title: Physical exercise for patients undergoing hematopoietic stem cell transplantation: systematic review and meta-analyses of randomized controlled trials.
abstract: BACKGROUND
  The treatment-related burden for patients undergoing hematopoietic stem cell transplantation (HSCT) may be relieved by physical exercises.
  
  
  OBJECTIVE
  The purpose of this study was to summarize and analyze the evidence provided by randomized controlled trials (RCTs) on physical exercise interventions among patients with cancer undergoing HSCT.
  
  
  METHODS
  PubMed, CINAHL, EMBASE, the Cochrane Library, and PEDro were searched for relevant RCTs up to October 1, 2011.
  
  
  METHODS
  Two reviewers screened articles on inclusion criteria and indentified relevant RCTs.
  
  
  METHODS
  Two authors assessed the selected articles for risk of bias. Data extraction was performed by 1 reviewer. Meta-analyses were undertaken to estimate the outcomes quality of life (QOL), psychological well-being and distress, and fatigue.
  
  
  RESULTS
  Eleven studies were included, with study populations consisting of recipients undergoing either an allogeneic or autologous HSCT (n=734). Four studies had low risk of bias. The exercise interventions were performed before, during, and after hospitalization for the HSCT. Different exercise programs on endurance, resistance and/or activities of daily living training, progressive relaxation, and stretching were used. Meta-analyses showed that exercise during hospitalization led to a higher QOL (weighted mean difference=8.72, 95% confidence interval=3.13, 14.31) and less fatigue (standardized mean difference=0.53, 95% confidence interval=0.16, 0.91) in patients with an allogeneic HSCT at the moment of discharge from the hospital. No marked effects were found for psychological well-being and distress. Individual study results suggested significant positive effects on QOL, fatigue, psychological well-being and distress, and physical functioning.
  
  
  CONCLUSIONS
  Prevalent shortcomings in the included studies were the heterogeneity among studies and the lack of blinding of participants, personnel, and outcome assessment.
  
  
  CONCLUSIONS
  The results suggest that recipients of HSCT may benefit from physical exercise.
authors.affiliation: Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Inge E P M
authors.initials: IE
authors.lastname: van Haren
authors.forename: Hans
authors.initials: H
authors.lastname: Timmerman
authors.forename: Carin M
authors.initials: CM
authors.lastname: Potting
authors.forename: Nicole M A
authors.initials: NM
authors.lastname: Blijlevens
authors.forename: J Bart
authors.initials: JB
authors.lastname: Staal
authors.forename: Maria W G
authors.initials: MW
authors.lastname: Nijhuis-van der Sanden
mesh_terms: D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005221:Fatigue / Q000534:rehabilitation*; D019337:Hematologic Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic