Osteopathic Treatment and Evaluation in the Clinical Setting of Childhood Hematological Malignancies
by
, , , , , , and
Monica Barbieri
1,2
,
William Zardo
1,
Chiara Frittoli
1,2,
Clara Rivolta
1
,
Valeria Valdata
1,
Federico Bouquin
1,
Greta Passignani
1
,
Alberto Maggiani
2,
Momcilo Jankovic
1, 
Andrea Cossio
3,
Andrea Biondi
1,
Adriana Balduzzi
1 and
Francesca Lanfranconi
1,* 1
Maria Letizia Verga Center, Department of Pediatrics, University of Milano-Bicocca, ASST Monza/MBBM Foundation, 20900 Monza, Italy
2
Division of Research, Italian Academy of Osteopathic Medicine (AIMO), 21047 Saronno, Italy
3
Department of Orthopedics, University of Milano-Bicocca, ASST Monza, 20900 Monza, Italy
*
Author to whom correspondence should be addressed.
Cancers 2021, 13(24), 6321; https://doi.org/10.3390/cancers13246321
Submission received: 23 November 2021
/
Revised: 10 December 2021
/
Accepted: 13 December 2021
/
Published: 16 December 2021
(This article belongs to the Special Issue Pediatric/Adolescent Cancer and Exercise)
Simple Summary
Children: adolescents, and young adults who are affected by hematological malignancies and who are undergoing intensive phases of cancer treatment including hematopoietic stem cell transplantation, experience diminished functional ability. This study was aimed at assessing if osteopathic treatment and evaluation can be used when an 11-week precision-based exercise program is run inside the hospital. Our results support that osteopathy plus precision-based intervention could be a desirable support in the clinical prise en charge of these children and adolescents. Osteopathy is a safe method for the evaluation of clinical conditions and requires strong multidisciplinary synergy between pediatricians and exercise physiologists.
Abstract
Children: adolescents, and young who are adults affected with hematological malignancies (CAYA-H) and who are undergoing intensive phases of cancer treatment, including hematopoietic stem cell transplantation (HSCT), experience diminished functional ability. This study was aimed at assessing the feasibility, efficacy, safety, and satisfaction of an osteopathic intervention in CAYA-H attending an 11-week precision-based exercise program (PEx). All of the participants were given 4–10 treatments according to the prescription ordered by the sports medicine doctor in charge of the PEx, and the following outcomes were assessed: (1) spinal column range of motion (ROM) by palpation; (2) lower and upper limb joints ROM by a goniometer; (3) orthostatic posture by plumb line assessment; (4) chest and abdomen mobility by inspection and palpation; (5) cranial-sacral rhythmic impulse (CRI) by palpation; and (6) adverse effects. Goal attainment scaling (GAS) was used to identify the accomplishment of a desired clinical result. Moreover, HSCT patients who were affected with graft-versus-host disease and/or osteonecrosis had their joints assessed in terms of ROM as tools to monitor the effectiveness of immunosuppressive treatment. A total of 231 CAYA-H were identified, and 104 participated in the study (age 10.66 ± 4.51 yrs; 43% F). PEx plus osteopathy reached positive GAS scores by improving the ROMs of the spinal column and/or limbs (81% and 78%, respectively), chest and abdomen mobility (82%), and CRI (76%). Only minor reversible adverse effects were noticed during the study. Together, our data seem to initiate a new course where osteopathy could be useful in evaluating structural edges due to the clinical history of each CAYA-H. Given the contributions that were obtained by the GAS scores, osteopathic treatment seems to reveal interesting potential that can be targeted in the future.
