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Effect of exercise therapy on muscle mass and physical functioning in patients undergoing allogeneic hematopoietic stem cell transplantation

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Abstract

Purpose

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is associated with transplant-related toxicities, which may have a profound impact on a patient’s physical functioning and body composition. In order to analyze the effect of exercise therapy on muscle mass and physical functioning in patients receiving allo-HSCT, we measured muscle mass and physical functioning before and after allo-HSCT.

Methods

Eighty-six patients who had undergone allo-HSCT between February 2010 and September 2013 at Imamura Bun-in Hospital participated in this study. Physical therapists performed exercise therapy with patients 5 days a week, starting 2 weeks before allo-HSCT. Body composition, 6-min walk test (6MWT) scores, and handgrip strength were evaluated 2 weeks before allo-HSCT and 6 weeks after allo-HSCT.

Results

Thirty-five patients were available for evaluation 2 weeks before and 6 weeks after allo-HSCT. The 6MWT (p = 0.005) and handgrip strength (p < 0.001) significantly decreased after allo-HSCT. Although upper extremity muscle mass (p = 0.001) and trunk muscle mass (p < 0.001) significantly decreased after allo-HSCT, lower extremity muscle mass remained unchanged.

Conclusions

In this study, it is suggested that exercise therapy may be effective for maintaining lower extremity muscle mass in patients undergoing allo-HSCT.

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References

  1. Kellerman J, Rigler D, Siegel SE (1977) Psychological effects of isolation in protected environments. Am J Psychiatry 134:563–565

    Article  CAS  PubMed  Google Scholar 

  2. Fobair P, Hoppe RT, Bloom J, Cox R, Varghese A, Spiegel D (1986) Psychosocial problems among survivors of Hodgkin’s disease. J Clin Oncol 14:805–814

    Google Scholar 

  3. Cunningham BA, Morris G, Cheney CL, Buergel N, Aker SN, Lenssen P (1986) Effects of resistive exercise on skeletal muscle in marrow transplant recipients receiving total parenteral nutrition. JPEN J Parenter Enter Nutr 10:558–563

    Article  CAS  Google Scholar 

  4. Decker WA, Turner-McGlade J, Fehir KM (1989) Psychosocial aspects and the physiological effects of a cardiopulmonary exercise program in patients undergoing bone marrow transplantation (BMT) for acute leukemia (AL). Transplant Proc 21:3068–3069

    CAS  PubMed  Google Scholar 

  5. Jarden M, Baadsgaard MT, Hovgaard DJ, Boesen E, Adamsen L (2009) A randomized trial on the effect of a multimodal intervention on physical capacity, functional performance and quality of life in adult patients undergoing allogeneic SCT. Bone Marrow Transplant 43:725–737

    Article  CAS  PubMed  Google Scholar 

  6. Dimeo F, Bertz H, Finke J, Fetscher S, Mertelsmann R, Keul J (1996) An aerobic exercise program for patients with haematological malignancies after bone marrow transplantation. Bone Marrow Transplant 18:1157–1160

    CAS  PubMed  Google Scholar 

  7. Coleman EA, Coon S, Hall-Barrow J, Richards K, Gaylor D, Stewart B (2003) Feasibility of exercise during treatment for multiple myeloma. Cancer Nurs 26:410–419

    Article  PubMed  Google Scholar 

  8. Carlson LE, Smith D, Russell J, Fibich C, Whittaker T (2006) Individualized exercise program for the treatment of severe fatigue in patients after allogeneic hematopoietic stem-cell transplant: a pilot study. Bone Marrow Transplant 37:945–954

    Article  CAS  PubMed  Google Scholar 

  9. DeFor TE, Burns LJ, Gold EM, Weisdorf DJ (2007) A randomized trial of the effect of a walking regimen on the functional status of 100 adult allogeneic donor hematopoietic cell transplant patients. Biol Blood Marrow Transplant 13:948–955

    Article  PubMed  Google Scholar 

  10. Hayes S, Davies PS, Parker T, Bashford J (2003) Total energy expenditure and body composition changes following peripheral stem cell transplantation and participation in an exercise programme. Bone Marrow Transplant 31:331–338

    Article  CAS  PubMed  Google Scholar 

  11. Knols RH, de Bruin ED, Uebelhart D, Aufdemkampe G, Schanz U, Stenner-Liewen F, Hitz F, Taverna C, Aaronson NK (2011) Effects of an outpatient physical exercise program on hematopoietic stem-cell transplantation recipients: a randomized clinical trial. Bone Marrow Transplant 46:1245–1255

    Article  CAS  PubMed  Google Scholar 

  12. Borg GA (1982) Psychophysical bases of perceived exertion. Med Sci Sports Exerc 14:377–381

    CAS  PubMed  Google Scholar 

  13. Karvonen MJ, Kentala E, Mustala O (1957) The effects of training on heart rate; a longitudinal study. Ann Med Exp Biol Fenn 35:307–315

    CAS  PubMed  Google Scholar 

  14. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories (2002) ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 166:111–117

    Article  Google Scholar 

  15. Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J, Thomas ED (1995) 1994 Consensus Conference on Acute GVHD Grading. Bone Marrow Transplant 15:825–828

    CAS  PubMed  Google Scholar 

  16. Morishita S, Kaida K, Setogawa K, Kajihara K, Ishii S, Ikegame K, Kodama N, Ogawa H, Domen K (2013) Safety and feasibility of physical therapy in cytopenic patients during allogeneic haematopoietic stem cell transplantation. Eur J Cancer Care 22:289–299. doi:10.1111/ecc.12027

    Article  CAS  Google Scholar 

  17. Baumann FT, Zopf EM, Nykamp E, Kraut L, Schüle K, Elter T, Fauser AA, Bloch W (2011) Physical activity for patients undergoing an allogeneic hematopoietic stem cell transplantation: benefits of a moderate exercise intervention. Eur J Haematol 87:148–156

    Article  PubMed  Google Scholar 

  18. Hung YC, Bauer J, Horsley P, Waterhouse M, Bashford J, Isenring E (2013) Changes in nutritional status, body composition, quality of life, and physical activity levels of cancer patients undergoing autologous peripheral blood stem cell transplantation. Support Care Cancer 21:1579–1586. doi:10.1007/s00520-012-1698-y

    Article  PubMed  Google Scholar 

  19. Ferrando AA, Stuart CA, Brunder DG, Hillman GR (1995) Magnetic resonance imaging quantitation of changes in muscle volume during 7 days of strict bed rest. Aviat Space Environ Med 66:976–981

    CAS  PubMed  Google Scholar 

  20. Atkinson K (1990) Chronic graft-versus-host disease. Bone Marrow Transplant 5:69–82

    CAS  PubMed  Google Scholar 

  21. Flowers ME, Kansu E, Sullivan KM (1999) Pathophysiology and treatment of graft-versus-host disease. Hematol Oncol Clin North Am 13:1091–112

    Article  CAS  PubMed  Google Scholar 

  22. Ericson MO, Nisell R, Ekholm J (1986) Quantified electromyography of lower-limb muscles during level walking. Scand J Rehabil Med 18:159–163

    CAS  PubMed  Google Scholar 

  23. Winter DA, Yack HJ (1987) EMG profiles during normal human walking: stride-to-stride and inter-subject variability. Electroencephalogr Clin Neurophysiol 67:402–411

    Article  CAS  PubMed  Google Scholar 

  24. Hodgson JA (1983) The relationship between soleus and gastrocnemius muscle activity in conscious cats—a model for motor unit recruitment. J Physiol 337:553–562

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  25. Kern DS, Semmler JG, Enoka RM (2001) Long-term activity in upper- and lower-limb muscles of humans. J Appl Physiol 91:2224–2232

    CAS  PubMed  Google Scholar 

  26. Ikeda S, Yoshida A, Matayoshi S, Tanaka N (2003) Repetitive stretch induces c-fos and myogenin mRNA within several hours in skeletal muscle removed from rats. Arch Phys Med Rehabil 84:419–423

    Article  PubMed  Google Scholar 

  27. Hides JA, Lambrecht G, Richardson CA, Stanton WR, Armbrecht G, Pruett C, Damann V, Felsenberg D, Belavý DL (2011) The effects of rehabilitation on the muscles of the trunk following prolonged bed rest. Eur Spine J 20:808–818. doi:10.1007/s00586-010-1491-x

    Article  PubMed Central  PubMed  Google Scholar 

  28. Belavý DL, Miokovic T, Armbrecht G, Richardson CA, Rittweger J, Felsenberg D (2009) Differential atrophy of the lower-limb musculature during prolonged bed-rest. Eur J Appl Physiol 107:489–499. doi:10.1007/s00421-009-1136-0

    Article  PubMed  Google Scholar 

  29. Minetto MA, Lanfranco F, Motta G, Allasia S, Arvat E, D'Antona G (2011) Steroid myopathy: some unresolved issues. J Endocrinol Invest 34:370–375

    Article  CAS  PubMed  Google Scholar 

  30. Morishita S, Kaida K, Yamauchi S, Sota K, Ishii S, Ikegame K, Kodama N, Ogawa H, Domen K (2013) Relationship between corticosteroid dose and declines in physical function among allogeneic hematopoietic stem cell transplantation patients. Support Care Cancer 21:2161–2169. doi:10.1007/s00520-013-1778-7

    Article  PubMed  Google Scholar 

  31. Baumann FT, Kraut L, Schüle K, Bloch W, Fauser AA (2010) A controlled randomized study examining the effects of exercise therapy on patients undergoing haematopoietic stem cell transplantation. Bone Marrow Transplant 45:355–362

    Article  CAS  PubMed  Google Scholar 

  32. Mello M, Tanaka C, Dulley FL (2003) Effects of an exercise program on muscle performance in patients undergoing allogeneic bone marrow transplantation. Bone Marrow Transplant 32:723–728

    Article  CAS  PubMed  Google Scholar 

  33. Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvão DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen VE, Schwartz AL (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42:1409–1426. doi:10.1249/MSS.0b013e3181e0c112

    Article  PubMed  Google Scholar 

  34. Mourtzakis M, Prado CM, Lieffers JR, Reiman T, McCargar LJ, Baracos VE (2008) A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care. Appl Physiol Nutr Metab 33:997–1006. doi:10.1139/H08-075

    Article  PubMed  Google Scholar 

  35. Pietrobelli A, Rubiano F, St-Onge MP, Heymsfield SB (2004) New bioimpedance analysis system: improved phenotyping with whole-body analysis. Eur J Clin Nutr 58:1479–1484

    Article  CAS  PubMed  Google Scholar 

  36. Morishita S, Kaida K, Tanaka T, Itani Y, Ikegame K, Okada M, Ishii S, Kodama N, Ogawa H, Domen K (2012) Prevalence of sarcopenia and relevance of body composition, physiological function, fatigue, and health-related quality of life in patients before allogeneic hematopoietic stem cell transplantation. Support Care Cancer 20:3161–3168. doi:10.1007/s00520-012-1460-5

    Article  PubMed  Google Scholar 

  37. Janssen I, Heymsfield SB, Baumgartner RN, Ross R (2000) Estimation of skeletal muscle mass by bioelectrical impedance analysis. J Appl Physiol 89:465–471

    CAS  PubMed  Google Scholar 

  38. Lorenzo AD, Andreoli A (2003) Segmental bioelectrical impedance analysis. Curr Opin Clin Nutr Metab Care 6:551–555

    Article  PubMed  Google Scholar 

  39. Wiskemann J, Dreger P, Schwerdtfeger R, Bondong A, Huber G, Kleindienst N, Ulrich CM, Bohus M (2011) Effects of a partly self-administered exercise program before, during, and after allogeneic stem cell transplantation. Blood 117:2604–2613. doi:10.1182/blood-2010-09-306308

    Article  CAS  PubMed  Google Scholar 

  40. Hacker ED, Larson J, Kujath A, Peace D, Rondelli D, Gaston L (2011) Strength training following hematopoietic stem cell transplantation. Cancer Nurs 34:238–249. doi:10.1097/NCC.0b013e3181fb3686

    Article  PubMed Central  PubMed  Google Scholar 

  41. Wilson RW, Jacobsen PB, Fields KK (2005) Pilot study of a home-based aerobic exercise program for sedentary cancer survivors treated with hematopoietic stem cell transplantation. Bone Marrow Transplant 35:721–727

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The authors are grateful to the study participants, the physical therapists at the Rehabilitation Department, and the physicians at Hematology and Rehabilitation Medicine in Imamura Bun-in Hospital.

Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, Imamura Bun-in Hospital, 11-23 Kamoikeshinmachi, Kagoshima, 890-0064, Japan

    Takahiro Takekiyo, Koichiro Dozono, Takayuki Mitsuishi, Yoshihiro Murayama & Ayako Maeda

  2. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan

    Nobuaki Nakano, Ayumu Kubota, Masahito Tokunaga, Shogo Takeuchi, Yoshifusa Takatsuka & Atae Utsunomiya

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  1. Takahiro Takekiyo
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  2. Koichiro Dozono
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  3. Takayuki Mitsuishi
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  4. Yoshihiro Murayama
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  9. Shogo Takeuchi
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  11. Atae Utsunomiya
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Correspondence to Takahiro Takekiyo.

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Takekiyo, T., Dozono, K., Mitsuishi, T. et al. Effect of exercise therapy on muscle mass and physical functioning in patients undergoing allogeneic hematopoietic stem cell transplantation. Support Care Cancer 23, 985–992 (2015). https://doi.org/10.1007/s00520-014-2425-7

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  • DOI: https://doi.org/10.1007/s00520-014-2425-7

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