Muscle strength and vegetative support at childhood on different stages of hematopoietic

Abstract

Conditioning for hematopoietic stem cells transplantation (HSCT) and long isolation period often results in movement disorders to patient undergoing HSCT. An increesing number of reaserch to showing of the importance physical therapy at different stages of HCST. Objective. Сomparative assessment muscles strength and vegetative support childhood at different stages of HSCT for the determine timing for the motor rehabilitation. The study was approved by the Independent Ethics Committee and the Scientific Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology. In the prospective comparative not randomized clinical trail were enrolled 27 patients aged 6-14 (11) years with acute lymphoblastic leukemia (ALL) (n=8), acute myeloblastic leukemia (AML) (n=8), sever aplastic anemia (n=2) and primary immune deficiency (n=9) at different stages of HSCT therapy. For all patients muscle strength and hemodynamic level in orthoclinistatic test were conducted before HSCT (-5 days of conditioning), after HSCT (+5 days after transplantation), and upon leaving hospital units (+30 days after HSCT). On the conditioning stage patient at ALL and AML diagnosis group had hyperchronotrope and hypostenic vegetative reaction type, while normostenic and normochronotrope vegetative reaction type at not malignant diseases diagnosis group. Muscle strength score at ALL and AML diagnosis group average was between 3-4 score, and 4-5 score at not malignant diseases diagnosis group. On the +5 days after HSCT in all researched diagnosis groups at 100% cases experienced hypostenic and hyper chronotrope vegetative type of reaction, and reduced muscle strength average 2 score. On the +30 days after HSCT at ALL diagnosis group experienced hypochronotrope and hypostenic type of vegetative reaction at 75% and 87.5% respectively, at AML diagnosis group experienced hypochronotrope and hypostenic type of vegetative reaction at 87.5% and 75% respectively, and at not malignant diagnosis group experienced hyperchronotrope and hyperstenic type of vegetative reaction at 81,8% cases. In the remaning cases at all diagnosis group experienced normostenic and normochronotrope type of vegetative reaction. Average muscle strength score at ALL and AML diagnosis group was 4 score. Average muscle strength score at not malignant diagnosis group was between 4-5 score. It’s important to get an early start physical therapist to childhood receiving of HSCT therapy.