A randomized control trial of a supervised versus a self-directed exercise program for allogeneic stem cell transplant patients

作者：Shelton Margarette L; Lee Jeannette Q; Morris G Stephen^*; Massey Pamela R; Kendall Deborah G; Munsell Mark F; Anderson Karen O; Simmonds Maureen J; Giralt Sergio A

来源：Psycho-Oncology, 2009, 18(4): 353-359.

DOI：10.1002/pon.1505

• oncology
• cancer
• physical exercise
• home exercise program
• allogeneic stem cell transplant

Objectives: To determine if therapist supervision of an exercise program produced better functional program outcomes in allogeneic stem cell transplant patients than a patient-directed exercise program.
Methods: Sixty-one patients who were less than 6 months post allogeneic stem cell transplant were randomly assigned to either a therapist supervised training group (supervised) or a patient-directed training group (Self-directed). Training consisted of aerobic exercises (treadmill, bicycle ergometer versus walking) and resistance exercises (free weights, weight machines versus resistive band activities). Subjects completed physical performance tests (50-foot fast walk, 6-min walk, forward reach, repeated sit-to-stand, uniped stance) and the Brief Fatigue Inventory (BFI) before and after 4 weeks of training. Pre- and post-training outcomes and group differences were analyzed by a Student t-test.
Results: Patients in both groups were similarly deconditioned at baseline. Training increased the 6-min walk distance and 50-foot walk in the supervised group by 12 and 14%, respectively, and increased the 6-min walk distance by 10% in the Self-directed group (P < 0.05). BFI score for worst level of fatigue declined in both groups but not significantly.
Conclusions: These results demonstrate that allogeneic transplant patients derive functional benefits from short-term exercise training regardless of how the training program is supervised. Determining (1) the reasons for the low participation rate (28%), (2) the patient-preferred characteristics of each exercise supervision style and (3) how best to match patient preference to exercise supervision style remain significant issues in this area of patient delivery services.

• 出版日期2009-4