Deconditioning after "Moving On" rehabilitation.

Abstract

291 Background: “Moving On” is a 12-week physical rehabilitation program that is offered to patients following cancer treatment. Autologous hematopoietic stem cell transplantation (HSCT) is considered a more aggressive cancer treatment due to myeloablative doses of chemotherapy. Our previous research has shown that deconditioning at the time of referral to Moving On is not significantly different in HSCT patients and non-HSCT cancer patients. Our objective here is to determine how deconditioning after Moving On completion compares in HSCT and non-HSCT groups, as well as by age. Methods: We retrospectively reviewed data from Moving On referrals made between March 2013 and March 2016 (N = 1,057) who completed the Moving On program (N = 322). This includes patients with solid or hematologic malignancies, some of whom received HSCT. Brief Fatigue Inventory scores and 6-minute timed walk (6-MTW) distances were recorded to assess deconditioning. Results: We found 296 of 615 (48%) non-HSCT patients evaluated for Moving On, completed the program; 26 of 43 (60%) HSCT patients evaluated for Moving On completed the program. For those completing Moving On, we found a mean fatigue score of 1.6 in non-HSCT patients (SD = 1.9) and 1.3 in HSCT patients (SD = 2.3) (p = 0.43). The mean distance walked in six minutes was 1543 feet (SD = 237) in non-HSCT patients and 1624 feet (SD = 247) in HSCT patients (p = 0.11). In patients < 70 years old, average fatigue scores were 1.6 for non-HSCT and 1.2 in HSCT (p = 0.29); average 6-MTW distances were 1564 ft. for non-HSCT and 1644 ft. in HSCT (p = 0.17). In patients ≥70 years old, average fatigue scores were 1.4 for non-HSCT and 1.6 in HSCT (p = 0.82); average 6-MTW distances were 1451 feet for non-HSCT and 1560 feet in HSCT (p = 0.20). Conclusions: We find that 25% more HSCT patients complete Moving On than non-HSCT patients. There is no significant difference in post-Moving On fatigue scores or 6-MTW distances between HSCT and non-HSCT groups. A significant difference in 6-MTW by age, is found in the non-HSCT group but not in HSCT patients. This may be due to selection bias in this group, as more fit patients ≥70 undergo HSCT. Our results show that deconditioning following rehabilitation in autologous HSCT is comparable to cancer patients not receiving HSCT, regardless of age.