Adherence of stem cell transplant recipients receiving glucocorticoid therapy to an exercise-based rehabilitation program
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The high acuity of hematopoietic stem cell transplant (HSCT) recipients receiving glucocorticoid (GC) therapy for acute graft vs. host disease (aGVHD) may limit their adherence to an exercise-based rehabilitation program and hence, slow their recovery. To make this determination, the medical records of 59 subacute outpatient stem cell transplant recipients receiving methylprednisolone (MP) were reviewed for demographic, anthropometric and medical information. Performance on the repeated sit-to-stand, 50-ft walk and 6-min walk tests were determined before and after completing a 4-week progressive exercise rehabilitation program and outcomes were compared by a paired t-test (P < 0.05). Thirty-two patients (54%) finished a treatment plan (adherent group), completing 80% of the prescribed sessions and were reevaluated. Twenty-seven patients (46%) did not complete the rehabilitation program (nonadherent group), primarily because of readmission to the hospital (18 patients, 62%). The adherent group did not significantly improve their physical performance (p > 0.05). However, a subgroup of 40% of these patients did experience clinically significant improvements in their physical performance.These findings 1) support the feasibility of having HSCT recipients receiving GC therapy to participate in an exercise-based rehabilitation program and 2) suggest that to do so can result in clinically significant improvements in functional capacity.
KeywordsHematopoietic stem cell transplantation Glucocorticoid Graft vs. host disease Rehabilitation Exercise Exercise adherence
The authors would like to acknowledge the time, effort and commitment of these patients as they worked to recover. No HSCT study could be completed without the involvement of the patients' caregivers and to this group we express our profound appreciation. The authors would also like to thank Nancy Paddison, PTA, BA, for providing invaluable editorial assistance and excellent patient care and to Naghma A. Ahmed, MSPT, ShammiVenkatachalam, MSPT and B.J. Jackson for providing excellent patient care.
Conflict of interest
The authors of this manuscript have no financial or other conflicts of interest to declare.
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