program in terms of De Morton Mobility Index (DEMMI) score, in hematologic cancer patients after chemotherapy.MethodsHematologic cancer patients admitted for chemotherapy were reviewed. They received a rehabilitation program during their hospital stay. DEMMI score measurement was performed, before and after rehabilitation. Demographics, diagnosis, chemotherapy information, rehabilitation program duration, mortality, body mass index (BMI), and laboratory test results were collected. For analysis, patients were classified according to diagnosis (multiple myeloma, leukemia, and others), mortality, and additional chemotherapy.ResultsThere was statistically significant improvement in DEMMI score of 10.1 points (95% confidence interval, 5.9–14.3) after rehabilitation. It was more evident in the multiple myeloma group, and they revealed less mortality. When patients were divided according to mortality, survivors received the program earlier, and in a shorter period than in mortality cases. Although survivors revealed higher initial DEMMI score, improvement after rehabilitation did not differ significantly.ConclusionIn hematologic cancer patients, rehabilitation program was effective for recovery from deconditioning, revealing significant increase in DEMMI score. Multiple myeloma patients may be good candidates for rehabilitation. Rehabilitation could be sustained during chemotherapy and for high-risk patients.

Relevant parameters for recommendations of physical activity in patients suffering from multiple myeloma

“…Regular physical activity and exercise are important measures to improve health-related quality of life and physical performance in cancer patients [4][5][6][7]. Recommendations for regular physical activity and exercise consist of 150 min/week of moderately intense or 75 min/week of vigorously intense activity or an equivalent combination, muscle strengthening activities of at least moderate intensity at least 2 days/week for each major muscle group and stretching of major muscle groups and tendons [2,[4][5][6][7][8][9][10][11][12].…”

“…Nevertheless, the opportunity to be involved in myeloma exer-cise groups does not yet exist in Austria. Due to bone manifestation of multiple myeloma and special clinical features (especially hypercalcemia and monoclonal gammopathy), a multiprofessional and interdisciplinary approach is required for planning and prescribing regular physical activity and exercise [2,[8][9][10][11][12]. Hereby, physical performance seems to be an important factor to identify which patients should receive an individual therapy or a therapy in an exercise group [11,[16][17][18][19].…”

Possibilities of rehabilitation treatment of children with lymphoblastic leukemia (literary review)

“…Так, хворі можуть бути направлені до відділення реабілітації вже після першого курсу хіміотерапії, особливо якщо вони скаржаться на фізичну слабкість. У випадку, коли пацієнт має високий ризик інфікування, кровотечі або розвитку шоку, фізичний терапевт може проводити реабілітаційну програму біля ліжка хворого [12].…”

Cancer Rehabilitation and Palliative Care—Exploring the Synergies

“…9 Research suggests that a multidisciplinary approach may result in better outcomes and provide the opportunity and support for patients to cope with treatment modalities. 8 Multiple studies have revealed some benefit from restorative rehabilitation for certain cancer populations, for example, esophagus, 30 colorectal, 23,31 lung, 25,26 pancreatic, 32 gastric, 33 prostate, 34 hematological, 35 and laryngeal cancers. 36 Restorative rehabilitation is usually multimodal, with a combination of early mobilization and physical therapy, nutritional management, breathing exercises, with or without formal respiratory rehabilitation, relaxation techniques, and lymphedema therapy.…”

“… 9 Research suggests that a multidisciplinary approach may result in better outcomes and provide the opportunity and support for patients to cope with treatment modalities. 8 Multiple studies have revealed some benefit from restorative rehabilitation for certain cancer populations, for example, esophagus, 30 colorectal, 23 , 31 lung, 25 , 26 pancreatic, 32 gastric, 33 prostate, 34 hematological, 35 and laryngeal cancers. 36 …”