Feasibility and acceptability of a home‐based resistance training intervention in adolescent and young adult hematopoietic cell transplant survivors

Abstract

Background Adolescent and young adult (AYA) hematopoietic cell transplantation (HCT) survivors are at increased risk of metabolic syndrome and lean body mass (LBM) deficits. Resistance training (RT) is a potential intervention to improve LBM, metabolic fitness, and reduce risk of cardiovascular disease. Procedure Eligible participants ages 13–39 years, 80–120 days post‐HCT, transfusion independent, and prednisone dose ≤1 mg/kg/day were approached. Baseline assessments of body composition (DXA), anthropometrics, and strength testing were completed and participants were taught a 12‐week, home‐based RT intervention with weekly remote coaching. Follow‐up assessments were at day +200 (FU1) and +365 post‐HCT (FU2). Feasibility targets were (a) 60% enrollment of approached patients, (b) 80% completion of weekly phone calls, and (c) 80% completion of the RT intervention and FU1 assessments. Acceptability was based on positive responses in qualitative interviews. Results Twenty of 31 (65%) eligible AYAs enrolled. Three participants failed to complete baseline measurements (2 = scheduling barriers, 1 = passive refusal) and four participants who completed baseline assessments did not receive the intervention (1 = medical reasons, 2 = no longer interested). Of those who completed baseline assessments, 13 received the intervention, completed 88.5% of coaching calls, and 11 (65%) completed FU1. LBM (kg) increased or remained unchanged in nine of nine participants with complete body composition data at FU1 (mean 1.1 kg; 95%CI: 0.4, 1.9). All participants who completed FU1 reported they would recommend the intervention to an AYA HCT survivor. Conclusions A home‐based RT intervention in AYA HCT survivors early post HCT is both feasible and acceptable and may maintain or increase LBM.

Interventions about physical activity and diet and their impact on adolescent and young adult cancer survivors: a Prisma systematic review

“…QoL-fatigue: FACIT, QoL-PedsQL. PA self-efficacy: Godin Leisure-Time Q Nutrition knowledge and dietary habit: a 20-question nutrition quiz and 3-day dietary intake records were completed at baseline and post-intervention Ketterl et al [ 43 ] 20 18–39 RT b 12 3 in-person exercise sessions with an exercise physiologist and a progressive increase in individual RT b - Body composition metabolic fitness, strength testing, feasibility Body composition: LBM and PFM. Strength and endurance assessments feasibility: number of enrolled participants, weekly follow-up phone calls with participants, number of participants who completed the intervention Smith et al [ 44 ] 35 21.1 ± 2.6 Rehabilitation Program 8 Weekly 1 h PA and 1 h education/self-management session - Feasibility, acceptability: adherence Program Ratings: exercise and PA, eating a healthy diet, accessing support in the community.…”

“…A 12-week combined in-person and remote study by Ketterl et al [ 43 ] explored a resistance training (RT) intervention for hematopoietic cell transplant survivors (HCT) during the early post-HCT period. This intervention primarily aimed at enhancing lean body mass (LBM) deficits and metabolic fitness in HTC survivors,a progressive program where participants had to exercise for 2 to 3 days per week [ 43 ].…”

“…A 12-week combined in-person and remote study by Ketterl et al [ 43 ] explored a resistance training (RT) intervention for hematopoietic cell transplant survivors (HCT) during the early post-HCT period. This intervention primarily aimed at enhancing lean body mass (LBM) deficits and metabolic fitness in HTC survivors,a progressive program where participants had to exercise for 2 to 3 days per week [ 43 ]. Findings indicated that LBM was either stable or increased at 12 weeks, and at the 1-year follow-up, participants also reported that the intervention was enjoyable and that they would recommend it to a friend or an HCT survivor [ 43 ].…”

“…For example, the retention rate was 59% at 6 and 49% at 12 months in Lynch et al [ 46 ], 94% in Wurz et al (2019), and 77% in Rabin et al [ 50 ]. Moreover, there was only a 10% attrition for the primary outcome assessment at 10 weeks in Atkinson et al [ 37 ], and 89% of participants in Ketterl et al [ 43 ] completed the weekly coaching phone calls and reportedly did a median of two exercise sessions per week. In terms of satisfaction, participants reported that they would recommend this RT intervention to a friend or a HCT survivor and shared that they enjoyed the intervention [ 43 ].…”

“…Moreover, there was only a 10% attrition for the primary outcome assessment at 10 weeks in Atkinson et al [ 37 ], and 89% of participants in Ketterl et al [ 43 ] completed the weekly coaching phone calls and reportedly did a median of two exercise sessions per week. In terms of satisfaction, participants reported that they would recommend this RT intervention to a friend or a HCT survivor and shared that they enjoyed the intervention [ 43 ]. Additionally, the eHealth intervention by Keadle et al [ 40 ] was acceptable and was deemed satisfying by both groups with the PA + Charity group being sig.…”