Shaza Abo1, Linda Denehy2, David Ritchie3, Kuan-Yin Lin4, Lara Edbrooke5, Cassie McDonald6, Catherine L Granger6. 1. Department of Physiotherapy, The University of Melbourne, VIC 3010, Australia; and Department of Physiotherapy, Royal Melbourne Hospital, Parkville, VIC 3052, Australia. 2. Department of Physiotherapy, The University of Melbourne; and Department of Allied Health, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia. 3. Department of Clinical Haematology and Bone Marrow Transplantation, Royal Melbourne Hospital, Parkville, VIC 3052, Australia. 4. Department of Physical Therapy, National Cheng Kung University, Tainan, Taiwan; and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 5. Department of Physiotherapy, The University of Melbourne; and Department of Allied Health, Peter MacCallum Cancer Centre. 6. Department of Physiotherapy, The University of Melbourne; and Department of Physiotherapy, Royal Melbourne Hospital.
Abstract
OBJECTIVE: For people with hematological malignancies treated with bone marrow transplantation (BMT), this systematic review aimed to identify, evaluate, and synthesize the evidence examining the effect of exercise training on the outcomes of exercise capacity, health-related quality of life (HRQoL), and hospital length of stay and to identify any difference in the effect on people treated with allogeneic versus autologous transplantation. METHODS: Five electronic databases were systematically searched from inception to December 5, 2020. Prospective studies with a comparator group, with or without randomization, were included if they investigated the effects of an exercise intervention compared with usual care or another intervention in adults who had a hematological malignancy and were undergoing BMT. Primary outcomes of interest were functional exercise capacity and HRQoL; secondary outcomes included strength, fatigue, hospital length of stay, and feasibility. Only randomized controlled trials were included in the meta-analyses. Risk of bias was evaluated using the Physiotherapy Evidence Database or Newcastle-Ottawa Scale; quality of evidence for meta-analyses was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS: Twenty-four randomized controlled trials and 3 prospective nonrandomized experimental trials were included (n = 2432). There was moderate-quality evidence that exercise improves functional exercise capacity (mean difference [MD] = 29 m; 95% CI = 12.59 to 45.4), global HRQoL (MD = 3.38 points; 95% CI = 0.37 to 6.39), and fatigue (MD = 2.52 points; 95% CI = 0.42 to 4.63) and low-quality evidence for reduced hospital length of stay (MD = 2.07 days; 95% CI = 0.43 to 3.72). These effects were more pronounced in recipients of allogeneic transplantation. No serious adverse events were associated directly with exercise in the included studies. CONCLUSIONS: Exercise is safe and improves outcomes, including functional exercise capacity, HRQoL, and hospital length of stay, in adults undergoing BMT. IMPACT: The results of this systematic review support the implementation of exercise programs in adults undergoing BMT, particularly recipients of allogeneic transplantation.
OBJECTIVE: For people with hematological malignancies treated with bone marrow transplantation (BMT), this systematic review aimed to identify, evaluate, and synthesize the evidence examining the effect of exercise training on the outcomes of exercise capacity, health-related quality of life (HRQoL), and hospital length of stay and to identify any difference in the effect on people treated with allogeneic versus autologous transplantation. METHODS: Five electronic databases were systematically searched from inception to December 5, 2020. Prospective studies with a comparator group, with or without randomization, were included if they investigated the effects of an exercise intervention compared with usual care or another intervention in adults who had a hematological malignancy and were undergoing BMT. Primary outcomes of interest were functional exercise capacity and HRQoL; secondary outcomes included strength, fatigue, hospital length of stay, and feasibility. Only randomized controlled trials were included in the meta-analyses. Risk of bias was evaluated using the Physiotherapy Evidence Database or Newcastle-Ottawa Scale; quality of evidence for meta-analyses was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS: Twenty-four randomized controlled trials and 3 prospective nonrandomized experimental trials were included (n = 2432). There was moderate-quality evidence that exercise improves functional exercise capacity (mean difference [MD] = 29 m; 95% CI = 12.59 to 45.4), global HRQoL (MD = 3.38 points; 95% CI = 0.37 to 6.39), and fatigue (MD = 2.52 points; 95% CI = 0.42 to 4.63) and low-quality evidence for reduced hospital length of stay (MD = 2.07 days; 95% CI = 0.43 to 3.72). These effects were more pronounced in recipients of allogeneic transplantation. No serious adverse events were associated directly with exercise in the included studies. CONCLUSIONS: Exercise is safe and improves outcomes, including functional exercise capacity, HRQoL, and hospital length of stay, in adults undergoing BMT. IMPACT: The results of this systematic review support the implementation of exercise programs in adults undergoing BMT, particularly recipients of allogeneic transplantation.
Authors: Shaza Abo; Selina M Parry; David Ritchie; Gabriella Sgro; Dominic Truong; Linda Denehy; Catherine L Granger Journal: Support Care Cancer Date: 2022-03-16 Impact factor: 3.359