Fatigue and Physical Activity in Patients Undergoing Hematopoietic Stem Cell Transplant

Hacker, Eileen Danaher; Ferrans, Carol Estwing; Verlen, Ellen; Ravandi, Farhad; Besien, Koen van; Gelms, Julie; Dieterle, Natalie

doi:10.1188/06.onf.614-624

Cited by 129 publications

(122 citation statements)

References 38 publications

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“…Our result is consistent with findings from other studies that measure sleep disturbances at least one time during inpatient treatment. [6][7][8][9] In line with our outcome, Hacker and Ferrans 8 showed that sleep difficulties are significantly worse during hospital stay compared with time points before admission and two weeks after discharge. At six weeks after discharge sleep problems were a little less pronounced than before admission.…”

Section: Discussionsupporting

confidence: 70%

“…In sum, the results of these studies show that disturbed sleep is one of the most prominent concerns among patients; sleep difficulties occur frequently and are worst during the inpatient treatment. [6][7][8][9][10][11] Anderson et al 6 assessed the symptom burden in 100 patients undergoing autologous SCT during their hospital stay. They identified sleep disturbance as one of the most pronounced symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Sleep disturbances and emotional distress in the acute course of hematopoietic stem cell transplantation

Rischer

Scherwath

Zander

et al. 2009

Bone Marrow Transplant

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Recent research has shown that patients undergoing hematopoietic SCT (HSCT) experience multiple symptoms that can affect the sleep quality adversely. This study investigated the sleep quality of patient in the acute course of HSCT, and measured the impact of sociodemographic, medical, physical and psychological factors. Fifty patients were assessed before admission, 44 participated during inpatient treatment and 32 on day 100 ( ± 20) posttransplantation. Measuring instruments included the Pittsburgh Sleep Quality Index (PSQI) and a sleep diary (sleep quality), the European Organization for Research and Treatment of Cancer Quality of Life QuestionnaireCore 30 (health-related quality of life), the Hospital Anxiety and Depression Scale -German version (anxiety/depression) and the German version of the Cancer and Treatment Distress Scale (treatment-specific distress). The prevalence of sleep disturbances was 32% before admission, 77% during the hospital stay and 28% after discharge. Difficulty in maintaining sleep was the most intense sleep problem during the inpatient phase. This was mainly caused by disturbing noises and need to use the bathroom frequently. Sleep problems were significantly worse during the hospital stay compared with the other measurement points in time (Po0.001). A significant interaction was seen between the time course of sleep disturbances and the type of transplantation (P ¼ 0.001). The findings suggest that sleep disturbances after HSCT are particularly associated with physical functioning, fatigue and treatment-specific distress, and factors that contribute to sleep difficulties in the general population seem to be less important.

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Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Sleep disturbances and emotional distress in the acute course of hematopoietic stem cell transplantation

Rischer

Scherwath

Zander

et al. 2009

Bone Marrow Transplant

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show abstract

“…This therapy, which was used in the last two decades for high-risk acute lymphoblastic leukemia (ALL) (typically at 18 Gy dose), is strongly associated with physical inactivity during adulthood. 9 Boys and girls (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) years) who are long-term ALL survivors (41.5 years posttreatment) have significantly reduced cardiorespiratory fitness, and this reduction is correlated with cumulative chemotherapy dose. 7 Likewise, higher chemotherapy dose is associated with lower cardiac function.…”

Section: Introductionmentioning

confidence: 99%

Exercise in adult and pediatric hematological cancer survivors: an intervention review

et al. 2010

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Observational research has shown that the physical activity levels of survivors of hematological cancer are low, with deleterious health consequences. This review summarizes the research on exercise interventions in adult and pediatric hematological cancer survivors. We searched MEDLINE, SPORTDiscus, CINAHL, Embase, Cochrane and PEDro through September 2009 for exercise intervention studies in children and adults with any type of hematological cancer. In the 24 adult intervention studies reviewed, we found strong evidence (that is, X3 high-quality studies and X75% reporting a significant benefit) for a benefit on body composition. Weak, but promising, evidence (X3 high-quality studies, but o75% reporting a significant benefit) was found for cardiorespiratory fitness, fatigue, muscle strength, physical functioning and quality of life. In pediatric interventions (13 studies), we found strong evidence for a benefit on muscle strength and cardiorespiratory fitness, particularly, if training was conducted in the hospital setting. Evidence is weak for ankle dorsiflexion, physical functioning and body composition. No exerciserelated risks were identified in adults or children studies. Though more randomized controlled trials are needed, a growing body of literature supports the notion that regular physical activity is safe and has potential benefits for both adult and pediatric hematological cancer survivors.

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“…4,6,11,17,18 In the mean time, greater efforts should be made to establish reference values for these functional tests predicated on specific cancer diagnoses. 6,18 The emerging picture of the functional capacity of SCT recipients is one of significant decline during and immediately after transplantation 2,19,20 followed by limited or no improvement of functional capacity during the sub-acute phase of recovery. [19][20][21] Results from this study provide further support of this clinical picture.…”

Section: Groupmentioning

confidence: 99%

“…However, available data suggest that pre-transplantation chemotherapy and the transplant process leave many of these patients with substantial physical and functional deficits. [1][2][3] As such, physical rehabilitation of these patients becomes an important post-transplant therapeutic intervention which is often directed by rehabilitation specialists, including occupational and physical therapists. 4,5 Central to the success of this rehabilitation process is an understanding of the initial physical and functional status of the patient and an ability to monitor changes in patient status over the course of rehabilitation treatment.…”

Section: Introductionmentioning

confidence: 99%

Functional performance status of hematopoietic SCT recipients in the sub-acute phase of recovery

Morris

Brueilly

Scheetz

et al. 2009

Bone Marrow Transplant

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This study assessed the functional capacity of sub-acute SCT recipients using validated physical performance tests, including 6-min walk distance, repeated sit-to-stand time and 50-ft walk time, and compared these outcomes with those reported for a heterogeneous oncology population. The medical records of 80 consecutive sub-acute SCT recipients not receiving corticosteroids were retrospectively reviewed for demographic, medical and anthropometric information, and outcomes for these physical performance tests administered at the time of initial physiotherapy evaluation. Measures of central tendency, 95% confidence intervals, unpaired t-tests and correlation coefficients were calculated using a SPSS statistical package. SCT recipients completed the 50-ft walk in 10.66 ± 4.43 s, repeated sit-to-stand trial in 4.16 ± 1.82 s and walked 400.2 m in 6 min. For the timed tests, SCT recipients were approximately twice as fast as a heterogeneous group of oncology patients and walked approximately 50% further in 6 min. No overlap in the 95% confidence intervals for the two groups was observed for any of the tests. These results (1) suggest that reference values describing the functional capacity of a heterogeneous oncology population underestimate the functional capacity of SCT recipients and (2) provide clinically useful reference values for assessing functional capacity of sub-acute SCT recipients referred for physiotherapy.

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Fatigue and Physical Activity in Patients Undergoing Hematopoietic Stem Cell Transplant

Abstract: Patients undergoing HSCT require considerable supportive nursing care immediately following transplant. Clinicians and researchers need to strive for effective symptom management to improve the likelihood of successful outcomes.

Cited by 129 publications

References 38 publications

Sleep disturbances and emotional distress in the acute course of hematopoietic stem cell transplantation

Sleep disturbances and emotional distress in the acute course of hematopoietic stem cell transplantation

Exercise in adult and pediatric hematological cancer survivors: an intervention review

Functional performance status of hematopoietic SCT recipients in the sub-acute phase of recovery

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