A prospective, randomized evaluation of the feasibility of exergaming on patients undergoing hematopoietic stem cell transplantation

Abstract

The positive effects of physical and sports therapy for strain dependent physical practice and improved quality of life (QoL) are well known. Nevertheless, the available capacities and problem-oriented therapies in the setting of hematopoietic stem cell transplantation (HSCT) are limited. We conducted a prospective, randomized study among 42 HSCT recipients in order to investigate the influence of exergaming on Nintendo Wii or classical physiotherapy (PT) on physical fitness and psychological well-being. The trial included evaluation of muscle strength, endurance, physical activity, distress, QoL, anxiety, and depression. Within the first 2 weeks after HSCT endurance, muscle strength and physical well-being decreased, while the value of distress increased significantly in both groups. However, exergaming on Nintendo Wii resulted in a decrease of anxiety and depression and improved emotional well-being, while the PT group showed a contrariwise pattern of these features. Analysis of the FACT-BMT revealed a decline of QoL domains 2 and 4 weeks after HSCT and an improvement afterwards. The decrease of functional status after HSCT was accompanied by a drop of QoL and an increase of distress in both groups. However, our prospective study demonstrates that exergaming using the Nintendo Wii is feasible and well tolerated in HSCT recipients.

The effects of exergames on anxiety levels: A systematic review and meta‐analysis

“…Adherence was reported in two different ways: as dropout rates and/or as proportion of sessions/days completed. With respect to dropouts, only three studies 47,53,60 did not lose any participants, while six studies lost between 2.0% and 8.4%, 18,49,51,56‐57,59 three studies lost 12.7%‐17.9%, 55,58,61 one study lost 26.2%, 48 one study lost 28.3%, 50 and one study lost 43.8% 54 of the participants. When considering the proportion of intervention sessions/days attended by the participants, only seven studies reported data, 50‐51,54‐56,60,61 with attendance rates to the exergame intervention being ~30%, 56 62%, 54 63.9%, 60 ~77%, 50,55 and ~84% 51,61 .…”

“…The number of participants in the studies varied from 15 60 to 88 52 . Two studies examined exclusively men, 47,50 three exclusively women, 32,51,60 while 11 studies assessed a mixed sex sample 18,48‐49,52‐56,58‐59,61 and one study did not report the participants’ sex 57 . In total, 236 men and 297 women participated in the included studies.…”

“…Only one study evaluated healthy young individuals 32 and other older adults 52 . The remaining 15 studies investigated participants with some type of disease 18,47‐51,53‐61 …”

“…Eight studies (47.1%) reported information about the intensity and/or intensity control of the exergame session, in which two studies used percentage of maximal HR predicted for age, 32,59 one percentage of the target HR measured by electrocardiogram telemetry during a graded exercise test, 49 one percentage of HR reserve, 50 and four studies used rating of perceived exertion (Borg 6 – 20 scale) 18,32,50,60 . Seven of 15 chronic studies provided a high supervision (one research per participant [1:1 ratio]) during all exergame sessions 47‐49,51,54,57,58 . One study provided supervision in all sessions but did not report the ratio 59 .…”

“…In this sense, Tsuda et al 54 reported an adherence to exergames intervention of 62% in patients with hematologic malignancies receiving chemotherapy, while Rosenberg et al 61 reported a high adherence (84%) though no significant change in anxiety levels in older patients with subsyndromal depression was found. Schumacher et al 48 reported that although 74% of patients undergoing hematopoietic stem cell transplantation were inexperienced on exergaming with the Nintendo Wii ® , 90% of patients quoted that the handling was simple and easy to learn. Also 84% of patients reported that exergames were fun and an acceptable diversion from day‐to‐day routines in the hospital.…”