All patients with documented baseline parameters (pre-transplant), an individualized strength, endurance, cardiovascular and balance training should be prescribed by the PT based on the patient’s individual ability. Please note, that the exercise program needs tailoring based on patient’s day-to-day symptoms throughout the in-patient admission.
Platelet count (<20) has historically been a concern and considered as a contraindication for exercises, however, majority of the HSCT patients are able to tolerate and benefit from exercises despite low platelets (<10). Furthermore, some studies have also reported no association between minor bleeding events with intensities of PT interventions and association between minor bleeding events and platelet counts [1,2]. However, since patients undergoing HSCT have complex needs and clinical judgement must be used to design any rehab program and ensure patient safety.
The patients who have haemoglobin level below 8 g/dL should not receive any intense PT management, as majority of the studies have indicated risk to patients like reduced exercise performance and the development of exercise-induced STsegment depression . Hence exercising with low haemoglobin should be considered by the therapists on individual patient basis with the patient’s overall clinical picture in mind.
A well monitored PT session may be safe for individuals with hematologic malignancies and those who are receiving an RBC transfusion. Furthermore, adverse events related to RBC transfusion are believed not to be influenced by PT intervention.