Department of Rehabilitation Services, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Support Care Cancer. 2012 Oct;20(10):2391-8. doi: 10.1007/s00520-011-1352-0. Epub 2011 Dec 28.
The high acuity of hematopoietic stem cell transplant (HSCT) recipients receiving glucocorticoid (GC) therapy for acute graft vs. host disease (aGVHD) may limit their adherence to an exercise-based rehabilitation program and hence, slow their recovery. To make this determination, the medical records of 59 subacute outpatient stem cell transplant recipients receiving methylprednisolone (MP) were reviewed for demographic, anthropometric and medical information. Performance on the repeated sit-to-stand, 50-ft walk and 6-min walk tests were determined before and after completing a 4-week progressive exercise rehabilitation program and outcomes were compared by a paired t-test (P < 0.05). Thirty-two patients (54%) finished a treatment plan (adherent group), completing 80% of the prescribed sessions and were reevaluated. Twenty-seven patients (46%) did not complete the rehabilitation program (nonadherent group), primarily because of readmission to the hospital (18 patients, 62%). The adherent group did not significantly improve their physical performance (p > 0.05). However, a subgroup of 40% of these patients did experience clinically significant improvements in their physical performance.These findings 1) support the feasibility of having HSCT recipients receiving GC therapy to participate in an exercise-based rehabilitation program and 2) suggest that to do so can result in clinically significant improvements in functional capacity.
接受糖皮质激素（GC）治疗急性移植物抗宿主病（aGVHD）的造血干细胞移植（HSCT）受者的高敏性可能限制了他们对基于运动的康复计划的依从性，从而减缓了他们的康复速度。为了确定这一点，回顾了 59 名接受甲基泼尼松龙（MP）治疗的亚急性门诊干细胞移植受者的病历，以获取人口统计学、人体测量学和医学信息。在完成为期 4 周的渐进式运动康复计划前后，进行了重复坐站、50 英尺步行和 6 分钟步行测试，通过配对 t 检验（P < 0.05）比较结果。32 名患者（54%）完成了治疗计划（依从组），完成了规定疗程的 80%，并进行了重新评估。27 名患者（46%）未完成康复计划（不依从组），主要是因为再次住院（18 名患者，62%）。依从组的身体表现没有显著改善（p > 0.05）。然而，这些患者中有 40%的亚组确实在身体表现方面有了临床显著的改善。这些发现 1）支持让接受 GC 治疗的 HSCT 受者参与基于运动的康复计划的可行性，2）表明这样做可以导致功能能力的临床显著改善。
