A Home-based Walking Program Is Feasible For Cancer Patients Prior To Undergoing Bone Marrow Transplant.

Abstract

Previous research has shown that patients with low fitness level prior to stem cell transplant have higher incidence of post-transplant complications. PURPOSE: To examine the feasibility of a home-based walking intervention in Brazilian patients with hematological cancers prior to undergoing a stem cell transplant in the Sistema Unico de Saude (SUS). Pre to post intervention physical function and patient reported outcomes (PROs) were also evaluated. METHODS: This single arm study enrolled 11 patients who scored >50 on the Karnosfsky performance status scale, presented no contra-indication for participating in light to moderate regular walking, and were cleared by their oncologist to participate in the study. The home-based walking intervention initiated with patients undergoing 20 minutes of moderate intensity (10-12 on the Original Borg Scale) per week progressing up to 150 minutes by week 7. After week 7, patients were asked to maintain the 150 minutes of walking at moderate intensity until transplant day. Feasibility was determined by the number of patients approached to participate in the study (>90%) and the number of patients (>60%) that were able to achieve at least 70% of the planned intervention. Physical function (6 minutes walk test (6MWT) and TUG test) and PROs (Depression (Beck Depression Scale), fatigue (Piper Fatigue Scale), and quality of life (QOL) (SF-36) were assessed prior and after the walking intervention. RESULTS: All (100%) eligible patients enrolled in the study. Out of the 11 patients, 1 patient was excluded because stopped chemotherapy treatment. Out of 10 patients, only 1 was not able to adhere to the study intervention. All other patients completed at least 70% of the planned walking intervention with some (66%) engaged in more than 150 minutes per week. Significant improvements from pre to post intervention in the 6MWT (344.4 ±117.8 and 490.6±111.2 meters, p=0.001) and PROs (Depression, 12.11±7.08 and 7.89±4.65, p=0.006; Fatigue, 62.00±25.98 and 26.22±10, p=0.002; overall QOL 23.11±4.34 and 26.33±2.45) were observed. CONCLUSION: Brazilian patients enrolled in the SUS not only were able to participate in the home-based walking intervention, but improvements in physical function and PROs were observed.