A 4-year-old child with acute lymphoblastic leukemia in the induction phase of treatment presents with the following lab values: Hemoglobin = 7.8 g/100 mm; Platelets = 74,000 mm³; Hematocrit = 28%. What is the most appropriate physical therapy intervention for this child you are seeing with deconditioning?

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Hemoglobin norms vary by age and gender. The norm for a child is 11-13 g/100 mm, whereas the norms for adult males are 13-18 and adult females 12-16 g/100 mm. In the pediatric acute care setting, for children whose baseline falls within the normal ranges, intervention is typically deferred when their hemoglobin level falls below 8 g/100 mm. For those children whose baseline ranges are typically already below 8 g/100 mm, clinical discussions should occur among the medical team on whether interventions are indicated. Although this lab value is a guideline, patient symptoms should be closely monitored. Refer to Table 21.2 for exercise guidelines and activity level in accordance with platelet count.

A 4-Year-Old Child with Acute Lymphoblastic Leukemia in the Induction