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物理治疗方案对造血干细胞移植后心肺功能、肌肉力量、有氧运动能力及生活质量的影响

Effects of a physiotherapeutic protocol in cardiorespiratory, muscle strength, aerobic capacity and quality of life after hematopoietic stem cell transplantation.

作者信息

Morais Natalia Igv, Palhares Luciana Campanatti, Miranda Eliana Cm, Lima Carmen Sp, De Souza Carmino A, Vigorito Afonso C

机构信息

Universidade de Campinas (Unicamp), Campinas, SP, Brazil.

Universidade de Campinas (Unicamp), Campinas, SP, Brazil.

出版信息

Hematol Transfus Cell Ther. 2023 Apr-Jun;45(2):154-158. doi: 10.1016/j.htct.2021.08.003. Epub 2021 Sep 10.

Abstract

OBJECTIVE

To analyze the effects of hospital cardiorespiratory physical therapy protocol on the functional capacity and quality of life of patients submitted to hematopoietic stem cell transplantation (HSCT).

METHODS

From January to December 2019, bilateral dynamometry, Manovacuometry and Ventilometry, peak expiratory flow "Peak Flow", 6-min walk test (6MWT), SF-36 Quality of Life Questionnaire and Visual Analog Scale (VAS) were applied in patients who have undergone an allogeneic or autologous hematopoietic stem cell transplantation (HSCT), pre-conditioning (initial evaluation) and pre-discharge (final evaluation). The patients were submitted to an intervention protocol, consisting of aerobic training, muscle strengthening and respiratory muscle training, between the two assessments.

RESULTS

29 patients were enrolled in the study and 24 (83%) completed all procedure. Myeloablative and reduced intensity conditioning were performed in 89.6% and 10.4%, respectively; 17 (58%) patients have undergone an autologous HSCT; 10 (35%) identical related allogeneic HSCT, and 2 (7%) haploidentical allogeneic HSCT. The median number of interventions per patient was 3 (1-9). A decreasing in the right and left dynamometry (p  ≤ 0.0001 and 0.002, respectively) and, also in the distance covered in the 6MWT (p  = 0.004), was observed after HSCT. There was no significant difference in respiratory muscle strength, quality of life and fatigue sensation.

CONCLUSION

Cardiorespiratory rehabilitation can preserve functional capacity and quality of life.

摘要

目的

分析医院心肺物理治疗方案对接受造血干细胞移植(HSCT)患者的功能能力和生活质量的影响。

方法

2019年1月至12月,对接受异基因或自体造血干细胞移植(HSCT)的患者在预处理(初始评估)和出院前(最终评估)时进行双侧握力测量、压力容积测量和通气测量、呼气峰值流速“峰值流量”、6分钟步行试验(6MWT)、SF-36生活质量问卷和视觉模拟量表(VAS)。在两次评估之间,患者接受了一项干预方案,包括有氧运动训练、肌肉强化和呼吸肌训练。

结果

29名患者纳入研究,24名(83%)完成了所有程序。分别有89.6%和10.4%的患者进行了清髓性和减低强度预处理;17名(58%)患者接受了自体HSCT;10名(35%)患者接受了全相合相关异基因HSCT,2名(7%)患者接受了单倍体异基因HSCT。每位患者的干预中位数为3次(1-9次)。HSCT后观察到左右握力测量值下降(分别为p≤0.0001和0.002),6MWT行走距离也下降(p = 0.004)。呼吸肌力量、生活质量和疲劳感方面无显著差异。

结论

心肺康复可以保留功能能力和生活质量。

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