The Effects of an Enhanced Exercise Program for Hematological Malignancy-Related Fatigue and Physical Function During Hospitalization Post-Stem Cell Transplant

Purpose/Hypothesis: Fatigue is a side effect in >90% of patients undergoing stem cell transplant (SCT), along with decreased physical function and quality of life (QOL). Exercise is feasible and safe during SCT but there is a lack of information examining impact on function and QOL. Patient-reported outcomes (PROs) quantify the effect of exercise impact. This randomized controlled trial aims to improve understanding of how PROs and physical function outcome measures change during hospitalization for SCT. Materials and Methods: Patients were randomized to Standard PT Protocol (SPT) control group or Experimental PT Protocol (EPT). Outcome measures were collected at inpatient admission, once a week, and hospital discharge. Data were analyzed using two- and one-way analysis of variance models with randomization factors for primary and secondary outcomes. Results: A statistical significance is observed for the following outcomes based on transplant type: 30” sit to stand ( P < .01), Right SLS EPT ( P = .052), and bilateral grip strength ( P < .01). A significant difference of the means for Left SLS between EPT versus SPT ( P = .03) and based on transplant type ( P = .05) is observed. No statistical significance is observed for PROMIS fatigue ( P = .64) or bilateral tandem stance based on transplant type ( P -value L = 0.43, R = 0.90). Conclusions: Participation in an enhanced exercise program demonstrated positive outcomes for patients with hematological malignancies following SCT. Primarily, there was less decline in strength and balance, and a reduced length of hospital stay. Standardizing the process of care and gathering PROs guides clinical decision-making and supports patient engagement in the treatment process.