造血干细胞移植中远程医疗支持的运动干预:一项范围综述
Telemedicine-Supported Exercise Interventions in Hematopoietic Stem Cell Transplantation: A Scoping Review.
作者信息
Gonçalves Leite Rocco Patricia, Reategui-Rivera C Mahony, Finkelstein Joseph
机构信息
Arizona Telemedicine Program, College of Medicine - Tucson, University of Arizona, Tucson, AZ, USA.
Department of Biomedical Informatics, School of Medicine, University of Utah, Salt Lake City, UT, USA.
出版信息
Int J Gen Med. 2025 Aug 5;18:4251-4265. doi: 10.2147/IJGM.S526025. eCollection 2025.
BACKGROUND
Hematopoietic stem cell transplantation is a potentially curative therapy for various hematologic conditions. Though physical exercise has been shown to positively affect physical and psychosocial function in patients undergoing hematopoietic stem cell transplantation, they often face multiple barriers to accessing comprehensive exercise-based rehabilitation programs. Telemedicine has emerged as a promising strategy to overcome these challenges by facilitating remote exercise interventions and potentially improving patient outcomes.
OBJECTIVE
This scoping review aimed to map the current landscape of telemedicine-supported exercise interventions in hematopoietic stem cell transplantation, assessing their clinical and technical characteristics, feasibility, effectiveness, and gaps in the literature.
METHODS
Following the Arksey and O'Malley framework and subsequent enhancements, we systematically searched MEDLINE, SCOPUS, Web of Science, and Embase from inception to July 31, 2024. We included experimental studies examining telemedicine-supported exercise interventions for hematopoietic stem cell transplantation recipients and extracted data on study design, participant characteristics, technology used, exercise modalities, and outcomes measured. Findings were synthesized narratively.
RESULTS
Our search resulted in 1116 papers, with 10 included in the final review. Most studies (90%) focused on feasibility and employed prospective designs, including quasi-experimental (60%) and randomized controlled trials (40%). Sample sizes were generally small, with 80% of studies enrolling fewer than 50 participants. Aerobic exercise was the most frequently implemented modality (80%), with reported improvements in VO2peak, 6-minute walk test performance, and quality of life. Functional outcomes were assessed in 90% of studies, while 50% evaluated quality-of-life metrics. Interventions were largely feasible, safe, and acceptable, overcoming barriers to care for hematopoietic stem cell transplantation patients.
CONCLUSION
Telemedicine-supported exercise interventions are feasible and show promise in improving physical function and quality of life for hematopoietic stem cell transplantation patients.
背景
造血干细胞移植是治疗多种血液系统疾病的一种潜在的治愈性疗法。尽管体育锻炼已被证明对接受造血干细胞移植的患者的身体和心理社会功能有积极影响,但他们在获得全面的基于运动的康复计划方面往往面临多重障碍。远程医疗已成为一种有前景的策略,通过促进远程运动干预并可能改善患者预后,来克服这些挑战。
目的
本范围综述旨在梳理造血干细胞移植中远程医疗支持的运动干预的现状,评估其临床和技术特征、可行性、有效性以及文献中的空白。
方法
遵循阿克西和奥马利框架及后续改进方法,我们系统检索了从创刊至2024年7月31日的MEDLINE、SCOPUS、科学引文索引和Embase。我们纳入了检验针对造血干细胞移植受者的远程医疗支持的运动干预的实验研究,并提取了关于研究设计、参与者特征、使用的技术、运动方式和测量结果的数据。研究结果进行了叙述性综合。
结果
我们的检索得到1116篇论文,最终综述纳入了10篇。大多数研究(90%)关注可行性并采用前瞻性设计,包括准实验(60%)和随机对照试验(4-0%)。样本量一般较小,80%的研究纳入的参与者少于50人。有氧运动是最常实施的运动方式(80%),据报告在最大摄氧量、6分钟步行试验表现和生活质量方面有改善。90%的研究评估了功能结果,而50%评估了生活质量指标。干预在很大程度上是可行、安全且可接受的,克服了造血干细胞移植患者的护理障碍。
结论
远程医疗支持的运动干预是可行的,并且在改善造血干细胞移植患者的身体功能和生活质量方面显示出前景。
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