Introduction: Physical rehabilitation is increasingly incorporated throughout the allogeneic hematopoietic stem cell transplant journey for older adults.
Objective: This study aimed to describe physical medicine and rehabilitation-related diagnoses, exercise barriers, and management recommendations for older adults before allogeneic hematopoietic stem cell transplant.
Design: Fifty physical medicine and rehabilitation consults as part of the Enhanced Recovery-Stem Cell Transplant multidisciplinary prehabilitation program at a comprehensive cancer center were retrospectively reviewed.
Results: Many physical medicine and rehabilitation-related diagnoses (173), exercise barriers (55), and management recommendations (112) were found. Common diagnoses were musculoskeletal dysfunction (more commonly back, shoulder, then knee) ( n = 39, 23%) and fatigue ( n = 36, 21%). Common exercise barriers were also musculoskeletal dysfunction (more commonly back, knee, then shoulder) (total n = 20, 36%) and fatigue ( n = 20, 36%). Most patients ( n = 32, 64%) had one or more exercise barriers. Common physical medicine and rehabilitation management recommendations were personalized exercise counseling ( n = 37, 33%), personalized nutrition management ( n = 19, 17%), body composition recommendations ( n = 17, 15%), medications ( n = 15, 13%), and orthotics and durable medical equipment ( n = 8, 7%).
Conclusions: Routine physical medicine and rehabilitation referral of older allogeneic hematopoietic stem cell transplant patients for prehabilitation resulted in the identification of many rehabilitative needs and substantial additional management recommendations. Increased early, collaborative prehabilitation efforts between physical medicine and rehabilitation and allogeneic hematopoietic stem cell transplant teams to optimize care for these patients is recommended.
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