1. Feasibility and Functional Outcomes of Children and Adolescents Undergoing Preoperative Chemotherapy Prior to a Limb-Sparing Procedure or Amputation
- Author
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Michael W. Bishop, Alberto S. Pappo, Michael D. Neel, Wei Liu, Angela Meyer Corr, Deo Kumar Srivastava, Terry Wilson, Kirsten K. Ness, and Bhaskar N. Rao
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,education.educational_degree ,Physical Therapy, Sports Therapy and Rehabilitation ,Malignancy ,Article ,Habilitation ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Generalizability theory ,education ,Oncology (nursing) ,business.industry ,Rehabilitation ,medicine.disease ,Clinical trial ,Oncology ,Amputation ,Sample size determination ,030220 oncology & carcinogenesis ,Physical therapy ,030211 gastroenterology & hepatology ,Sarcoma ,business ,Range of motion - Abstract
Background Survivors of lower extremity (LE) malignancies experience functional deficits. Purpose The purpose of this prospective clinical trial was to determine feasibility and functional outcomes of adding pre-habilitation during the 10-12 week period prior to a planned surgery to remove the tumor in children and adolescents with a LE sarcoma. Design Pilot study. Setting St. Jude Children's Research Hospital (SJCRH). Patients Participants included 14 individuals between the ages of 8 and 20 years who were diagnosed with a LE sarcoma. Participant outcomes were compared to a control group of 35 individuals treated for osteosarcoma that obtained the same functional assessments but no pre-habilitation. Intervention The intervention group received strengthening exercises and mobility training 3 times per week for 30-60 minutes for 10-12 weeks preoperatively. Measurements Participants completed the Functional Mobility Assessment (FMA) and measures of strength and range of motion (ROM) of bilateral lower extremities (BLEs) at baseline, after 10-12 weeks of preoperative PT, and at 20-22 weeks. Results Twelve participants completed at least 50% of their schedule pre-habilitative sessions. The intervention group scored significantly better on the FMA than the control group at weeks 20-22 (35.6 vs. 25.7, p .0267). No significant difference was found in ROM or strength. Limitations Due to this study being a pilot study, the sample size was small. Therefore, we cannot infer generalizability. Conclusions Findings suggest that those diagnosed with a LE malignancy awaiting a limb sparing procedure or amputation participate in at least 50% of scheduled PT sessions and benefit from them.
- Published
- 2017