PC-06. Muscle strength and vegetative support at childhood on different stages of hematopoietic transplantation
Mikhail Y. Zhukov, Nikolay N. Mitrakov, Alexey V. Korochkin, Olga A. Laisheva
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
Contact: Mikhail Y. Zhukov, phone: +7 (915) 294 7189, e-mail: zhukovmihail1594@gmail.com
Summary
Introduction
Conditioning for hematopoietic stem cells transplantation (HSCT) and long isolation period often result in the movement disorders to patient undergoing HSCT. An increasing number of research to showing of the importance physical therapy at different stages of HCST. Our objective was to perform comparative assessment of muscle strength and vegetative support in children at different stages of HSCT to determine terms for motor rehabilitation.
Patients and methods
In the prospective comparative not randomized clinical study, we enrolled 27 patients aged 6-14 (11) years with acute lymphoblastic leukemia (ALL) (n=8), acute myeloblastic leukemia (AML )(n=8), severe aplastic anemia (n=2) and primary immune deficiency (n=9) at different stages of HSCT therapy. For all patients, muscle strength and hemodynamic level in orthoclinistatic test were conducted before HSCT (-5 days of conditioning), after HSCT (+ 5 days after transplantation), and upon leaving hospital department (+30 days after HSCT).
Results
On the conditioning stage, the patients with ALL and AML diagnosis had hyperchronotropic and hypostenic vegetative reaction type, while normostenic and normochronotrope vegetative reaction prevailed in the group with non-malignant diseases. The average muscle strength score in ALL and AML groups was between 3-4, and 4-5 points in the group with non-malignant diseases. On the day +5 after HSCT, all the patients (100% of cases) experienced hypostenic and hyper chronotrope vegetative type of reaction, and reduced muscle strength by an average of 2 points. On the day +30, after HSCT, the patients from ALL and AML groups exhibited hypochronotrope and hypostenic types of vegetative reactions (87.5% and 75%, respectively), and in cases of non-malignant disorders, they showed hyperchronotrope and hyperstenic type of vegetative reaction in 81.8% of cases. In remaining cases, the patients experienced normostenic and normochronotrope type of vegetative reaction. The average muscle strength score in the groups with ALL and AML was 4 points. Average muscle strength scores in the group with non-malignant disorders was 4 to 5 points.
Conclusion
The study shows high importance of early starting rehabilitation and supervision of the patients undergoing HSCT by physical therapist.
Keywords
Physical therapy, hematopoietic stem cell transplantation, autonomous nervous functions, muscular strength.
