Adherence of stem cell transplant recipients receiving glucocorticoid therapy to an exercise-based rehabilitation program.
The high acuity of hematopoietic stem cell transplant (HSCT) recipients receiving glucocorticoid (GC) therapy for acute graft vs. host disease (aGVHD) may limit their adherence to an exercise-based rehabilitation program and hence, slow their recovery. To make this determination, the medical records of 59 subacute outpatient stem cell transplant recipients receiving methylprednisolone (MP) were reviewed for demographic, anthropometric and medical information. Performance on the repeated sit-to-stand, 50-ft walk and 6-min walk tests were determined before and after completing a 4-week progressive exercise rehabilitation program and outcomes were compared by a paired t-test (P < 0.05). Thirty-two patients (54%) finished a treatment plan (adherent group), completing 80% of the prescribed sessions and were reevaluated. Twenty-seven patients (46%) did not complete the rehabilitation program (nonadherent group), primarily because of readmission to the hospital (18 patients, 62%). The adherent group did not significantly improve their physical performance (p > 0.05). However, a subgroup of 40% of these patients did experience clinically significant improvements in their physical performance.These findings 1) support the feasibility of having HSCT recipients receiving GC therapy to participate in an exercise-based rehabilitation program and 2) suggest that to do so can result in clinically significant improvements in functional capacity.
Department of Rehabilitation Services, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA. steve.morris2@stjude.org
G Stephen
GS
Morris
Kevin E
KE
Brueilly
Janet S
JS
Scheetz
Marcos J
MJ
de Lima
D000328:Adult; D000368:Aged; D015444:Exercise; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010349:Patient Compliance; D055815:Young Adult
D005938:Glucocorticoids