Occupational Therapy Interventions for Pediatric Patients with Cancer and Avascular Necrosis: A Case Report

Background: Avascular necrosis (AVN) is a rare disease that can be caused by cancer treatment. AVN can affect multiple joints, which can disrupt one’s ability to perform daily activities. Rehabilitation services, including occupational therapy (OT) and physical therapy, are used to improve a patient’s quality of life through skilled conservative interventions that improve daily task engagement. Occupational therapists are trained to address functional deficits experienced by pediatric patients with cancer and may play a key role in treating patients who have AVN. This case report describes the role of OT in addressing self-care for a patient experiencing early multifocal AVN. Case Description: The patient was a 15-year-old with acute lymphoblastic leukemia and had progressive AVN of bilateral hips, knees, and shoulders. This case report discusses nonoperative approaches and OT administered between October 2023 and March 2024. The patient experienced progressive pain and a loss of range of motion (ROM) in all affected joints. Before OT intervention, the patient required caregiver assistance with most activities of daily living. Interventions included the use of adaptive equipment or task modification approaches. Outcomes: The occupational therapist provided services once per week in an outpatient setting over a 6-month period to help the patient gain independence in activities of daily living. The patient showed improvements in occupational performance after OT intervention despite maintaining ROM differences in all affected joints. Conclusion: This study provides evidence that occupational therapists can help improve occupational performance in patients with early multifocal AVN.