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Effects of a structured exercise therapy on health-related quality of life in pediatric stem cell transplantation
 
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1
School for Health Science, University of Cooperative Education, Darmstadt, Germany
 
2
Medical School, Fresenius University of Applied Sciences, Frankfurt, Germany
 
3
Department of Pediatrics, University Cancer Center, Frankfurt, Germany
 
 
Submission date: 2023-08-21
 
 
Acceptance date: 2023-11-07
 
 
Publication date: 2024-09-09
 
 
Corresponding author
Michael Wilhelm Jung   

School for Health Science, University of Cooperative Education, Poststr. 4-6, D-64293 Darmstadt, Germany
 
 
Physiother Quart. 2024;32(3):29-39
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
This randomized controlled trial investigated the effects of exercise therapy on cancer-related fatigue (CRF) and its association with health-related quality of life. The effect of exercise therapy on the quality of life of children after stem cell transplantation has not been extensively studied to date.

Methods:
Seventy-two children and adolescents after stem cell transplantation were randomly assigned to either an exercise therapy intervention group (IG) or a control group (CG). The children in IG received sports therapy, while the children in the CG engaged in concentration tasks, memory games, and quizzes.

Results:
Significant improvements in CRF were found in IG only after discharge from the hospital. The improved CRF correlated significantly with increased health-related quality of life. However, during the inpatient phase, there was a rapid increase in CRF initially, which was accompanied by a significant reduction in health-related quality of life.

Conclusions:
Exercise therapy can help reduce CRF and, therefore, increase health-related quality of life after the inpatient phase.

 
REFERENCES (30)
1.
Miano M, Labopin M, Hartmann O, Angelucci E, Cornish J, Gluckman E, Locatelli F, Fischer A, Egeler RM, Or R, Peters C, Ortega J, Veys P, Bordigoni P, Iori AP, Niethammer D, Rocha V, Dini G; Paediatric Diseases Working Party of the European Group for Blood and Marrow Transplantation. Haematopoietic stem cell transplantation trends in children over the last three decades: a survey by the paediatric diseases working party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant. 2007;39(2):89–99; doi: 10.1038/sj.bmt.1705550.
 
2.
Remberger M, Ackefors M, Berglund S, Blennow O, Dahllöf G, Dlugosz A, Garming-Legert K, Gertow J, Gustafsson B, Hassan M, Hassan Z, Hauzenberger D, Hägglund H, Karlsson H, Klingspor L, Kumlien G, Le Blanc K, Ljungman P, Machaczka M, Malmberg K-J, Marschall H-U, Mattsson J, Olsson R, Omazic B, Sairafi D, Schaffer M, Svahn B-M, Svenberg Pr, Swartling L, Szakos A, Uhlin M, Uzunel M, Watz E, Wernerson A, Wikman A, Wikström A-C, Winiarski J, Ringdén O. Improved survival after allogeneic hematopoietic stem cell transplantation in recent years. A single-center study. Biol Blood Marrow Transplant. 2011;17(11):1688–97; doi: 10.1016/j.bbmt.2011.05.001.
 
3.
Baker KS, Bresters D, Sande JE. The burden of cure: long-term side effects following hematopoietic stem cell transplantation (HSCT) in children. Pediatr Clin In Am. 2010;57(1):323–42; doi: 10.1016/j.pcl.2009.11.008.
 
4.
Mohty B, Mohty M. Long-term complications and side effects after allogeneic hematopoietic stem cell transplantation: an update. Blood Cancer J. 2011;1(4):e16; doi: 10.1038/bcj.2011.14.
 
5.
Ruble K, Krupski C, Chen A, Dandoy CE. Quality and safety in hematopoietic stem cell transplant patients. In: Dandoy C, Hilden J, Billett A, Mueller B (eds.) Patient Safety and Quality in Pediatric Hematology/Oncology and Stem Cell Transplantation. Cham: Springer; 2017, pp. 297–324.
 
6.
Packman W, Weber S, Wallace J, Bugescu N. Psychological effects of hematopoietic SCT on pediatric patients, siblings and parents: a review. Bone Marrow Transplant. 2010;45(7):1134–46; doi: 10.1038/bmt.2010.74.
 
7.
Tremolada M, Bonichini S, Pillon M, Messina C, Carli M. Quality of life and psychosocial sequelae in children undergoing hematopoietic stem-cell transplantation: a review. Pediatr Transplant. 2009;13(8):955–70; doi: 10.1111/j.1399-3046.2009.01203.x.
 
8.
Felder-Puig R, Di Gallo A, Waldenmair M, Norden P, Winter A, Gadner H, Topf R. Health-related quality of life of pediatric patients receiving allogeneic stem cell or bone marrow transplantation: results of a longitudinal, multi-center study. Bone Marrow Transpl. 2006;38(2):119–26; doi: 10.1038/sj.bmt.1705417.
 
9.
Ness KK, Hudson M, Ginsberg J, Nagarajan R, Kaste SC, Marina N, Whitton J, Robison LL, Gurney JG. Physical performance limitations in the childhood cancer survivor study cohort. J Clin Oncol. 2009; 27:2382–9; doi: 10.1200/JCO.2008.21.1482.
 
10.
Tanzi EM. Health-related quality of life of hematopoietic stem cell transplant childhood survivors: state of the science. J Pediatr Oncol Nurs. 2011;28(4):191–202; doi: 10.1177/1043454211408100.
 
11.
Morishita S, Tsubaki A, Hotta K, Fu JB, Fuji S. The benefit of exercise in patients who undergo allogeneic hematopoietic stem cell transplantation. J Int Soc Phys Rehabil Med. 2019;2(1):54–61; doi: 10.4103/jisprm.jisprm_2_19.
 
12.
Hacker ED, Collins E, Park C, Peters T, Patel P, Rondelli D. Strength training to enhance early recovery after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2017;23(4):659–69; doi: 10.1016/j.bbmt.2016.12.637.
 
13.
Wiskemann J, Dreger P, Schwerdtfeger R, Bondong A, Huber G, Kleindienst N, Ulrich CM, Bohus M. Effects of a partly self-administered exercise program before, during, and after allogeneic stem cell transplantation. Blood. 2011;117:2604–13; doi: 10.1182/blood-2010-09-306308.
 
14.
Kisch A, Jakobsson S, Forsberg A. Implementing a feasible exercise programme in an allogeneic haematopoietic stem cell transplantation setting-impact on physical activity and fatigue. Int J Environ Res Public Health. 2020;17(12):4302; doi: 10.3390/ijerph17124302.
 
15.
Liang Y, Zhou M, Wang F, Wu Z. Exercise for physical fitness, fatigue and quality of life of patients undergoing hematopoietic stem cell transplantation: a meta-analysis of randomized controlled trials. Jpn J Clin Oncol. 2018;48(12):1046–57; doi: 10.1093/jjco/hyy144.
 
16.
Oberoi S, Robinson PD, Cataudella D, Culos-Reed SN, Davis H, Duong N, Gibson F, Götte M, Hinds P, Nijhof SL, Tomlinson D, van der Torre P, Cabral S, Dupuis LL, Sung L. Physical activity reduces fatigue in patients with cancer and hematopoietic stem cell transplant recipients: a systematic review and meta-analysis of randomized trials. Crit Rev Oncol Hematol. 2018;122:52–9; doi: 10.1016/j.critrevonc.2017.12.011.
 
17.
Lago AS, Zaffarani C, Mendonça JF, Moran CA, Costa D, Gomes ELFD. Effects of physical exercise for children and adolescents undergoing hematopoietic stem cell transplantation: a systematic review and meta-analysis. Hematol Transfus Cell Ther. 2021;43(3):313–23; doi: 10.1016/j.htct.2020.07.013.
 
18.
Martha BA, Vacchi CO, Fattori RA, Macagnan FE. Effect of physical exercise on the functional capacity of children and adolescents submitted to transplantation of hematopoietic stem cells – a systematic review with meta-analysis. J Child Health Care. 2021;25(1):18–30; doi: 10.1177/1367493520903626.
 
19.
Rosenhagen A, Bernhoerster M, Vogt L, Weiss B, Senn A, Arndt S, K Siegler, M Jung, P Bader,. Implementation of structured physical activity in the pediatric stem cell transplantation. Klin Padiatr. 2011;223(3):147–51; doi: 10.1055/s-0031-1271782.
 
20.
Jung M, Wallek S, Senn-Malashonak A, Schubert P, Siegler K, Rosenhagen A, Banzer W, Bader P. Effects of a structured exercise therapy on cancer-related fatigue during and after paediatric stem cell transplantation: a randomized controlled trial. Physiother Quart. 2021;29(3):76–85; doi: 10.5114/pq.2021.107847.
 
21.
Weiß B. Quality of Life and Tumor-Related Fatigue in Relation to Physical Activity in Pediatric Supportive Care. Darmstadt: TU Darmstadt; 2009.
 
22.
Varni JW, Seid M, Kurtin PS. PedsQL 4.0: reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations. Medical Care. 2001;39(8):800–82; doi: 10.1097/00005650-200108000-00006.
 
23.
Kumle L, Võ MH, Draschkow D. Estimating power in (generalized) linear mixed models: an open introduction and tutorial. R Behav Res. 2021;53:2528–25; doi: 10.3758/s13428-021-01546-0.
 
24.
Brysbaert M, Stevens M. Power analysis and effect size in mixed effects models: a tutorial. J Cogn. 2018;1(1):9:1–20; doi: 10.5334/joc.10.
 
25.
Mustian KM, Alfano CM, Heckler C, Kleckner AS, Kleckner IR, Leach CR, Mohr D, Palesh OG, Peppone LJ, Piper BF, Scarpato J, Smith T, Sprod LK, Miller SM. Comparison of pharmaceutical, psychological, and exercise treatments for cancer-related fatigue: a meta-analysis. JAMA Oncol. 2017;3(7):961–8.
 
26.
Repka CP, Hayward R. Effects of an exercise intervention on cancer-related fatigue and its relationship to markers of oxidative stress. Integr Cancer Ther. 2018;17(2):503–10.
 
27.
Chamorro-Viña C, Valentín J, Fernández L, González-Vicent M, Pérez-Ruiz M, Lucía A, Culos-Reed SN, Díaz MA, Pérez-Martínez A. Influence of a moderate-intensity exercise program on early NK cell immune recovery in pediatric patients after reduced-intensity hematopoietic stem cell transplantation. Integr Cancer Ther. 2017;16(4):464–72; doi: 10.1177/1534735416679515.
 
28.
Gaser D, Peters C, Oberhoffer-Fritz R, Götte M, Feuchtinger T, Schmid I, Haller B, von Luettichau I, Kesting S. Effects of strength exercise interventions on activities of daily living, motor performance, and physical activity in children and adolescents with leukemia or non-Hodgkin lymphoma: results from the randomized controlled activeADL study. Front Pediatr. 2022;10:982996; doi: 10.3389/fped.2022.982996.
 
29.
Beller R, Bennstein SB, Götte M. Effects of exercise interventions on immune function in children and adolescents with cancer and HSCT recipients – a systematic review. Front. Immunol. 2021;12:746171; doi: 10.3389/fimmu.2021.746171.
 
30.
Adiguzel H, Ergun N, Elbasan B. Anxiety levels and health-related quality of life in parents of children with different types of physical disabilities. Physiother Quart. 2022;30(1):7–13; doi: 10.5114/pq.2020.102158.
 
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