Physical Therapy Utilization Lacking for Hospitalized Pediatric ALL Patients

The majority of hospitalized pediatric patients with acute lymphocytic leukemia (ALL) did not receive inpatient physical therapy (PT) despite evidence of its benefits, according to a recent study.

“Multiple studies have suggested the potential benefit of PT to improve motor function in pediatric ALL patients, even in those without known neuromuscular conditions,” the researchers wrote. “Despite the potential benefit of PT shown in clinical trials, little is known about routine utilization of PT in pediatric ALL patients, and there are no guidelines dictating receipt of this intervention.”

In this study, researchers looked at data from the Premier Healthcare Database on 5,488 pediatric patients hospitalized with ALL at age 0-21 years from January 2010 through March 2017. Of these, only 27.2% overall and 58.9% with neuromuscular conditions received physical therapy within a year of first ALL admission.

Using multivariable analysis, the researchers found that patients were more likely to receive PT when aged 10-14 years (odds ratio [OR]=1.46) or 15-21 years (OR=1.66) compared with 0-4 years. Physical therapy receipt was also more likely in Hispanic participants (OR=1.27) compared with White participants.

Finally, physical therapy receipt was less likely when treated by a non-hematology/oncology pediatric (OR=0.56) or adult (OR=0.50) specialist.

“Although the benefit of PT has been most frequently described in pediatric ALL patients with neuromuscular conditions, a growing body of literature also suggests the benefit of this service in improving health and physical function in patients with ALL even without known neuromuscular conditions,” the researchers wrote. “These findings highlight the need for interventions to promote PT during inpatient hospitalization since most patients do not currently receive this service.”

Rodwin RL, Ma X, Ness KK, et al. Physical therapy utilization among hospitalized patients with acute lymphoblastic leukemia. JCO Oncol Pract. 2022. doi:10.1200/OP.21.00796