Controlled study to evaluate physical and psychosocial effects of a standardized in-patient rehabilitation program for patients after allogenic stem cell transplantation

Abstract

16519 Background: Allogeneic stem cell transplantation (HSCT) involves somatic restrictions as well as psychosocial problems. We devolped a specific, standardized in-patient rehabilitation program (RP) for pts after HSCT. Main goals of this combined medical and psychosocial RP are the accelerated increase of physical strength and the decrease of psychosocial distress to improve health related quality of life (QoL).The purpose of this study was to evaluate this RP and define prognostic factors to discriminate between groups of pts. who might differentially benefit by the program. Methods: 132 pts. after HSCT were prospectively enrolled in the treatment group and compared to 22 pts. after HSCT who did not receive the specific RP. Besides an elucidated medical and physical assessment all pts. answered different standadized questionaires for evaluation of treatment related symptoms, fatigue (MFI), QoL (QlQ), and psycosocial distress (HADS). All measurements were repeated at different time points. RP-Pts received the first questionnaire at their admission to our center, controls during the first control after HSCT at their respective treatment center (T1). T2 was at discharge from the hospital or four to six weeks after T1. T3 was six months and T4 twelve months after T2. A matched-pairs strategy was chosen to compare the smaller group of 22 control patients with matching partners selected from the treatment group. Results: The analyses reveal that the rehabilitation patients as a group had significant poorer initial values compared to controls, particularly in physical parameters and fatigue. At T2 and T3 both groups did improve significantly compared to T1 in different physical and psychosocial measures. However the matched pair analysis is still ongoing and data will be presented. Conclusions: Our data show that pts who are obviously more impaired following HSCT were preferentially transferred to our in-patient RP and benefit significantly from a standardized RP in physical as well as psychosocial conditions. The improvement increases over time and reaches after one year values comparable to those of healthy people. No significant financial relationships to disclose.