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Is there any role for physical therapy in chronic GvHD?

Bone Marrow Transplantation volume 53, pages 22–28 (2018)Cite this article

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Abstract

Chronic GvHD is the leading cause of non-relapse mortality in recipients of hematopoietic cell transplantation. Although the benefit of physical therapy (PT) has been reported in some GvHD studies, a literature gap is identified in demonstrating the exact role of different types of PT interventions and their impact on GvHD outcomes. An electronic search was undertaken using 13 peer-reviewed databases from 1994 to 2016. JADAD scoring method was used to score the quality of articles. PT interventions utilized for non-GvHD aspects of transplantation were excluded. Out of the 4775 articles on the electronic search, 297 articles were reviewed out of which 3 fulfilled the selection criteria. Moderately high evidence for effectiveness of supervised PT intervention was found, whereas moderate evidence for a self-administered exercise program was established. No safety concerns with PT were observed in any of the studies, however none of the studies were conducted to directly evaluate safety and effectiveness specifically in GvHD patients. PT is a safe but understudied therapy for GvHD. Limited evidence on the effectiveness of most PT interventions is available through randomized control trials. Well-designed trials are urgently needed for musculoskeletal GvHD especially with focused PT interventions.

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Acknowledgements

Author contributions

JM and SKH wrote the manuscript. All authors contributed substantially to the conception, acquisition, analysis and interpretation of the data for the work.

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Authors and Affiliations

  1. Department of Physical Therapy and Rehabilitation, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    J Mohammed

  2. Department of Medicine, Vanderbilt University, Nashville, TN, USA

    B N Savani

  3. Department of Hematology-Oncology Bone Marrow Transplant Program Massachusetts General Hospital, MA, USA

    A El-Jawahri & J Vanderklish

  4. Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA

    A L Cheville

  5. Blood and Marrow Transplant Division, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    S K Hashmi

Authors
  1. J Mohammed
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  2. B N Savani
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  4. J Vanderklish
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  5. A L Cheville
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Correspondence to S K Hashmi.

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Mohammed, J., Savani, B., El-Jawahri, A. et al. Is there any role for physical therapy in chronic GvHD?. Bone Marrow Transplant 53, 22–28 (2018). https://doi.org/10.1038/bmt.2017.155

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