title: Effects of a partly self-administered exercise program before, during, and after allogeneic stem cell transplantation.
abstract: Before, during, and after allogeneic hematopoietic stem cell transplantation (allo-HSCT), patients experience considerable physical and psychologic distress. Besides graft-versus-host disease and infections, reduced physical performance and high levels of fatigue affect patients' quality of life. This multicenter randomized controlled trial examined the effects of a partly self-administered exercise intervention before, during, and after allo-HSCT on these side effects. After randomization to an exercise and a social contact control group 105 patients trained in a home-based setting before hospital admission, during inpatient treatment and a 6- to 8-week period after discharge. Fatigue, physical performance, quality of life, and physical/psychologic distress were measured by standardized instruments at baseline, admission to, and discharge from hospital and 6 to 8 weeks after discharge. The exercise group showed significantly improvement in fatigue scores (up to 15% improvement in exercise group vs up to 28% deterioration in control; P<.01-.03), physical fitness/functioning (P=.02-.03) and global distress (P=.03). All effects were at least detectable at one assessment time point after hospitalization or repeatedly. Physical fitness correlated significantly with all reported symptoms/variables. In conclusion, this partly supervised exercise intervention is beneficial for patients undergoing allo-HSCT. Because of low personnel requirements, it might be valuable to integrate such a program into standard medical care.
authors.affiliation: Central Institute of Mental Health, Mannheim, Germany. joachim.wiskemann@nct-heidelberg.de
authors.forename: Joachim
authors.initials: J
authors.lastname: Wiskemann
authors.forename: Peter
authors.initials: P
authors.lastname: Dreger
authors.forename: Rainer
authors.initials: R
authors.lastname: Schwerdtfeger
authors.forename: Andrea
authors.initials: A
authors.lastname: Bondong
authors.forename: Gerhard
authors.initials: G
authors.lastname: Huber
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Kleindienst
authors.forename: Cornelia M
authors.initials: CM
authors.lastname: Ulrich
authors.forename: Martin
authors.initials: M
authors.lastname: Bohus
mesh_terms: D000328:Adult; D000368:Aged; D003710:Demography; D005081:Exercise Therapy; D005221:Fatigue / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010809:Physical Fitness; D012646:Self Administration; D033581:Stem Cell Transplantation; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult