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Multidirectional walking in hematopoietic stem cell transplant patients
Potiaumpai M, Cutrono S, Medina T, Koeppel M, Pereira DL, Pirl WF, Jacobs KA, Eltoukhy M, Signorile JF
Medicine and Science in Sports and Exercise 2021 Feb;53(2):258-266
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: The effect of a peritransplant multidirectional walking intervention to target losses in physical function and quality of life (QOL) has not been investigated. PURPOSE: This study examined the effects of a novel multidirectional walking program on physical function and QOL in adults receiving a hematopoietic stem cell transplant (HSCT). METHODS: Thirty-five adults receiving an autologous or allogeneic HSCT were randomized to a multidirectional walking (WALK) or usual care (CONT) group. The WALK group received supervised training during hospitalization; the CONT group received usual care. Patients were assessed at admission (t0), 3 to 5 d post-HSCT (T1), and 30 d post-HSCT (T2). Physical function measures included the 6-min walk test (6MWT), the Physical Performance Test, and the Timed Up and Go test. Health-related QOL was collected using the Functional Assessment of Cancer Therapy -- Bone Marrow Transplant (FACT-BMT) questionnaire. RESULTS: There were no significant between-group changes for physical function or QOL. However, after the intervention (T1 to T2), the WALK group showed significant improvement in aerobic capacity (6MWT p = 0.01), physical (p < 0.01) and functional well-being (p = 0.04), and overall QOL scores (p < 0.01). The CONT group saw no significant changes in physical function or QOL. Effect sizes showed the WALK group had a larger positive effect on physical function and QOL. Minimal clinically important differences in the 6MWT and FACT-BMT were exceeded in the WALK group. CONCLUSION: A multidirectional walking program during the transplant period may be effective at increasing aerobic capacity and QOL for patients receiving HSCT compared with no structured exercise.

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