Effects of multimodal exercise on clinical status and patient-reported outcomes in children undergoing hematopoietic stem cell transplantation

Abstract

There are limited data available regarding effectiveness of exercise training in children undergoing hematopoietic stem cell transplantation (HSCT). We aimed to investigate effects of multimodal exercise program on clinical status and patient-reported outcomes including pain, fatigue, depression, and quality of life (QOL) level of children and their parents' QOL level. Twenty-six children undergoing HSCT participated in this study. Clinical status, pain, fatigue, depression, and QOL level of children were assessed three times: before HSCT, at discharge, and one month later. For intervention group (IG, n ¼ 15), multimodal exercise program was performed five days a week, throughout hospitalization and children were advised to continue exercise program at home. For control group (CG, n ¼ 11), being active as much as possible was advised. The number of painful day and pain intensity was significantly lower in IG than in CG during hospitalization (p < .05). Depression level decreased in IG at the time points (p ˂ .05); however, there was no significantly difference between groups. The QOL level was higher in IG than CG only at control measurements (p ˂ .05). In addition, QOL level of the parents decreased in both groups (p ˂ .05). There was no statistically difference between groups in terms of other clinical variables. The multimodal supervised exercise program has positive effects on children's pain and QOL level. Exercise program was also well tolerated by children during hospitalization. In addition, QOL levels of the parents were also negatively affected during hospitalization, and interventions aiming to increase QOL level of the parents should be considered.

The effects of administered interventions on quality of life of children with cancer in Turkey: A systematic review and meta‐analysis

“…The results of the seven studies included herein are explicitly indicated. The study results suggested that video game intervention (Kurt & Savaşer, 2013) positively affected the quality of life of adolescents with cancer and that the administration of a multimodal exercise programme reduced pain and increased the quality of life in children with cancer (Yildiz Kabak et al, 2019). Another article determined that informing the children with acute lymphoblastic leukaemia about chemotherapy increased their quality of life (Çetinkaya & Kurt, 2010).…”

Growth in the face of overwhelming pressure: A narrative review of sibling donor experiences in pediatric hematopoietic stem cell transplant

“…All 21 studies reviewed reported that pediatric sibling donors express some form of psychosocial distress across the donation process. Only three studies in this review explicitly measured trauma symptoms experienced by donors and nondonors, which included anxiety (Erden et al, 2019;Packman et al, 1997a), depression (Erden et al, 2019;Packman et al, 1997a), and PTS symptoms (Gizli Coban et al, 2017;Packman et al, 1997a). However, within the remaining articles, siblings did express experiences of distress, fear, overwhelming pressure, guilt and blame, as well as emotional and social isolation.…”

“…The term "post-traumatic growth" was not explicitly used in the studies analyzed in this review; however, sibling donors described personal gains and growth post-donation in 48% of studies reviewed (D'Auria et al, 2015;Erden et al, 2019;Hoag et al, 2018;Hutt et al, 2015;MacLeod et al, 2003;Packman et al, 1997b;Pelletier et al, 2014;Pentz et al, 2014;Weiner et al, 2008;Wilkins and Woodgate, 2007), suggesting that a PTG lens was an appropriate fit. This novel analysis provides an increased understanding of the potential for growth during sibling donation, which may contribute to the development of new approaches to psychosocial intervention in the future.…”

“…Most siblings felt proud and happy about their donation decision (Hoag et al, 2018;Packman et al, 1997b) or experienced increased self-esteem and felt good about themselves (Erden et al, 2019;Hutt et al, 2015). Sibling donors also shared that they felt they had grown as a person after donating.…”

“…A large percentage of pediatric HSCT treatments rely on a donation of bone marrow or stem cells from siblings because of their close genetic match at the human leukocyte antigen loci (HLA) (D'Auria et al, 2015). Although the success rate of HSCT is high, a small but growing body of literature suggests that there are significant but often overlooked psychosocial risks for pediatric siblings before, during, and after donation (D'Auria et al, 2015;Erden et al, 2019;Gizli Coban et al, 2017;Hoag et al, 2018;Hutt et al, 2015;MacLeod et al, 2003;Packman et al, 1997aPackman et al, , 1997bPelletier et al, 2014;Pentz et al, 2012;Pot-Mees and Zeitlin, 1987;Stegenga et al, 2019;Switzer et al 2016;White et al, 2017;Wiener et al, 2008;Wilkins and Woodgate, 2007;Zajac-Spychala et al, 2020). Even less research attention has been focused on potential positive gains for sibling donors, such as posttraumatic growth (PTG) which has been defined by Tedeschi and Calhoun (2004) as positive psychological change gained through the struggle of facing highly challenging circumstances.…”