Abstract
Physical exercise for patients treated with allogeneic haematopoietic stem cell transplantation (allo-HSCT) has shown positive effects on the quality of life and fatigue in experimental trials. However, there is a need for longitudinal evaluation of exercise programmes implemented in a real-world clinical setting. The aim of this prospective study was to evaluate the impact of an exercise programme introduced before allo-HSCT on physical activity and fatigue before, during and after in-patient care. A structured exercise programme, including strength and endurance exercises, was implemented at a Swedish university hospital four weeks before transplantation, continuing during in-patient care and after discharge. Between March 2016 and May 2018, 67 adult patients, 33 women and 34 men with a mean age of 55.5 years participated. Fatigue was measured by the Multidimensional Fatigue Inventory at four time points. The patients documented their exercises on a checklist each week during the entire study period. The fatigue trajectory differed between various sub-groups, thus individualized supervision and support to maintain motivation is needed. In conclusion, a structured yet realistic exercise programme before admission is beneficial for allo-HSCT patients in order to reduce fatigue and prepare them for transplantation both physically and mentally.
Highlights
Allogeneic haematopoietic stem cell transplantation is mainly a treatment for haematological malignancies, with the potential to cure the disease
The aim of this study was to evaluate the impact of an exercise programme introduced before allo-HSCT on physical activity and fatigue before, during and after in-patient care
Despite the significantly longer duration of strength exercises performed by the female patients they were more fatigued both at discharge and three months after the HSCT than the male patients, who were already back to baseline at the time of discharge
Summary
Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is mainly a treatment for haematological malignancies, with the potential to cure the disease. The treatment is very demanding with a long period of in-patient care and rehabilitation and associated with numerous side-effects and risks of various complications [1,2]. The majority of patients are immobilized and experience high levels of fatigue due to the side-effects, the long duration of in-patient care and the burden of post-transplant complications [4,6]. CRF affects the majority of cancer patients and is caused by various factors; the cancer itself, the different treatments as well as psychological conditions [7,8]. CRF is common among allo-HSCT patients and has been shown to
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