Submission To Be Reviewed
Title: Should healthcare organisations offer continued physiotherapy services as a routine for all patients undergoing Haematopoietic Stem Cell Transplant (HSCT)? A Systematic Review and future directions.
The improved survivorship post hematopoietic stem cell transplant has shifted the burden of the suffering from disease associated to treatment-related complications impacting patient’s quality of life. The current systematic review was conducted to analyse the current evidence of PT intervention in this patient group with the aim of informing the healthcare policy makers the importance of providing ongoing physiotherapy access to the patients undergoing transplant and to and highlight the need for further research.
Literature search was carried out using a vast database as per the inclusion and exclusion criteria, covering the duration between 1998 to 2018 with the following terms and text word and thesaurus Hematopoietic Stem Cell Transplant, Chronic graft versus host disease, Rehabilitation, Exercise, Physiotherapy. Population Intervention Comparison Outcome (PICO) framework was used to make sure the search strategies are structured and of high precision.
The initial search was carried out using the above-mentioned database which resulted in 1531 citations. After screening the articles, a total of 19 articles were included in this study.
Majority of the trials included in this systematic review demonstrated some benefit of physiotherapy intervention on various parameters body parameters, however, the reported benefits were overshadowed by the level of the overall quality of trials scored by the JADAD scale.
Healthcare policy makers and the insurance companies need to recognise that transplant patients need ongoing physiotherapy for early identification of any functional impairments and appropriate timely intervention.
Contribution of paper:
Physiotherapy intervention has a positive impact on various physical, physiological and psychological parameters including fatigue, muscle strength, muscle endurance, anxiety and depression, Hgb, diarrhoea, QOL, psychological wellbeing, functional capacity, immune cell recovery, BMI, cytopenia, muscle mass and cardiorespiratory fitness in patients undergoing haematopoietic stem cell transplant.
There are shortfalls which needs addressing in future trials including standardising exercise protocols, including pre-transplant physical assessments and designing of appropriate out-patient rehab protocols.
Exercise, HSCT, allogeneic, Physiotherapy, Healthcare policy
Editor's request 02-05-2019
REVIEW FORM RESPONSE