title: Feasibility of integrated home/hospital physiotherapeutic support for children with cancer.
abstract: OBJECTIVE
  Children suffering from cancer often have to undergo physiotherapy that either extends the duration of in-patient hospitalisation or requires more frequent visits to the outpatient clinic. To improve care and to decrease the length of hospitalisation of children being treated at the Dept. of Haematoloy/Oncology of the Gaslini Children's Hospital, a programme of Home Care was set up in April 2000.
  
  
  METHODS
  In June 2003, rehabilitation was added to the procedures that were feasible at home and included i.v. therapy administration, blood examinations, transfusion and/or psychological support, as well as palliative care for terminally ill children. The physiotherapy sessions were done in the ward, in the Rehabilitation Unit Gym, or at home, depending on the clinical conditions and the needs of the child and the family.
  
  
  RESULTS
  Between June 2003 and May 2005, 46 children, whose median age was 7 years (range 6 months-21 years) suffering from CNS tumours (13), leukaemia (13), neuroblastoma (7), bone tumours (6), sarcoma (4) and lymphoma (3), underwent 1,398 physiotherapy sessions for neuro-motor re-education (534), motor rehabilitation (485), strain re-education and training (250), respiratory care (79), or to improve comfort during the terminal phase of the disease (50). To maintain continuity of care, the treatments were performed at home (931), in the hospital ward (282), or in the gymnasium of our Physiotherapy Service (185).
  
  
  CONCLUSIONS
  The physiotherapist was able to start or to continue assistance at home or in the hospital, and to keep up the programme based on the child's needs. Integrated home/hospital physiotherapy for children suffering from cancer is feasible and is useful for maintaining continuity of treatment without lengthening hospitalisation.
authors.affiliation: Department of Paediatric Haematology/Oncology, Giannina Gaslini Children's Hospital, Largo G. Gaslini 5, 16148, Genoa, Italy.
authors.forename: Christian
authors.initials: C
authors.lastname: Savio
authors.forename: Alberto
authors.initials: A
authors.lastname: Garaventa
authors.forename: Marina
authors.initials: M
authors.lastname: Gremmo
authors.forename: Riccardo
authors.initials: R
authors.lastname: Camoriano
authors.forename: Luca
authors.initials: L
authors.lastname: Manfredini
authors.forename: Sara
authors.initials: S
authors.lastname: Fieramosca
authors.forename: Giorgio
authors.initials: G
authors.lastname: Dini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Miano
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D019033:Delivery of Health Care, Integrated; D005240:Feasibility Studies; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000191:economics / Q000458:organization & administration*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000191:economics / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000191:economics / Q000458:organization & administration*