title: A randomized control trial of a supervised versus a self-directed exercise program for allogeneic stem cell transplant patients.
abstract: OBJECTIVE
  To determine if therapist supervision of an exercise program produced better functional outcomes in allogeneic stem cell transplant patients than a patient-directed exercise program.
  
  
  METHODS
  Sixty-one patients who were less than 6 months post allogeneic stem cell transplant were randomly assigned to either a therapist supervised training group (supervised) or a patient-directed training group (Self-directed). Training consisted of aerobic exercises (treadmill, bicycle ergometer versus walking) and resistance exercises (free weights, weight machines versus resistive band activities). Subjects completed physical performance tests (50-foot fast walk, 6-min walk, forward reach, repeated sit-to-stand, uniped stance) and the Brief Fatigue Inventory (BFI) before and after 4 weeks of training. Pre- and post-training outcomes and group differences were analyzed by a Student t-test.
  
  
  RESULTS
  Patients in both groups were similarly deconditioned at baseline. Training increased the 6-min walk distance and 50-foot walk in the supervised group by 12 and 14%, respectively, and increased the 6-min walk distance by 10% in the Self-directed group (p<0.05). BFI score for worst level of fatigue declined in both groups but not significantly.
  
  
  CONCLUSIONS
  These results demonstrate that allogeneic transplant patients derive functional benefits from short-term exercise training regardless of how the training program is supervised. Determining (1) the reasons for the low participation rate (28%), (2) the patient-preferred characteristics of each exercise supervision style and (3) how best to match patient preference to exercise supervision style remain significant issues in this area of patient delivery services.
authors.affiliation: Department of Occupational Therapy, The University of Texas-Pan American, Edinburg, TX, USA.
authors.forename: Margarette L
authors.initials: ML
authors.lastname: Shelton
authors.forename: Jeannette Q
authors.initials: JQ
authors.lastname: Lee
authors.forename: G Stephen
authors.initials: GS
authors.lastname: Morris
authors.forename: Pamela R
authors.initials: PR
authors.lastname: Massey
authors.forename: Deborah G
authors.initials: DG
authors.lastname: Kendall
authors.forename: Mark F
authors.initials: MF
authors.lastname: Munsell
authors.forename: Karen O
authors.initials: KO
authors.lastname: Anderson
authors.forename: Maureen J
authors.initials: MJ
authors.lastname: Simmonds
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Giralt
mesh_terms: D000328:Adult; D000368:Aged; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D011369:Professional-Patient Relations; D016730:Program Development; D020377:Self Efficacy; D012944:Social Support; D033581:Stem Cell Transplantation / Q000706:statistics & numerical data*; D013997:Time Factors; D014184:Transplantation, Homologous; D055815:Young Adult