Pilot study of a multimodal intervention: mixed-type exercise and psychoeducation in patients undergoing allogeneic stem cell transplantation

Abstract

Substantial physical and functional deconditioning and diminished psychological wellbeing are all potential adverse effects of allogeneic stem cell transplantation (allo-HSCT). The aim of this study was to evaluate the feasibility, safety and benefits (physical and functional capacity) of a 4-6 week supervised and structured mixed-type exercise, progressive relaxation and psychoeducation programme in patients undergoing allo-HSCT. Nineteen patients were randomized to an intervention or a conventional care group (CC) and were tested for physical and functional capacity before admission and upon hospital discharge. In all, 14 patients completed all study requirements (74%) and no adverse reactions that could be attributed to the intervention were observed. At the time of discharge, the intervention group showed significant improvements in several muscle strength scores as compared to the CC group; chest press (P=0.023), leg extension (P=0.007) and isometric right knee flexor (P=0.033). The intervention proved feasible, safe and well tolerated in this small sample of patients undergoing allo-HSCT. An intervention of this type may be a useful strategy for maintaining or improving muscle strength, and minimizing loss of physical and functional capacity in patients undergoing allo-HSCT.

Effect of physical exercise on muscle mass and strength in cancer patients during treatment—A systematic review

“…Thus, data extraction was performed on 18 papers. Two of the papers were publications based on the same study and were excluded [27,28], leaving 16 trials for final synthesis. Figure 1 shows the outcome of the search process and selection of studies.…”

The Impact of a Multidimensional Exercise Intervention on Physical and Functional Capacity, Anxiety, and Depression in Patients With Advanced-Stage Lung Cancer Undergoing Chemotherapy

“…[9][10][11][12][13][14] Moreover, physical activity and relaxation training have been shown to relieve side effects and symptoms in cancer patients with advanced disease undergoing chemotherapy. [15][16][17] Patients with advanced-stage lung cancer face poor survival and experience co-occurring chronic physical and psychosocial symptoms. The nature of symptoms calls for complex interventions designed to address these symptoms, which is why our group designed a multimodal supervised group intervention combined with a home-based walking program that was tested in a feasibility study.…”

Functional performance status of hematopoietic SCT recipients in the sub-acute phase of recovery

“…Functional capacity and physical capacity have also been shown to change in tandem in allo-SCT recipients immediately after transplantation. 5 Hence, it seems reasonable to suggest that the results from these physical performance tests reflect functional capacity and, more importantly, changes in test results can be used to document changes in the ability of patients to engage in activities associated with daily living. 6,26,28 A major complication of allo-SCT is acute GVHD, which is estimated to occur upwards in 41% of transplant recipients.…”

“…[1][2][3] As such, physical rehabilitation of these patients becomes an important post-transplant therapeutic intervention which is often directed by rehabilitation specialists, including occupational and physical therapists. 4,5 Central to the success of this rehabilitation process is an understanding of the initial physical and functional status of the patient and an ability to monitor changes in patient status over the course of rehabilitation treatment. A battery of physical performance tests has recently been described that are valid and reliable in the oncology population, well tolerated by patients, completed quickly and easily used by clinicians.…”

“…These data also demonstrate that a spontaneous return to normal or even optimal functional capacity is unlikely to occur in this patient population during the sub-acute phase of recovery, adding further impetus to previous calls for implementing rehabilitation interventions for SCT patients early in the sub-acute recovery phase. 5,25 …”