The Effect of Exercise Compliance in Patients Undergoing Hematopoietic Stem Cell Transplantation On Their Functional Capacity During Their Hospitalization

Purpose/Hypothesis: To examine the impact of an in-patient exercise program of participants undergoing hematopoietic stem cell transplant (HSCT) on functional capacity, and to compare the relationship between exercise compliance and incidence of exercise-related adverse events.  The goals are 1) to examine the feasibility of tracking outcomes of an exercise program in patients undergoing HSCT on their functional capacity, and 2) to examine the association between exercise compliance and exercise-related effects in patients with severe pancytopenia within this patient cohort.

Materials/Methods: 30 adult participants were recruited during their inpatient hospital stay.  Participants completed the short form Physical Activity Questionnaire (PAQ), 6-minute walk test and 5-times-repeated-sit-to-stand test at time of transplant and 12-14 days post-transplant. Participants instructed in a multimodal intervention to include aerobic (walking or stationary bike), resistance (resistance bands), and active range of motion exercises. Exercise compliance was measured by the patient’s exercise log. Incidence of hemorrhagic events and platelet levels were collected. This research consisted of a one group pre-test/post-test study design with consecutive sampling over an estimated nine month span (recruitment to be finished by October 2012). Descriptive statistics will be used to describe functional capacity trends from pre and post-test measurements, to examine patient’s functional capacity from start and end of study. This study will be utilizing a post hoc analysis to further investigate compliance and differences on functional capacity measures by subgroups. Will also determine the relationship of the incidence of exercise-related pancytopenia events over 14 days and percent exercise compliance rate, controlling for confounding factors.

Results: We anticipate that participants performing the prescribed exercise program will have improved functional capacity.  We expect no difference with higher exercise compliant participants in incidence of hemorrhagic events as compared to participants with lower exercise compliance during pancytopenic phase after transplant.

Conclusions: By undertaking this study we will find out whether there is preliminary support for the effectiveness of the currently used in-hospital exercise program for people who are undergoing HSCT with various levels of pancytopenia. We will also determine whether higher compliance with an exercise program is associated with better functional outcomes.

Clinical Relevance: Since there are few studies supporting patient exercising or performing functional activities with acute pancytopenia, we hope to lay some groundwork in this area for further research into this and other similar patient populations.

KEYWORDS: pancytopenia, exercise compliance, hematopoietic stem cell transplant.