The Impact of Exercise On Hematopoietic Stem Cell Transplant Patients

The Impact of Exercise on Hematopoietic Stem Cell Transplant Patients Background: Preliminary research in exercise with patients undergoing hematopoietic stem cell transplantation shows similar positive benefits in physical performance and fatigue to research in cancer and physical activity. Small sample sizes, lack of randomization and heterogeneity of settings limit translation in to clinical practice. Objective: The aims of this study were to 1) test the feasibility ( recruitment, adherence and attrition) of introducing an exercise intervention versus attention control with patients undergoing a hematopoietic stem cell transplant and 2) examine the relationship between the exercise intervention versus the attention control on functional capacity, fatigue, perceived exertion, muscular strength, cardio-pulmonary status A third, exploratory aim was to examine the relationships of attitudes, intention to exercise, subjective norms and perceived behavioral control and exercise behavior. (Based on The Theory of Planned Behavior, Ajzen, 1992) Methods: Sixty participants were randomly assigned to either the exercise intervention or the attention control group. Groups met three times per week for one hour. Participants were followed during the stem cell collection (if applicable), chemotherapy and recovery of their white count, typically for six weeks. Outcomes included functional performance (Functional Performance Inventory), fatigue (Schwartz Cancer Fatigue Scale), cardio-pulmonary status (Six Minute Walk) and muscular strength (grip strength test and step ascent test). Results: Compared to the attention control group, the intervention group showed a statistically significant difference on functional performance (p= .041), fatigue (p=.041), cardiovascular and pulmonary status (p=.001) and one measure of muscular strength (p< .001). Intention to exercise and perceived behavioral control explained 20% and 25% of the variance in exercise behavior (respectively). Conclusions: This pilot study provides support that an exercise program during transplant can improve function, cardiopulmonary status and fatigue. Intention to exercise and a belief that an exercise program is under their control contributes to exercise adherence.