Alberta Health Services, Edmonton, Alberta, Canada.
University of Alberta, Edmonton, Alberta, Canada.
Can J Cardiol. 2018 Oct;34(10 Suppl 2):S263-S269. doi: 10.1016/j.cjca.2018.07.001. Epub 2018 Jul 12.
Worldwide > 50,000 hematopoietic stem cell transplants (HSCTs) are performed annually. HSCT patients receive multiple cardiotoxic therapies (chemotherapy and radiation therapy) in addition to severe physical deconditioning during hospital admission. We hypothesized that guided exercise in a cardiac rehabilitation (CR) program following autologous HSCT is a safe and feasible intervention.
Pilot project to assess for safety, feasibility and impact of 8 weeks of CR in HSCT patients following transplant. Consecutive patients with lymphoma underwent standard activity protocol testing before HSCT, at 6 weeks following HSCT (prior to CR), and at 14 weeks following HSCT (at completion of CR), consisting of grip strength (GS), gait speed (GtS), timed up-and-go (TUG), and 6-minute walk test (6MWT). CR consisted of 8 weekly visits for guided exercise.
Activity tolerance protocol data of 30 patients (24 male, 6 female) from December 2014 to December 2016 were analyzed using repeated measures (analysis of variance [ANOVA]) to observe for changes in GS, GtS, TUG, and 6MWT. Statistically significant improvements were found in GS (P < 0.005), GtS (P = 0.02), and 6MWT (P = 0.001). These improvements show that guided CR-based exercise may assist HSCT survivors to meet or even surpass baseline exercise levels and improve physical functioning. There were no adverse events (ie, death or injury) during the study period. Fifty-seven percent of referred patients participated in CR, exceeding documented CR adherence in cardiac populations.
The addition of CR-based exercise programming in HSCT survivorship care of patients with lymphoma is a safe and feasible intervention to assist in recovery following transplant.
全球每年有超过 50000 例造血干细胞移植（HSCT）。HSCT 患者在住院期间除了严重的身体不适外，还接受多种心脏毒性治疗（化疗和放疗）。我们假设，在自体 HSCT 后进行心脏康复（CR）计划中的指导运动是一种安全且可行的干预措施。
这是一个评估 HSCT 患者在移植后进行 8 周 CR 的安全性、可行性和影响的试点项目。连续接受淋巴瘤治疗的患者在 HSCT 前、HSCT 后 6 周（在 CR 之前）和 HSCT 后 14 周（在 CR 完成时）进行标准活动方案测试，包括握力（GS）、步态速度（GtS）、计时起立行走测试（TUG）和 6 分钟步行测试（6MWT）。CR 由 8 次每周的指导运动组成。
使用重复测量（方差分析 [ANOVA]）分析 2014 年 12 月至 2016 年 12 月期间 30 名患者（24 名男性，6 名女性）的活动耐受方案数据，以观察 GS、GtS、TUG 和 6MWT 的变化。GS（P<0.005）、GtS（P=0.02）和 6MWT（P=0.001）均有统计学意义的改善。这些改善表明，基于 CR 的指导运动可能有助于 HSCT 幸存者达到甚至超过基线运动水平，并改善身体功能。在研究期间没有发生不良事件（即死亡或受伤）。有 57%的被推荐患者参加了 CR，超过了心脏人群中记录的 CR 依从性。
在淋巴瘤 HSCT 幸存者护理中增加基于 CR 的运动计划是一种安全且可行的干预措施，有助于移植后康复。
