Impact of the initial fitness level on the effects of a structured exercise therapy during pediatric stem cell transplantation

Pediatr Blood Cancer. 2018 Feb;65(2). doi: 10.1002/pbc.26851. Epub 2017 Oct 19.

Abstract

Background: Before and after hematopoietic stem cell transplantation (HSCT), most patients suffer from psychophysical limitations due to the treatment. Exercise interventions demonstrate beneficial effects on, for example, strength, endurance, or health-related quality of life during and after HSCT, but with a great variation among patients concerning the response to exercise. This study examines the influence of the initial fitness on the effects of an exercise therapy in pediatric HSCT.

Procedure: Fifty-three children and adolescents (10.9 ± 3.5 years) scheduled for HSCT were randomized into an exercise intervention group (IG) or a control group (CG). During hospitalization, the IG performed endurance, strength, and flexibility training three times per week. The CG included a nonexercise program. A 6-min walk test was completed before and after the inpatient period. Baseline results (6-min walking distance [6MWD]) were used to split both groups into the following: IGUNFIT , n = 14; IGFIT , n = 12; CGUNFIT , n = 16; CGFIT , n = 11. Differences in outcome changes between groups were analyzed with H-test.

Result: Intergroup comparison revealed significant differences between IGUNFIT and CGUNFIT (P < 0.05). The IGUNFIT increased their 6MWD by +8% (vs. IGFIT , +1%); both CGs presented a decline in 6MWD (CGUNFIT , -14%; CGFIT , -16%). At discharge, the IGFIT achieved 85.5 ± 10.3% of healthy reference values.

Conclusions: The current results indicate that exercise during pediatric HSCT is feasible and contributes to prevention of treatment-related loss of physical function. As seen in healthy persons, patients' benefits might depend on their initial fitness level. As a diminished physical capability may result in higher training effects, impaired especially patients should engage in exercise.

Keywords: 6-min walk test; aerobic capacity; exercise; hematopoietic stem cell transplant; pediatric oncology.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Allografts
  • Child
  • Child, Preschool
  • Exercise Therapy*
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Male
  • Physical Endurance*
  • Quality of Life*