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Impact of the initial fitness level on the effects of a structured exercise therapy during pediatric stem cell transplantation
Author(s) -
Wallek Susanne,
SennMalashonak Anna,
Vogt Lutz,
Schmidt Katharina,
Bader Peter,
Banzer Winfried
Publication year - 2018
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26851
Subject(s) - medicine , hematopoietic stem cell transplantation , physical therapy , quality of life (healthcare) , physical fitness , transplantation , psychological intervention , flexibility (engineering) , cardiovascular fitness , physical medicine and rehabilitation , nursing , psychiatry , statistics , mathematics
Abstract Background Before and after hematopoietic stem cell transplantation (HSCT), most patients suffer from psychophysical limitations due to the treatment. Exercise interventions demonstrate beneficial effects on, for example, strength, endurance, or health‐related quality of life during and after HSCT, but with a great variation among patients concerning the response to exercise. This study examines the influence of the initial fitness on the effects of an exercise therapy in pediatric HSCT. Procedure Fifty‐three children and adolescents (10.9 ± 3.5 years) scheduled for HSCT were randomized into an exercise intervention group (IG) or a control group (CG). During hospitalization, the IG performed endurance, strength, and flexibility training three times per week. The CG included a nonexercise program. A 6‐min walk test was completed before and after the inpatient period. Baseline results (6‐min walking distance [6MWD]) were used to split both groups into the following: IG UNFIT , n = 14; IG FIT , n = 12; CG UNFIT , n = 16; CG FIT , n = 11. Differences in outcome changes between groups were analyzed with H‐test. Result Intergroup comparison revealed significant differences between IG UNFIT and CG UNFIT ( P < 0.05). The IG UNFIT increased their 6MWD by +8% (vs. IG FIT , +1%); both CGs presented a decline in 6MWD (CG UNFIT , –14%; CG FIT , –16%). At discharge, the IG FIT achieved 85.5 ± 10.3% of healthy reference values. Conclusions The current results indicate that exercise during pediatric HSCT is feasible and contributes to prevention of treatment‐related loss of physical function. As seen in healthy persons, patients’ benefits might depend on their initial fitness level. As a diminished physical capability may result in higher training effects, impaired especially patients should engage in exercise.