Translational Value of Exercise in Routine Care Following Hematopoietic Stem Cell Transplantation: A Retrospective Analysis

Abstract

Purpose: Exercise is an effective adjuvant therapy to address many of the symptoms experienced by Hematopoietic Stem Cell Transplant (HSCT) recipients. However, there is little translational research examining meaningful clinical effects. A retrospective analysis of a community-embedded exercise program based at a large urban comprehensive cancer hospital was conducted, with the aim of establishing the translational value of exercise in a clinical setting. A secondary aim was to determine the impact of baseline function on exercise response. Methods: The Living Well Program is an evidence-based program supervised by Accredited Exercise Physiologists, delivered through the Chris O’Brien Lifehouse. HSCT recipients are prescribed individualised, once-weekly 1-hour aerobic, resistance and balance training. Changes in physical function (6-minute walk distance, strength, and balance), fatigue, and quality of life measures from baseline to post-intervention were analysed, and also assessed in relation to session attendance. Participants were then stratified as low- or high-function for each measure of physical function. Results: Data from 48 participants (male n=27, age=54.3±11.7-years) was included in the analysis. Significant improvements were found for all outcome measures, with improvements exceeding minimal clinically important differences for 6-minute walk distance (6MWD) and 30-second sit-to-stand. Greater session attendance correlated with improvements in 6MWD and strength outcomes. Exercise response was greater among those with lower baseline scores for 6MWD only (p<0.001).Conclusions: An existing exercise program embedded in cancer care was successful in eliciting improvements that are both significant and clinically relevant. Further investigations into key factors that influence the efficacy of these programs are required.