| Description |
Exercise studies with patients undergoing hematopoietic stem cell transplantation (HSCT) show promising benefits in physical performance and fatigue. However, small sample sizes, lack of randomization, and heterogeneity of settings limit translation of findings into clinical practice. The aims of this randomized control trial were to (a) determine the feasibility and rate of adherence to a supervised exercise intervention during the active phase of HSCT, and (b) examine the intervention impact on functional capacity, fatigue, perceived exertion, muscular strength, cardiovascular endurance and pulmonary status. An additional aim examined the contribution of the Theory of Planned Behavior (TPB), which includes attitudes subjective norms and perceived behavioral control, in explaining exercise behavior. Sixty participants were randomly assigned to either the exercise intervention (resistance and aerobic exercise for 1 hour three times/week) or the attention control group (patient education group for 1 hour three times/week). The average participant was Caucasian, age 55 and a candidate for autologous or allogeneic transplant. Participants were followed from initial stem cell collection through recovery of their white count, typically for 6 weeks. The adherence rate to attendance at the exercise program was 79.63%. There was no attrition. Compared to the attention control, the exercise intervention showed a significant difference on functional performance (p = .041), fatigue (p = .041), cardiovascular and pulmonary status (p = <.001). The overall model of TPB contributed 20.3% of the variance in exercise behavior. While no individual variable was found to predict exercise on its own, perceived behavioral control (p = .09) and intention (p = .19) trended towards significance. This study provides support for the benefits of an exercise program during the active treatment phase of HSCT. Nurses, and other health care professionals, should consider implementing exercise programs to maintain and potentially improve functional outcomes for patients during the active phase of HSCT. While adherence to exercise was only partially explained by TPB, the theory offers insight into factors that might be important to exercise adherence and areas to emphasize in coaching patients about exercise during stem cell transplant. |
