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老年异基因造血干细胞移植患者运动计划的可行性——一项试点研究

Feasibility of an exercise programme in elderly patients undergoing allogeneic stem cell transplantation - a pilot study.

作者信息

Schuler M K, Hornemann B, Pawandenat C, Kramer M, Hentschel L, Beck H, Kasten P, Singer S, Schaich M, Ehninger G, Platzbecker U, Schetelig J, Bornhäuser M

机构信息

Department of Internal Medicine I, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.

University Cancer Center, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.

出版信息

Eur J Cancer Care (Engl). 2016 Sep;25(5):839-48. doi: 10.1111/ecc.12400. Epub 2015 Nov 3.

Abstract

It has been demonstrated that physical exercise benefits younger patients undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT). We designed a prospective pilot study investigating whether elderly patients (>60 years) would also be able to participate in such a programme. It consisted of physiotherapist-supervised alternating endurance and resistance workouts on 6 of 7 days a week. Sixteen consecutive patients undergoing allo-HSCT were enrolled into the study. The median age was 64.5 years. Twelve patients participated in the programme until the time of discharge (75%) from the transplant unit. Therefore, the predefined criteria regarding feasibility were met. The reason for drop out was transplantation associated mortality in all patients (n = 4). Adherence was very good with a median of 85% attended training sessions. No adverse events were recorded. The endurance capacity dropped by 7% and lower extremity strength improved by 2% over time. Quality of life decreased during the study period, with global health being significantly worse at the time of discharge. In conclusion, a combined and intensified strength and endurance exercise programme is feasible and safe in a population of elderly patients undergoing allo-HSCT. Further research should focus on exploring effect sizes of such an intervention by conducting randomised controlled trials.

摘要

已有研究表明,体育锻炼对接受异基因造血干细胞移植(allo-HSCT)的年轻患者有益。我们设计了一项前瞻性试点研究,以调查老年患者(>60岁)是否也能够参与这样的项目。该项目包括每周7天中有6天在物理治疗师的监督下进行耐力和阻力交替训练。连续16例接受allo-HSCT的患者被纳入研究。中位年龄为64.5岁。12例患者在从移植单元出院时(75%)参与了该项目。因此,满足了关于可行性的预先设定标准。所有患者(n = 4)退出的原因均为移植相关死亡率。依从性非常好,参加训练课程的中位数为85%。未记录到不良事件。随着时间的推移,耐力下降了7%,下肢力量提高了2%。在研究期间生活质量下降,出院时总体健康状况明显更差。总之,在接受allo-HSCT的老年人群中,联合强化的力量和耐力锻炼项目是可行且安全的。进一步的研究应集中于通过开展随机对照试验来探索这种干预措施的效应大小。

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