Adherence, Viability, Clinical Evolution and Therapeutic Efficacy in Patients Undergoing Bone Marrow Transplantation
- Conditions
- Stem Cell Transplantation
- Interventions
- Device: Cycle ergometerDevice: Strength Training - elastic band and shin guardsDevice: Cycle ergometer, elastic band and shin guards
- Registration Number
- NCT06134297
- Lead Sponsor
- Federal University of Health Science of Porto Alegre
- Brief Summary
Hematological neoplasms originate from the differentiation and proliferation of abnormal lymphatic or myeloid cells that alter the constitution of elements of the blood, bone marrow and lymph nodes. Treatment includes high-dose chemotherapy alone or associated with hematopoietic stem cell transplantation (HSCT). However, the adverse effects of this treatment affect multiple organs and systems, reducing physical capacity, increasing the feeling of fatigue, anxiety and depression, which together affect quality of life. Patients who exercise before, during or after anti-neoplastic treatment demonstrate significant benefits. But rehabilitating physical capacity involves the challenge of fluctuations in the patient's readiness along with daily clinical variations, which ultimately directly affects the rate of adherence to exercises, impacting the effectiveness of the physical rehabilitation program. There is no specific individualization of muscular overload that takes into account such variability in pathophysiological, functional and psychological situations, but the cardiorespiratory response and muscular strength performance in the face of progressive overload can be measured with sufficient recovery periods to optimize the physiological adaptations promoted by muscular overload. regularly, even in patients undergoing antineoplastic treatment. Objective: To evaluate the adherence rate, operational feasibility, clinical/behavioral evolution and effectiveness of three different muscle overload models (aerobic, anaerobic and mixed) used for the physical rehabilitation of patients hospitalized for antineoplastic hematological treatment with HSCT
- Detailed Description
This is a randomized clinical trial. Patients will be allocated into groups (1) Aerobic; (2) Anaerobic and (3) Mixed. The manifestation of signs and symptoms will be evaluated using the Edmonton Symptom Assessment System (ESAS) inventory, a sensation of fatigue using the multidimensional fatigue questionnaire (MIF), and quality of life using the European Organization for Research and Treatment of Cancer Core Quality of Life questionnaire. Questionnaire (EORTC QLQ-30) and the incidence and intensity of anxiety and depression symptoms using the General Hospital Anxiety and Depression Scale (HAD), in addition to the strength assessment of the upper limbs (HANDGRIP) and lower limbs (TSL). Participants in the aerobic group will perform exercises for the lower limbs with a cycle ergometer for 15 consecutive minutes and participants in the anaerobic group will perform exercises with an overload of shin weights or dumbbells of 0.5kg/1kg for large muscle groups. Participants in the mixed group will have a mixed muscular overload, performed by alternating between aerobic and anaerobic overload with a 1:1 ratio until the end of the program.
Recruitment & Eligibility
- Status
- ENROLLING_BY_INVITATION
- Sex
- All
- Target Recruitment
- 93
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Aerobic Exercise Group Cycle ergometer Aerobic exercise using a cycle ergometer lasting 15 consecutive minutes with load adjusted to maintain heart rate (HR) between 65-75% of the maximum HR predicted for age (HRmax = 200-age). Anaerobic Exercise Group Strength Training - elastic band and shin guards Muscle strength training using shin guards and elastic bands to promote muscle overload, generating maximum force production, where the contraction time should not exceed 20 seconds. Mixed Exercise Group Cycle ergometer, elastic band and shin guards Exercises through alternation between aerobic and anaerobic overload (performing the exercises from the previously mentioned groups on alternate days), in a 1:1 ratio until the end of the physical rehabilitation program.
- Primary Outcome Measures
Name Time Method Effectiveness of the physical rehabilitation program for upper limb strength using dynamometry During the period of hospital stay, an average 1 month It will be determined by evaluating the strength performance of the upper limbs through dynamometry. The value will be given in kilograms of force. And it will be calculated through the average of three measurements.
Effectiveness of the physical rehabilitation program for lower limb strength through sitting and standing exercises During the period of hospital stay, an average 1 month. It will be determined by evaluating lower limb strength performance in the 30-second sit-to-stand test. The score will be based on the number of repetitions performed during the 30 timed seconds.
Clinical behavioral evolution of signs and symptoms related to cancer During the period of hospital stay, an average 1 month The following will be carried out at the beginning and end of the intervention:
- Edmonton Sympton Assessment System Inventory (scale with 9 items; each can be scored from 0 to 10; the final value of the scale is the sum of each item; the higher the score, the worse the symptoms).Clinical behavioral evolution of signs of anxiety and depression During the period of hospital stay, an average 1 month The following will be carried out at the beginning and end of the intervention:
- General Hospital Anxiety and Depression Scale (14 questions, scored from 0 to 3; the higher the final score, the worse the symptoms).Satisfaction with physiotherapy care During the period of hospital stay, an average 1 month It will be evaluated through a satisfaction questionnaire (contains 11 questions and a maximum score of 55 points; the higher the score, the better the test result and better satisfaction).
Adherence to physical rehabilitation sessions During the period of hospital stay, an average 1 month It will be evaluated through the ratio between the number of sessions actually carried out by the number of days in which the minimum clinical conditions for practicing physical exercise can be fully characterized during the hospital admission.
Operational viability for implementing the exercise protocol During the period of hospital stay, an average 1 month It will be evaluated through the time needed to execute the different muscle overload protocols
Clinical behavioral evolution of signs of fatigue During the period of hospital stay, an average 1 month The following will be carried out at the beginning and end of the intervention:
- Multidimensional Fatigue Questionnaire - (20 questions scored from 1 to 5; the higher the final score, the worse the symptoms).Clinical behavioral evolution of quality of life perception During the period of hospital stay, an average 1 month The following will be carried out at the beginning and end of the intervention:
- Basic Quality of Life Questionnaire of the European Organization for Research and Treatment of Cancer (30 questions scored from 1 to 4; the higher the final score, the worse the symptoms).
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Santa Casa de Misericórdia de Porto Alegre
🇧🇷Porto Alegre, RS, Brazil