Functional evaluation indicates physical losses after hematopoietic stem cell transplantation

Abstract

Objective To perform a function evaluation of patients before and after hematopoietic stem cell transplantation. Methods From November 2008 to November 2010, 29 female (58%) and 21 male patients (42%) with median age of 48 years (range: 24-67) were enrolled in this study. Data collection was performed before and after autologous or allogeneic hematopoietic stem cell transplantation. Evaluation instruments included the 2-minute walking test to evaluate gait performance with assessment of the oxygen saturation, heart rate and Borg Scale before and after the test; grip strength for strength evaluation, Schober Test for spine mobility testing and maximum and adapted activity scores of the Human Activity Profile questionnaire to test functionality in daily activities. Results Fifty patients were evaluated at baseline; six did not undergo hematopoietic stem cell transplantation (three died, one refused and two were excluded). Thus 44/50 (88% - 21 allogeneic and 23 autologous) transplantations were performed. Only 33 of the 44 patients (75%) performed evaluations after transplantation (nine died and two were excluded). Of the patients who performed both evaluations, significantly lower values were found in the evaluation after transplantation for the 2-minute walking test (p-value = 0.004), grip strength of both right and left hands (p-value = 0.004 and p-value < 0.0001, respectively), the Schober Test, and maximum and adapted activity scores (p-value < 0.0001). The heart rate was higher (p-value = 0.01) before the 2-minute walking test and oxygen saturation was higher (p-value = 0.02) after. Conclusion Statistical differences indicate functional impairment after transplantation showing physical losses in this population.

Impact of the initial fitness level on the effects of a structured exercise therapy during pediatric stem cell transplantation

“…The multimodal training had a stabilizing effect on patients' 6MWD, while there was a significant decrease in the nonexercise CG. A negative impact of stem cell transplantation on physical performance and endurance has already been observed in previous studies with adults and young recipients . Further, our findings are also consistent with previous research that demonstrated moderate significant effects in favor of an exercise intervention compared to the usual care in adult HSCT patients .…”

“…Moreover, prolonged isolated hospitalization required for HSCT leads to sedentary behavior, causing further numerous adverse symptoms . As a result, prospective evaluation indicates losses of aerobic capacity, musculoskeletal performance, physical activity, and health‐related quality of life (HRQoL) following transplantation …”

“…15 As a result, prospective evaluation indicates losses of aerobic capacity, musculoskeletal performance, physical activity, and health-related quality of life (HRQoL) following transplantation. [16][17][18][19] Exercise therapy has been shown to be a supportive strategy to minimize or even prevent these disease-or transplant-related consequences. In a meta-analysis, Van Haren et al 20 incorporated 11 intervention randomized clinical trials (RCTs) in adult HSCT patients, showing valuable effects regarding physical functioning, medical outcomes, and psychological variables in adults prior, 21 during, 22 and after therapy.…”

Impact of an Incentive-Based Mobility Program, “Motivated and Moving,” on Physiologic and Quality of Life Outcomes in a Stem Cell Transplant Population

“…23 In addition, structured exercise programs for the HSCT population have been shown to stabilize endurance performance and muscular strength during transplantation, 23 reduce the intensity of symptom clusters over time, 12 increase strength and endurance after transplantation, 24 and show stabilization and recovery of physiologic performance by days 90 to 120. 25 Moreover, exercise-based programs have been shown to improve the physical performance of patients after high-dose chemotherapy in comparison with rest after treatment. 26 No physical activity study has examined the use of an incentivebased exercise program during hospitalization for transplant therapy.…”

Translation, Cross-Cultural Adaptation, and Validation of the Lee Chronic Graft-versus-Host Disease Symptom Scale in a Brazilian Population

“…Data about QoL associated with clinical manifestations are used as a health indicator in clinical trials and also for counseling patients and to help guide treatment. 4, 5 Moreover, higher levels of function are related to good health and longevity and should be considered when assessing disease processes. 4 …”