Ye Menghua, Xu Chenyi, Tan Xiaoxue, Cao Min, Xu Min
Department of Hematology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
The College of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
J Cancer Surviv. 2025 Jun 5. doi: 10.1007/s11764-025-01824-2.
This study aims to assess the adherence and safety of the home-based exercise program in patients with aplastic anemia (AA) who are undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Additionally, it aims to determine whether this program can enhance patients' quality of life (QoL), alleviate fatigue, increase exercise tolerance, and reduce psychological stress.
This study involved 80 patients with AA from the Hematology Department of a comprehensive tertiary hospital. All participants met the British Committee for Standards in Haematology (BCSH) diagnostic criteria, were aged 18-65 years, and had undergone allo-HSCT within the past 1-12 months. All patients were enrolled within 100 days post-transplant discharge. The control group received standard exercise nursing care, while the intervention group completed a 12-week home-based exercise program. Adherence and safety were monitored during the intervention, and QoL, fatigue level, exercise tolerance, and psychological distress were assessed at baseline (T0), week 4 (T1), week 8 (T2), and week 12 (T3).
Exercise adherence exceeded 70%, with no adverse events reported. Repeated measures analysis revealed that QoL scores and 6MWD increased over time for both groups. At weeks 4, 8, and 12 of the intervention, the experimental group exhibited significantly higher QoL scores and 6MWD compared to the control group, with the differences being statistically significant. Both groups demonstrated a decrease in fatigue and psychological distress scores as the intervention progressed. At weeks 4, 8, and 12, the experimental group reported significantly lower levels of fatigue and psychological distress than the control group, with these differences also reaching statistical significance and a small to moderate effect size.
Home-based exercise is feasible for patients with AA undergoing allo-HSCT and showed an improvement in QoL, fatigue, exercise tolerance, and psychological status, which can serve as an effective adjuvant therapy during the post allo-transplant rehabilitation process.
This study provides a new perspective and method for the long-term rehabilitation of AA patients following allo-HSCT.
本研究旨在评估接受异基因造血干细胞移植（allo-HSCT）的再生障碍性贫血（AA）患者居家锻炼计划的依从性和安全性。此外，旨在确定该计划是否能提高患者的生活质量（QoL）、减轻疲劳、增加运动耐力并减轻心理压力。
本研究纳入了一家综合性三级医院血液科的80例AA患者。所有参与者均符合英国血液学标准委员会（BCSH）的诊断标准，年龄在18至65岁之间，且在过去1至12个月内接受了allo-HSCT。所有患者均在移植出院后100天内入组。对照组接受标准运动护理，干预组完成为期12周的居家锻炼计划。在干预期间监测依从性和安全性，并在基线（T0）、第4周（T1）、第8周（T2）和第12周（T3）评估QoL、疲劳水平、运动耐力和心理困扰。
运动依从性超过70%，未报告不良事件。重复测量分析显示，两组的QoL评分和6分钟步行距离（6MWD）均随时间增加。在干预的第4周、第8周和第12周，实验组的QoL评分和6MWD显著高于对照组，差异具有统计学意义。随着干预的进行，两组的疲劳和心理困扰评分均有所下降。在第4周、第8周和第12周，实验组报告的疲劳和心理困扰水平显著低于对照组，这些差异也具有统计学意义，且效应大小为小到中度。
居家锻炼对接受allo-HSCT的AA患者是可行的，并显示出在QoL、疲劳、运动耐力和心理状态方面有所改善，可作为异基因移植后康复过程中的有效辅助治疗。
本研究为AA患者allo-HSCT后的长期康复提供了新的视角和方法。
