Abstract
Exercise tolerance (ET) and health related quality of life (QOL) are reduced in patients with allotransplantation of hematopoietic stem cells (ATHC) particularly in the case of graft versus host disease (GVH). We evaluated the effect of multidisciplinary rehabilitation (MDR) in such cases,
Between Sept 2013 and Nov 2015 12 patients with ATCH benefitted from 16 courses of inpatient MDR (6 female) in an in-patient rehabilitation unit. Patients' aged median 58 yrs (range 33 -71 years), median BMI median 20 Kg/m² (15,8-30,8), Median FEV1 46% expected (range 15-107%), median duration of stay 50 days (from 2 to 171 days).
Each patient had daily physical activity sessions consisting of cycloergometer exercise, gymnastic sessions, muscle reinforcement and aquagym. Median endurance power on cycling went from 19 to 47 Watts, (+28 Watts), Six-minute walking test distance improved from 435 to 499meters (median gain =64m),
Self-administered quality of life questionnaires were completed before and after rehabilitation evaluating physical activity, fatigue, anxiety and depression, and global quality of life (Ricci questionnaire), Hospital anxiety and Depression score (HAD), VQ11 (respiratory related QOL) and the generic QOL SF-36 score.
The rehabilitation programme improved effort tolerance and perceived QOL whatever the interval from marrow transplantation, but larger studies are needed to define the type of patient most likely to benefit, It would seem that a global multidisciplinary programme is preferable and individually tailored for this diverse group of patients as regards age, general health and pre-rehabilitation capacity, Nonetheless physical activity seems positive in this severe condition.
- Copyright ©the authors 2016