Hanajima Wataru, Hirano Yuma, Takeda Natsuki, Nagafusa Tetsuyuki, Yamauchi Katsuya
Department of Rehabilitation Medicine, Ayase Heart Rehabilitation Hospital, Tokyo, JPN.
Department of Rehabilitation Medicine, Hamamatsu University School of Medicine, Shizuoka, JPN.
Cureus. 2025 May 13;17(5):e84048. doi: 10.7759/cureus.84048. eCollection 2025 May.
Exercise tolerance prior to hematopoietic stem cell transplantation (HSCT) is an important prognostic indicator. Nevertheless, patients with acute lymphocytic leukemia (ALL) before HSCT have reduced exercise tolerance after multiple rounds of chemotherapy. Exercise is encouraged in these patients to prevent reduced exercise tolerance. However, exercise compliance is reduced during chemotherapy. Therefore, we focused on the potential role of high-intensity interval training (HIIT), which improves exercise tolerance but requires fewer interventions. The efficacy and safety of HIIT in patients undergoing chemotherapy remain unknown. Here, we report an exercise intervention that incorporated HIIT in a patient with ALL undergoing consolidation chemotherapy (CC). The patient was a 40-year-old female diagnosed with ALL for whom rehabilitation was implemented after initiation of induction chemotherapy. The patient underwent aerobic exercise on an ergometer (20 min at 50-60% intensity, using the Karvonen method) and weight-bearing resistance training (three sets of 10-20 repetitions at a 4-5 rating on the modified Borg scale) five times a week. The physical function assessment before the third CC session showed decreased exercise tolerance. An HIIT intervention was added as a more effective rehabilitation strategy for the patient. HIIT was performed on an ergometer. The protocol consisted of a 5-min warm-up, three to four sets of alternating between 80-90% peak oxygen uptake (peak VO) and anaerobic threshold (AT) load for 3 min, and a 5-min cool-down. The number of HIIT interventions was nine of the 21 scheduled for rehabilitation. When HIIT was difficult, aerobic exercise was performed using an ergometer. Exercise tolerance improved without any adverse events, including bleeding, during rehabilitation. In conclusion, practicing HIIT sessions in patients receiving CC appears to safely enhance exercise tolerance with minimal intervention.
造血干细胞移植（HSCT）前的运动耐量是一项重要的预后指标。然而，HSCT前患有急性淋巴细胞白血病（ALL）的患者在经过多轮化疗后运动耐量会降低。鼓励这些患者进行运动以防止运动耐量降低。然而，化疗期间运动依从性会降低。因此，我们关注了高强度间歇训练（HIIT）的潜在作用，它能提高运动耐量但所需干预较少。HIIT在接受化疗患者中的疗效和安全性尚不清楚。在此，我们报告了一项对一名正在接受巩固化疗（CC）的ALL患者实施包含HIIT的运动干预。该患者为一名40岁女性，被诊断为ALL，在诱导化疗开始后实施康复治疗。患者每周在测力计上进行5次有氧运动（采用卡尔森法，强度为50 - 60%，持续20分钟）和负重抗阻训练（在改良的博格量表上评分为4 - 5级，每组10 - 20次重复，共三组）。第三次CC疗程前的身体功能评估显示运动耐量下降。作为对该患者更有效的康复策略，增加了HIIT干预。HIIT在测力计上进行。方案包括5分钟热身、三到四组，每组在80 - 90%的峰值摄氧量（峰值VO）和无氧阈（AT）负荷之间交替进行3分钟，以及5分钟的冷却。HIIT干预次数为康复计划安排的21次中的9次。当HIIT难以进行时，使用测力计进行有氧运动。康复期间运动耐量提高且未出现包括出血在内的任何不良事件。总之，在接受CC的患者中进行HIIT训练似乎能以最少的干预安全地提高运动耐量。
