Abstract

Patients undergoing allogeneic hematopoietic cell transplantation (alloHCT) experience a considerable decline in physical and psycho-social capacity. Since whole body vibration (WBV) is known to efficiently stimulate the neuromuscular system and enhance cardiorespiratory fitness and muscle strength in frail individuals, we hypothesized that WBV would maintain various physical and psychological capacities in patients during alloHCT. Seventy-one patients were randomly allocated to either an intervention group (IG) doing WBV or an active control group (CG) doing mobilization exercises five times per week. We determined peak oxygen consumption (VO2peak) and maximum power, maximum strength, functional performance, body composition, quality of life (QoL), and fatigue. Tests were carried out before conditioning therapy, at hospital discharge and at day ± 180 (follow-up). As 18 patients did not participate in post-intervention assessment and follow-up data from 9 patients was not collectible, per-protocol (PP) analysis of 44 patients is presented. During hospitalization, WBV maintained maximum strength, height, and power output during jumping, as well as reported QoL, physical functioning, and fatigue level compared with mobilization. At follow-up, relative VO2peak (p = 0.035) and maximum power (p = 0.011), time and power performing chair-rising test (p = 0.022; p = 0.009), and reported physical functioning (p = 0.035) significantly increased in the IG, while fatigue decreased (p = 0.005). CG’s body cell mass and phase angle had significantly decreased at follow-up (p = 0.002; p = 0.004). Thus, WBV might maintain maximum strength, functional performance, QoL, and fatigue during alloHCT, while cardiorespiratory fitness might benefit from accelerated recovery afterwards.

Highlights

  • Allogeneic hematopoietic cell transplantation is usually associated with hospitalization lasting at least 4 weeks

  • As 18 patients did not participate in post-intervention assessment and follow-up data from 9 patients was not collectible (Fig. 1), we present a per-protocol (PP) analysis of 44 patients who completed at least two of three measurement sessions

  • Groups did not differ according to patients’ characteristics (Table 1) and training compliance (IG 58.8%, 95% confidence interval (95% CI) 48.9– 66.7; control group (CG) 60.8%, 95% CI 41.2–68; p = 0.962)

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Summary

Introduction

Allogeneic hematopoietic cell transplantation (alloHCT) is usually associated with hospitalization lasting at least 4 weeks. Cunningham et al [24] showed that resistance training can counteract protein degradation initiated by bed rest and medical treatment and may maintain muscle mass during alloHCT. WBV, similar to low-intensity electrical muscle stimulation [32], enables high neuromuscular activity that can improve functional performance as well as cardiorespiratory fitness [33,34,35], may increase muscle strength [36], and is known to prevent muscle-mass loss during bed rest in healthy individuals [4, 37]. Provided patients have no acute infection, restrictive orthopedic disease in the lower body, or untreated cardiovascular illness, no adverse events are likely [40]. We implemented a stratified randomized controlled trial to assess the effects of WBV on patients undergoing alloHCT

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