Baumann, F.T., Zopf, E.M., Nykamp, E., Kraut, L., Schüle, K., Elter, T., . . . Bloch, W. (2011). Physical activity for patients undergoing an allogeneic hematopoietic stem cell transplantation: Benefits of a moderate exercise intervention. European Journal of Haematology, 87, 148–156.

To demonstrate the effects of an exercise program on endurance, strength, lung function, and quality of life in patients undergoing allogeneic transplantation.

Forty-seven patients undergoing allogeneic transplantation during a three-year period were recruited and randomized into either the exercise group (EG) or the control group (CG). The EG received daily aerobic endurance training with a cycle and ADL training, involving relaxation, stair climbing coordination, and strengthening. Exercise was done 20–30 minutes per day, twice daily. CG patients received standard physiotherapy for 20 minute five days per week, consisting of active and passive mobilization with low intensity. Fatigue measurement was conducted two days after admission and one day before discharge. Exercise began the first day after transplantation.

• N = 33
• MEAN AGE: EG 41.41 years, CG 42.81 years
• MALES: EG 6%, CG 3%; FEMALES: EG 3.5%, CG 7%
• KEY DISEASE CHARACTERISTICS: Patients with malignant hematologic disease undergoing bone marrow transplantation

• SITE: Single site  
• SETTING: Inpatient
• LOCATION: Center of Transplantation in Idar-Oberstein, Germany

• PHASE OF CARE: Active treatment

• RCT

• Modified WHO test on a cycle ergometer (aerobic endurance)
• Digimax2000-load cell (strength) 
• Vital capacity, forced vital capacity (lung function)
• EORTC-QLQ C30 (quality of life)

Increase in the experience of fatigue in the CG. Deterioration of physical function was seen in both study groups. There was improved emotional state for patients in the EG (p = .028). Relative endurance improved in EG both groups. There was no significant group by time effect on fatigue. No effect for strength, lung function, or anthropometric assessments reached significance in either group.

The only significant difference between the two groups was found in relative endurance in favor of EG.

• Small sample (< 30)
• Patients, therapists, and outcome assessors were not blinded to the groups.  
• Some patients in the CG exercised on the cycle ergometers that were used in the EG.
• It was stated that exercise would not be done if patients were unable to participate due to clinical condition, etc., but no information is provided regarding the actual percent who were able to adhere to the exercise schedule.

Physical activity during acute phase of transplantation appears safe and can improve physical endurance and strength.