Dados do Resumo

Título

Updating an Institutional Physiotherapy Protocol for Patients Undergoing Hematopoietic Stem Cell Transplantation (HSCT) at a Cancer Center

Introdução

Sarcopenia is a disorder that frequently affects hematologic patients and those undergoing hematopoietic stem cell transplantation, leading to decreased mobility and functional impairment. Exercise is associated with numerous benefits as a management strategy for this condition. However, uncertainties regarding exercise prescription, particularly concerning the timing, frequency, intensity, and type of exercise, still persist among professionals.

Objetivo

To update the rehabilitation guidelines for hematologic patients and patients in pre- and post-HSCT conditions at the AC Camargo Cancer Center.

Métodos

This study describes the process of updating the rehabilitation guidelines for hematologic patients and patients in pre- and post-HSCT conditions at a leading cancer hospital in Brazil, recognized throughout Latin America. The methodology applied in this development followed three stages:
First stage: a manual search was conducted in the PubMed, Cochrane, and PEDro databases.
Second stage: a committee of experts consisting of five clinicians working in this area was formed. All members independently analyzed the selected articles, followed by a consensus to validate the key findings and organize them into a protocol model.
Third stage: a consensus review of the articles was conducted, and interventions and routines were aligned with the multidisciplinary team through the presentation of the protocol at a clinical meeting of the department.

Resultados

The new guideline covers the care of all adult patients in all phases of HSCT treatment. Patients will be referred to the physiotherapy department only after a medical consultation and evaluation. The care will be individualized, including the following stages of evaluation and follow-up: outpatient evaluation; during hospitalization; post-engraftment evaluation; and post-transplant evaluation. The physiotherapist will explain the importance and objectives of the intervention and clarify any doubts regarding laboratory tests and exercise routines. A detailed assessment will be conducted, including grip strength evaluation, functional capacity through the six-minute walk test, respiratory muscle strength with manovacuometry, pain intensity using the visual analog scale, physical effort by the Borg scale, fatigue perception using the Brief scale, and quality of life by the global effect perception scale (EPEG).

Conclusões

The search for currently available scientific evidence, the formation of a committee of specialists, and meetings with the multidisciplinary team enabled the creation of an institutional rehabilitation protocol for patients undergoing hematopoietic stem cell transplantation.

Palavras Chave

Stem Cell Transplantation Hematopoietic; Physiotherapy Specialty; Hematologic Neoplasm