A Hybrid-Delivery Physical Therapy Program for Children With Acute Lymphoblastic Leukemia: Results of an Innovative Patient-Centered Intervention

Background: Children with acute lymphoblastic leukemia are at a high risk for long-term neuromuscular and musculoskeletal side effects from cancer treatment, many of which are amenable to physical therapy (PT). Our aim is to determine the feasibility, acceptability, and safety of a hybrid approach (in-person and/or virtual) to pediatric PT service delivery using a web-based platform. Methods: We conducted a single-group prospective proof-of-concept, before-and-after intervention study with children aged 4 to 17 years, who were undergoing or had completed acute lymphoblastic leukemia treatment. Children participated in a hybrid 12-week PT program, tailored to identified functional goals. Families chose their preferred mode of PT delivery for each session and had access to a web-based platform comprising educational videos and resources to support physical activity and fine motor dexterity. Primary outcomes were feasibility, acceptability, and safety. Secondary outcomes included quality of life, completion of routine clinical measures, and reporting of symptoms and functional deficits. Assessments were conducted at baseline and at a 3-month follow-up. Results: Ten children aged 7.3 ± 2.6 years participated. Results demonstrated high retention (100%) and adherence rates to PT sessions (96.7%), and high satisfaction with the program and the online platform (80%). No intervention-related adverse events occurred. Improvements were observed in parent-reported child quality of life and motor function outcomes. Conclusion: This proof-of-concept study supports the feasibility of delivering a patient-centered hybrid PT intervention incorporating telehealth in children with cancer. Preliminary findings suggest potential for this model to support access to PT services, warranting further evaluation in larger, controlled studies.