Physical Performance Following Hematopoietic Stem Cell Transplantation: A Prospective Observational Study

Abstract

Background and Purpose/Objective: Patients undergoing hematopoietic stem cell transplantation (HSCT) are at risk for strength impairments and activity limitations. Research describing how HSCT affects physical performance is limited. The purposes of this study were to report the short-term (≤30 days) effects of HSCT on physical performance and to compare changes among patients during the engraftment and recovery periods following HSCT. Methods: Design: Prospective observational study. Setting: Academic medical center. Patients: Twenty-five adults 21 years and older undergoing HSCT. Intervention: None. Measurements: Measures were collected at 3 time points: (1) day of transplant; (2) 8 to 14 days posttransplant; and (3) 15 to 30 days posttransplant. Beside demographic data, the authors collected Short Physical Performance Battery (SPPB) scores, Functional Comorbidity Index scores, resting heart rate, and hospitalization status. Longitudinal changes in SPPB scores were analyzed with a generalized linear model (α = 0.05). Results: SPPB scores were negatively associated with patients' body mass index values and resting heart rate measurements. Additionally, the hospitalization × time interaction was statistically significant. SPPB scores among nonhospitalized patients remained consistent across the testing periods but among hospitalized patients decreased from the day of transplant to both the 8 to 14 days (mean change = 4.0 points) and 15 to 30 days (mean change = 4.1 points) posttransplant time points. Conclusion: Physical performance scores decreased in the first 30 days of recovery among patients who were hospitalized following HSCT, but not among patients who received transplant on an outpatient basis. Future studies to examine causes of and interventions for the reduction in physical performance among hospitalized patients post-HSCT are warranted.