Physical therapy and quality of life in pediatric palliative care: An evidence-based literature review. Fisioterapia y calidad de vida en cuidados paliativos pediátricos: Una revisión de la literatura basada en la evidencia A Scoping Review

Abstract

Objective This study aims to explore the impact of physical therapy on the quality of life of pediatric patients in palliative care, highlighting its role within the interdisciplinary team. Materials and Methods This project will use a literature review approach to examine the available evidence on physical therapy in pediatric palliative care. The review was registered prospectively. The information search was conducted in recognized academic databases such as Medline, PubMed, Web of Science and Physiotherapy Evidence Database (PEDro), Scopus, Google Scholar, Dialnet, and Scielo. To ensure comprehensive coverage, specific terms and keyword combinations related to physical therapy in pediatric palliative care were used. Results Various physical therapy interventions were found in pediatric palliative care, especially in patients with oncological diseases. Physical therapy in this context focuses on maintaining and improving essential functions such as mobility, ventilation, and pain control, addressing common symptoms such as fatigue, dyspnea, and chronic pain. The most common interventions include respiratory techniques such as bronchial hygiene, breathing exercises, and the use of noninvasive ventilation, as well as motor therapies focused on mobilization, resisted exercises, positioning, and the use of orthoses to promote functionality. The use of complementary therapies such as therapeutic massage is also notable, having shown benefits in reducing pain, anxiety, and muscle tension. Another relevant aspect was the implementation of personalized exercise programs tailored to each child's interests and clinical condition, combining strength, endurance, mobility, and body awareness, and delivered both at home and in the clinic. These approaches not only contributed to improving the child's quality of life but also had a positive impact on the well-being of their caregivers.  Conclusion It is evident that physical therapy in pediatric palliative care is a valuable tool through various specialized interventions. Different adapted exercise programs, combining strength, coordination, and mobility training, have shown 73% adherence in children with advanced cancer, maintaining functional benefits even in the terminal stages of the disease (López et al., cited in Ortiz-Campoy et al., 2021). In essence, physical therapy in pediatric palliative care is chosen as a fundamental pillar to optimize patients' quality of life, addressing both physical and emotional and social aspects. Its impact is evident in the reduction of debilitating symptoms such as pain, fatigue, and dyspnea; the preservation of functionality; the promotion of independence; the prevention of complications secondary to immobility; the relief of physical discomfort; and the promotion of participation in meaningful activities. Despite growing evidence of its benefits, studies also point to the need for stronger research, specialized training for professionals, and the allocation of greater resources in this field, particularly in resource-limited countries (Ortiz-Campoy et al., 2021). The integration of physical therapy into multidisciplinary teams is considered crucial to providing comprehensive care focused on the needs of children and their families.