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Research ArticleResearch Reports

Physical Exercise for Patients Undergoing Hematopoietic Stem Cell Transplantation: Systematic Review and Meta-Analyses of Randomized Controlled Trials

Inge E.P.M. van Haren, Hans Timmerman, Carin M. Potting, Nicole M.A. Blijlevens, J. Bart Staal and Maria W.G. Nijhuis-van der Sanden
Demo Journal of Physical Therapy April 2013, 93 (4) 514-528; DOI: https://doi.org/10.demo/ptj.20120181
Inge E.P.M. van Haren
I.E.P.M. van Haren, PT, MSc, Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
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Hans Timmerman
H. Timmerman, PT, MSc, Department of Anesthesiology, Pain, and Palliative Medicine, Radboud University Nijmegen Medical Centre.
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Carin M. Potting
C.M. Potting, RN, PhD, Department of Hematology and Research Institute for Oncology (RUCO), Radboud University Nijmegen Medical Centre.
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Nicole M.A. Blijlevens
N.M.A. Blijlevens, MD, PhD, Department of Hematology and Research Institute for Oncology (RUCO), Radboud University Nijmegen Medical Centre.
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J. Bart Staal
J.B. Staal, PT, PhD, Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Nijmegen Medical Centre.
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Maria W.G. Nijhuis-van der Sanden
M.W.G. Nijhuis-van der Sanden, PT, PhD, Department of Rehabilitation and Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Nijmegen Medical Centre.
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Abstract

Background The treatment-related burden for patients undergoing hematopoietic stem cell transplantation (HSCT) may be relieved by physical exercises.

Purpose The purpose of this study was to summarize and analyze the evidence provided by randomized controlled trials (RCTs) on physical exercise interventions among patients with cancer undergoing HSCT.

Data Sources PubMed, CINAHL, EMBASE, the Cochrane Library, and PEDro were searched for relevant RCTs up to October 1, 2011.

Study Selection Two reviewers screened articles on inclusion criteria and indentified relevant RCTs.

Data Extraction Two authors assessed the selected articles for risk of bias. Data extraction was performed by 1 reviewer. Meta-analyses were undertaken to estimate the outcomes quality of life (QOL), psychological well-being and distress, and fatigue.

Data Synthesis Eleven studies were included, with study populations consisting of recipients undergoing either an allogeneic or autologous HSCT (n=734). Four studies had low risk of bias. The exercise interventions were performed before, during, and after hospitalization for the HSCT. Different exercise programs on endurance, resistance and/or activities of daily living training, progressive relaxation, and stretching were used. Meta-analyses showed that exercise during hospitalization led to a higher QOL (weighted mean difference=8.72, 95% confidence interval=3.13, 14.31) and less fatigue (standardized mean difference=0.53, 95% confidence interval=0.16, 0.91) in patients with an allogeneic HSCT at the moment of discharge from the hospital. No marked effects were found for psychological well-being and distress. Individual study results suggested significant positive effects on QOL, fatigue, psychological well-being and distress, and physical functioning.

Limitations Prevalent shortcomings in the included studies were the heterogeneity among studies and the lack of blinding of participants, personnel, and outcome assessment.

Conclusions The results suggest that recipients of HSCT may benefit from physical exercise.

Footnotes

  • All authors provided concept/idea/research design. Ms van Haren, Mr Timmerman, Dr Blijlevens, Dr Staal, and Dr Nijhuis-van der Sanden provided writing. Ms van Haren, Mr Timmerman, Dr Staal, and Dr Nijhuis-van der Sanden provided data collection and analysis. Ms van Haren, Mr Timmerman, and Dr Nijhuis-van der Sanden provided project management. Dr Blijlevens provided fund procurement. Dr Nijhuis-van der Sanden provided facilities/equipment. Dr Potting and Dr Blijlevens provided consultation (including review of manuscript before submission).

  • Received April 20, 2012.
  • Accepted December 4, 2012.
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Demo Journal of Physical Therapy: 93 (4)
Demo Journal of Physical Therapy
Vol. 93, Issue 4
1 Apr 2013
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Physical Exercise for Patients Undergoing Hematopoietic Stem Cell Transplantation: Systematic Review and Meta-Analyses of Randomized Controlled Trials
Inge E.P.M. van Haren, Hans Timmerman, Carin M. Potting, Nicole M.A. Blijlevens, J. Bart Staal, Maria W.G. Nijhuis-van der Sanden
Demo Journal of Physical Therapy Apr 2013, 93 (4) 514-528; DOI: 10.demo/ptj.20120181

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Physical Exercise for Patients Undergoing Hematopoietic Stem Cell Transplantation: Systematic Review and Meta-Analyses of Randomized Controlled Trials
Inge E.P.M. van Haren, Hans Timmerman, Carin M. Potting, Nicole M.A. Blijlevens, J. Bart Staal, Maria W.G. Nijhuis-van der Sanden
Demo Journal of Physical Therapy Apr 2013, 93 (4) 514-528; DOI: 10.demo/ptj.20120181
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