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Bayram S, Barğı G, Çelik Z, Boşnak Güçlü M. Effects of pulmonary rehabilitation in hematopoietic stem cell transplantation recipients: a randomized controlled study. Support Care Cancer 2023; 32:72. [PMID: 38158450 DOI: 10.1007/s00520-023-08236-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 12/03/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE During hematopoietic stem cell transplantation (HSCT), patients' exercise capacity and quality of life (QOL) are impaired. Exercise training is recommended to preserve cardiorespiratory fitness during the compelling HSCT period. However, studies investigating the effects of pulmonary rehabilitation (PR) in HSCT recipients are limited. Therefore, this study aimed to investigate the effects of two different PR programs on maximal exercise capacity, respiratory muscle strength and endurance, pulmonary function, and QOL. METHODS This is a prospective, randomized, controlled, triple-blinded study. Thirty hospitalized patients undergoing HSCT were randomized to the pulmonary rehabilitation plus inspiratory muscle training (PR + IMT) group and the PR group. PR group performed upper extremity aerobic exercise training (AET) and progressive resistance exercise training (PRET), PR + IMT group performed IMT in addition to the upper extremity AET and PRET. Maximal exercise capacity (cardiopulmonary exercise testing), respiratory muscle strength (mouth pressure device, (MIP and MEP)) and respiratory muscle endurance (threshold loading test), pulmonary function (spirometry), and QOL (European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) were evaluated before HSCT and after discharge. RESULTS Changes in pulmonary function, respiratory muscle strength and endurance, and QOL were similar within groups (p > 0.05). The MEP, peak oxygen consumption, and oxygen pulse significantly decreased in both groups (p < 0.05). CONCLUSION Pulmonary function, inspiratory muscle strength and endurance, and QOL preserved after HSCT. Expiratory muscle strength and maximal exercise capacity decreased even though PR during HSCT. Breathing reserve and restriction improved in the PR + IMT group. In addition, minute ventilation and dyspnea were preserved in the PR + IMT group, while these values were worsened during two structured PR programs. Therefore, PR should be applied in accordance with the patient's current clinical and hematologic status to patients undergoing HSCT. CLINICALTRIALS gov (19/07/2018, NCT03625063).
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Affiliation(s)
- Selin Bayram
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Gazi University, 06490, Emek, Ankara, Turkey.
| | - Gülşah Barğı
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Izmir Democracy University, Izmir, Turkey
| | - Zeliha Çelik
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Gazi University, 06490, Emek, Ankara, Turkey
| | - Meral Boşnak Güçlü
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Gazi University, 06490, Emek, Ankara, Turkey
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Wheatley T, Desrosiers M, Specchierla D, Lynn EK, Jackson S. Increased Mobility and Fall Reduction: An Interdisciplinary Approach on a Hematology-Oncology and Stem Cell Transplantation Unit. Clin J Oncol Nurs 2021; 25:329-332. [PMID: 34019032 DOI: 10.1188/21.cjon.329-332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patients in the hematology-oncology and stem cell transplantation (SCT) setting are at high risk for functional decline and falls related to prolonged hospitalizations and inactivity during inpatient treatment. After underperforming on the Press Ganey National Database of Nursing Quality Indicators benchmark for falls in 2018, staff on a hematology-oncology and SCT unit implemented a practical and evidence-based fall prevention program. Fall rates from 2018 to 2019 ranged from 3.4 to 4.8 falls per 1,000 patient days. After the introduction of the unit-based gym program, early mobility increased and falls decreased to 2.57 per 1,000 patient days.
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Mohammed J, Aljurf M, Althumayri A, Almansour M, Alghamdi A, Hamidieh AA, ElHaddad A, Othman TB, Bazarbachi A, Almohareb F, Alzahrani M, Alkindi SS, Alsharif F, Da'na W, Alhashmi H, Bekadja MA, Al-Shammari SH, El Quessar A, Satti TM, Aljohani N, Rasheed W, Ghavamzadeh A, Chaudhri N, Hashmi SK. Physical therapy pathway and protocol for patients undergoing hematopoietic stem cell transplantation: Recommendations from The Eastern Mediterranean Blood and Marrow Transplantation (EMBMT) Group. Hematol Oncol Stem Cell Ther 2019; 12:127-132. [PMID: 30653940 DOI: 10.1016/j.hemonc.2018.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 12/14/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Patients undergoing hematopoietic stem cell transplantation (HSCT) are often referred for physical therapy (PT) to help improve their quality of life. However, to our knowledge there is no clear PT pathway to guide therapists and patients before, during, and after HSCT. METHODS A comprehensive literature review was carried out exploring the role and benefits of PT in HSCT patients. The current evidence was comlimented with recommendations and opinions from the experts in the field, which included PT's and hematology consultants from PTAGVHD and the EMBMT group. RESULT A clear pathway and protocol as a working guide for rehabilitation professionals working with the HSCT patient's was developed. CONCLUSION This paper not only reviews the current evidence on safe PT practice but also puts forward a protocol and pathway for HSCT rehabilitation, highlights the importance of individualized exercise intervention for HSCT patients, and outlines safe practice guidelines for the physical therapists working in this field.
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Affiliation(s)
- Jaleel Mohammed
- Department of Physical Therapy and Rehabilitation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Rehabilitation department, Physical Therapy Association for Graft Versus Host Disease, Swindon, UK.
| | - Mahmoud Aljurf
- Department of Physical Therapy and Rehabilitation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Rehabilitation department, Physical Therapy Association for Graft Versus Host Disease, Swindon, UK
| | - Abdulaziz Althumayri
- Department of Physical Therapy and Rehabilitation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Muntaha Almansour
- Department of Physical Therapy and Rehabilitation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ahmed Alghamdi
- Department of Physical Therapy and Rehabilitation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Amir Ali Hamidieh
- Stem Cell Transplantation, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - Alaa ElHaddad
- Oncology, National Cancer Institute, Cairo University, Giza, Egypt
| | - Tarek Ben Othman
- Hematology, Centre National De Greffe De La Moelle Osseuse, Tunis, Tunisia
| | - Ali Bazarbachi
- Hematology/Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fahad Almohareb
- Department of Physical Therapy and Rehabilitation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohsen Alzahrani
- Hepatology & Hematology, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Salam S Alkindi
- Hematology, Sultan Qaboos University Hospital, Al-Khoud, Oman
| | - Fahad Alsharif
- Department of Physical Therapy and Rehabilitation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Waleed Da'na
- Implantalogy/Hematology, King Hussein Cancer Center, Amman, Jordan
| | - Hani Alhashmi
- Adult Hematology and Stem Cell Transplantation, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Mohamed A Bekadja
- Department of Hematology and Cell Therapy, University Hospital EHU 1er November, Oran, Algeria
| | | | - Asma El Quessar
- Hematology and Oncology Pediatric Department, University Hospital Ibn Rochd, Casablanca, Morocco
| | - Tariq M Satti
- Bone Marrow Transplant, Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan
| | - Naif Aljohani
- Adult Bone Marrow Transplant, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Walid Rasheed
- Department of Physical Therapy and Rehabilitation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ardeshir Ghavamzadeh
- Stem Cell Transplantation, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
| | - Naeem Chaudhri
- Department of Physical Therapy and Rehabilitation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Shahrukh K Hashmi
- Rehabilitation department, Physical Therapy Association for Graft Versus Host Disease, Swindon, UK; Hematology/Oncology, Mayo Clinic, Rochester, MN, USA
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