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Effects of partly supervised and home-based exercise program in patients undergoing hematopoietic stem cell transplantation: a case-control study

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Abstract

Purpose

The aim of this study was to determine effectiveness of an individual exercise program by starting before hematopoietic stem cell transplantation (HSCT) and continued with home exercise program after discharge up to 100 days after transplantation.

Methods

Totally, 50 patients were included in this study, and participants were assigned to two groups as intervention group (IG, n = 25) and control group (CG, n = 25). Participants were assessed at three time points: before HSCT, at the discharge, and at the 100th day after HSCT. Functional exercise capacity, physical functions, muscle strength, cognitive functions, quality of life, fatigue, and emotional status of the individuals were assessed. For IG, aerobic, muscle strengthening, endurance, and stretching exercises were performed through hospitalization, and an individual exercise and walking program was advised as home exercise program after discharge.

Results

Peripheral muscle strength and quality of life level was higher in IG than CG as a result of inpatient supervised exercise program (p ˂ 0.05). At the 100th day, positive effects of the home exercise program on cardiopulmonary exercise capacity, peripheral muscle strength, quality of life, and fatigue level continued when compared with CG (p ˂ 0.05).

Conclusion

As a result of our study, an exercise program continued up to 100 days after HSCT which is individual and partly supervised by a physiotherapist has positive effects on physical functions, clinical status, fatigue, and quality of life level throughout HSCT. Exercise programs for individuals undergoing HSCT should be performed day by day according to the patients’ daily clinical and hematologic status and their performance capacity.

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References

  1. Khaddour K, Mewawalla P (2019) Hematopoietic stem cell transplantation. StatPearls Publishing LLC, Treasure Island

    Google Scholar 

  2. Copelan EA (2006) Hematopoietic stem-cell transplantation. N Engl J Med 354:1813–1826

    Article  CAS  PubMed  Google Scholar 

  3. Cant AJ, Galloway A, Jackson G (2008) Practical hematopoietic stem cell transplantation. Wiley, UK

    Google Scholar 

  4. Niederwieser D, Baldomero H, Szer J, Gratwohl M, Aljurf M, Atsuta Y, Bouzas LF, Confer D, Greinix H, Horowitz M (2016) Hematopoietic stem cell transplantation activity worldwide in 2012 and a SWOT analysis of the worldwide network for blood and marrow transplantation group including the global survey. Bone Marrow Transplant 51:778–785

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Brice L, Gilroy N, Dyer G, Kabir M, Greenwood M, Larsen S, Moore J, Kwan J, Hertzberg M, Brown L, Hogg M, Huang G, Tan J, Ward C, Gottlieb D, Kerridge I (2017) Haematopoietic stem cell transplantation survivorship and quality of life: is it a small world after all? Support Care Cancer 25:421–427

    Article  PubMed  Google Scholar 

  6. Andrykowski M, McQuellon R (1999) Psychological issues in hematopoietic cell transplantation. Blackwell Science Inc, Maryland

    Google Scholar 

  7. Baker F, Marcellus D, Zabora J, Polland A, Jodrey D (1997) Psychological distress among adult patients being evaluated for bone marrow transplantation. Psychosom 38:10–19

    Article  CAS  Google Scholar 

  8. Bevans MF, Mitchell SA, Marden S (2008) The symptom experience in the first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT). Support Care Cancer 16:1243–1254

    Article  PubMed  PubMed Central  Google Scholar 

  9. Miano M, Faraci M, Dini G, Bordigoni P (2008) Early complications following haematopoietic SCT in children. Bone Marrow Transplant 41:39–42

    Article  Google Scholar 

  10. Danaher EH, Ferrans C, Verlen E, Ravandi F, van Besien K, Gelms J, Dieterle N (2006) Fatigue and physical activity in patients undergoing hematopoietic stem cell transplant. Oncol Nurs Forum 33:614–624

    Article  PubMed  Google Scholar 

  11. Wiskemann J, Huber G (2008) Physical exercise as adjuvant therapy for patients undergoing hematopoietic stem cell transplantation. Bone Marrow Transplant 41:321–329

    Article  CAS  PubMed  Google Scholar 

  12. Baker F, Zabora J, Polland A, Wingard J (1999) Reintegration after bone marrow transplantation. Cancer Pract 7:190–197

    Article  CAS  PubMed  Google Scholar 

  13. Andrykowski MA, Brady MJ, Greiner CB, Altmaier EM, Burish TG, Antin JH, Gingrich R, McGarigle C, Henslee-Downey PJ (1995) 'Returning to normal' following bone marrow transplantation: outcomes, expectations and informed consent. Bone Marrow Transplant 15:573–581

    CAS  PubMed  Google Scholar 

  14. Mohammed J, Aljurf M, Althumayri A, Almansour M, Alghamdi A, Hamidieh AA, ElHaddad A, Othman TB, Bazarbachi A, Almohareb F (2019) Physical therapy pathway and protocol for patients undergoing hematopoietic stem cell transplantation: recommendations from the eastern Mediterranean Blood and Marrow Transplantation (EMBMT) group. Hematol Oncol Stem Cell Ther 12:127–132

    Article  PubMed  Google Scholar 

  15. Steinberg A, Asher A, Bailey C, Fu JB (2015) The role of physical rehabilitation in stem cell transplantation patients. Support Care Cancer 23:2447–2460

    Article  PubMed  PubMed Central  Google Scholar 

  16. Keser I, Suyani E, Aki SZ, Sucak AGT (2013) The positive impact of regular exercise program on stem cell mobilization prior to autologous stem cell transplantation. Transfus Apher Sci 49:302–306

    Article  PubMed  Google Scholar 

  17. De Lisio M, Baker JM, Parise G (2013) Exercise promotes bone marrow cell survival and recipient reconstitution post-bone marrow transplantation, which is associated with increased survival. Exp Hematol 41:143–154

    Article  PubMed  Google Scholar 

  18. Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, McCormack MC, Carlin BW, Sciurba FC, Pitta F, Wanger J, MacIntyre N, Kaminsky DA, Culver BH, Revill SM, Hernandes NA, Andrianopoulos V, Camillo CA, Mitchell KE, Lee AL, Hill CJ, Singh SJ (2014) An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J 44:1428–1446

    Article  PubMed  Google Scholar 

  19. Singh SJ, Puhan MA, Andrianopoulos V, Hernandes NA, Mitchell KE, Hill CJ, Lee AL, Camillo CA, Troosters T, Spruit MA, Carlin BW, Wanger J, Pepin V, Saey D, Pitta F, Kaminsky DA, McCormack MC, MacIntyre N, Culver BH, Sciurba FC, Revill SM, Delafosse V, Holland AE (2014) An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease. Eur Respir J 44:1447–1478

    Article  PubMed  Google Scholar 

  20. Balogun JA, Akomolafe CT, Amusa LO (1991) Grip strength: effects of testing posture and elbow position. Arch Phys Med Rehabil 72:280–283

    CAS  PubMed  Google Scholar 

  21. Liu CJ, Marie D, Fredrick A, Bertram J, Utley K, Fess EE (2017) Predicting hand function in older adults: evaluations of grip strength, arm curl strength, and manual dexterity. Aging Clin Exp Res 29:753–760

    Article  PubMed  Google Scholar 

  22. Adams GM, Beam WC (1998) Exercise physiology: laboratory manual. McGraw-Hill, WCB

    Google Scholar 

  23. Bohannon RW, Andrews AW (1987) Interrater reliability of hand-held dynamometry. Phys Ther 67:931–933

    Article  CAS  PubMed  Google Scholar 

  24. Bohannon RW (2006) Reference values for the timed up and go test: a descriptive meta-analysis. J Geriatr Phys Ther 29:64–68

    Article  PubMed  Google Scholar 

  25. Jones CJ, Rikli RE, Beam WC (1999) A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport 70:113–119

    Article  CAS  PubMed  Google Scholar 

  26. Guzelant A, Goksel T, Ozkok S, Tasbakan S, Aysan T, Bottomley A (2004) The European Organization for Research and Treatment of Cancer QLQ-C30: an examination into the cultural validity and reliability of the Turkish version of the EORTC QLQ-C30. Eur J Cancer Care 13:135–144

    Article  CAS  Google Scholar 

  27. Armutlu K, Keser I, Korkmaz N, Akbıyık DI, Sümbüloğlu V, Güney Z, Karabudak R (2007) Psychometric study of Turkish version of fatigue impact scale in multiple sclerosis patients. J Neurol Sci 255:64–68

    Article  PubMed  Google Scholar 

  28. Aydemir Ö, Guvenir T, Kuey L, Kultur S (1997) Validity and reliability of Turkish version of hospital anxiety and depression scale. Turk Psikiyatri Derg 8:280–287

    Google Scholar 

  29. Cheung YT, Foo YL, Shwe M, Tan YP, Fan G, Yong WS, Madhukumar P, Ooi WS, Chay WY, Dent RA, Ang SF, Lo SK, Yap YS, Ng R, Chan A (2014) Minimal clinically important difference (MCID) for the functional assessment of cancer therapy: cognitive function (FACT-cog) in breast cancer patients. J Clin Epidemiol 67:811–820

    Article  PubMed  Google Scholar 

  30. Norton K, Norton L, Sadgrove D (2010) Position statement on physical activity and exercise intensity terminology. J Sci Med Sport 13:496–502

    Article  PubMed  Google Scholar 

  31. 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

    Article  CAS  PubMed  Google Scholar 

  32. Hacker ED, Mjukian M (2014) Review of attrition and adherence in exercise studies following hematopoietic stem cell transplantation. Eur J Oncol Nurs 18:175–182

    Article  PubMed  Google Scholar 

  33. 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 

  34. Kim SD, Kim HS (2006) A series of bed exercises to improve lymphocyte count in allogeneic bone marrow transplantation patients. Eur J Cancer Care 15:453–457

    Article  Google Scholar 

  35. Dimeo F, Fetscher S, Lange W, Mertelsmann R, Keul J (1997) Effects of aerobic exercise on the physical performance and incidence of treatment-related complications after high-dose chemotherapy. Blood 90:3390–3394

    Article  CAS  PubMed  Google Scholar 

  36. Pedersen BK, Febbraio MA (2008) Muscle as an endocrine organ: focus on muscle-derived interleukin-6. Physiol Rev 88:1379–1406

    Article  CAS  PubMed  Google Scholar 

  37. Gleeson M, Bishop NC, Stensel DJ, Lindley MR, Mastana SS, Nimmo MA (2011) The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nat Rev Immunol 11:607–615

    Article  CAS  PubMed  Google Scholar 

  38. Bohannon RW, Crouch R (2017) Minimal clinically important difference for change in 6-minute walk test distance of adults with pathology: a systematic review. J Eval Clin Pract 23:377–381

    Article  PubMed  Google Scholar 

  39. Jones LW, Devlin SM, Maloy MA, Wood WA, Tuohy S, Espiritu N, Aquino J, Kendig T, Michalski MG, Gyurkocza B (2015) Prognostic importance of pretransplant functional capacity after allogeneic hematopoietic cell transplantation. Oncologist 20:1290–1297

    Article  PubMed  PubMed Central  Google Scholar 

  40. 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

    Article  PubMed  Google Scholar 

  41. 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

    Article  PubMed  PubMed Central  Google Scholar 

  42. Ozdemir K, Keser I, Yegin ZA, Kaynar LA (2020) Efficacy of manual lymph drainage plus exercise on range of motion and flexibility in refractory chronic cutaneous graft-versus-host disease: a case report. Curr Res Transl Med 68:1–4

    Article  PubMed  Google Scholar 

  43. Baumann F, Kraut L, Schüle K, Bloch W, Fauser A (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 

  44. Takekiyo T, Dozono K, Mitsuishi T, Nara S, Yoshida K, Murayama Y, Maeda A, Chaen T, Nakano N, Kubota A, Tokunaga M, Takeuchi S, Takatsuka Y, Utsunomiya A (2016) Recovery of physical function and quality of life in patients undergoing hematopoietic stem cell transplantation: a 1-year follow-up. Bone Marrow Transplant 51:1127–1130

    Article  CAS  PubMed  Google Scholar 

  45. Cramp F, Byron-Daniel J (2012) Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev 11:CD006145

    PubMed  Google Scholar 

  46. Jones D, Vichaya EG, Wang XS, Sailors MH, Cleeland CS, Wefel JS (2013) Acute cognitive impairment in patients with multiple myeloma undergoing autologous hematopoietic stem cell transplant. Cancer 119:4188–4195

    Article  PubMed  Google Scholar 

  47. Scherwath A, Schirmer L, Kruse M, Ernst G, Eder M, Dinkel A, Kunze S, Balck F, Bornhauser M, Ehninger G, Dolan K, Gramatzki M, Kolb HJ, Heussner P, Wilhelm H, Beelen DW, Schulz-Kindermann F, Zander AR, Koch U, Mehnert A (2013) Cognitive functioning in allogeneic hematopoietic stem cell transplantation recipients and its medical correlates: a prospective multicenter study. Psycho-oncol 22:1509–1516

    Article  Google Scholar 

  48. Myers JS, Erickson KI, Sereika SM, Bender CM (2018) Exercise as an intervention to mitigate decreased cognitive function from cancer and cancer treatment: an integrative review. Cancer Nurs 41:327–343

    Article  PubMed  PubMed Central  Google Scholar 

  49. Dimeo FC, Stieglitz RD, Novelli-Fischer U, Fetscher S, Keul J (1999) Effects of physical activity on the fatigue and psychologic status of cancer patients during chemotherapy. Cancer 85:2273–2277

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Vesile Yildiz Kabak.

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The Hacettepe University Ethical Committee approved the study.

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Yildiz Kabak, V., Goker, H. & Duger, T. Effects of partly supervised and home-based exercise program in patients undergoing hematopoietic stem cell transplantation: a case-control study. Support Care Cancer 28, 5851–5860 (2020). https://doi.org/10.1007/s00520-020-05432-x

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