Exercise Gaming During Hospitalization for Pediatric And Adolescent/Young Adult (AYA) Patients Undergoing Hematopoietic Stem Cell Transplant (HSCT)

Abstract

The treatment of childhood malignancies with hematopoietic stem cell transplant (HSCT) is potentially curative. However, the procedure can detrimentally affect a patient's overall well being. The literature demonstrates that one week post HSCT, distress and anxiety peak and physical activity significantly decreases. These changes may be more profound in pediatric and adolescent/young adult (AYA) patients that require reverse isolation. Together, these changes can lead to persistent fatigue, physical deconditioning and reduced ability to engage in activities of daily living. Emerging literature suggests that engaging in physical exercise during admission for HSCT can stabilize a patient's current level of physical performance, prevent further decreases in performance status, improve mood and enhance overall quality of life. With this knowledge, it is imperative that supportive care measures be developed that will counter these negative effects of treatment. We propose that participation in a developmentally appropriate physical activity program throughout hospitalization for HSCT can decrease patient distress and anxiety and maintain their physical performance capacity. Exercise equipment using video gaming technology (Play Station exercise game bikes, dance pads and Nintendo Wii's) to encourage compliance will be provided to pediatric and AYA patients, ages 7–25, hospitalized for HSCT. Patients will be asked to exercise a minimum of 4 days/week for at least 20 minutes/day during their hospitalization. Adherence to the program, use of the equipment and a quality of life measure, the Behavioral, Affective and Somatic Experiences Scale (BASES), will be assessed before transplantation and then weekly during admission. Performance status measures (six-minute walk test and Timed Up and Go) will be administered at admission and prior to discharge. We hypothesize that use of exercise/gaming devices will maintain current performance status and lead to an improved quality of life in these patients. The treatment of childhood malignancies with hematopoietic stem cell transplant (HSCT) is potentially curative. However, the procedure can detrimentally affect a patient's overall well being. The literature demonstrates that one week post HSCT, distress and anxiety peak and physical activity significantly decreases. These changes may be more profound in pediatric and adolescent/young adult (AYA) patients that require reverse isolation. Together, these changes can lead to persistent fatigue, physical deconditioning and reduced ability to engage in activities of daily living. Emerging literature suggests that engaging in physical exercise during admission for HSCT can stabilize a patient's current level of physical performance, prevent further decreases in performance status, improve mood and enhance overall quality of life. With this knowledge, it is imperative that supportive care measures be developed that will counter these negative effects of treatment. We propose that participation in a developmentally appropriate physical activity program throughout hospitalization for HSCT can decrease patient distress and anxiety and maintain their physical performance capacity. Exercise equipment using video gaming technology (Play Station exercise game bikes, dance pads and Nintendo Wii's) to encourage compliance will be provided to pediatric and AYA patients, ages 7–25, hospitalized for HSCT. Patients will be asked to exercise a minimum of 4 days/week for at least 20 minutes/day during their hospitalization. Adherence to the program, use of the equipment and a quality of life measure, the Behavioral, Affective and Somatic Experiences Scale (BASES), will be assessed before transplantation and then weekly during admission. Performance status measures (six-minute walk test and Timed Up and Go) will be administered at admission and prior to discharge. We hypothesize that use of exercise/gaming devices will maintain current performance status and lead to an improved quality of life in these patients.