Hematopoietik kök hücre nakli uygulanan bireylerde nakil tipine göre kas kuvveti, ağrı, yorgunluk ve fiziksel aktivite düzeylerinin incelenmesi

Abstract

Amaç: Çalışmamızın amacı, hematopoietik kök hücre nakli (HKHN) tedavisi uygulanan bireylerde nakil tipine göre kas kuvveti, ağrı, yorgunluk ve fiziksel aktivite düzeyini araştırmaktı.

Yöntem: Çalışmamıza HKHN ile tedavi olmuş ve en az 3 ay geçmiş toplam 61 birey dahil edildi. Ağrı ve yorgunluk düzeyi Vizuel Analog Skalası ile değerlendirildi. Katılımcıların kavrama kuvveti ve periferal kas kuvveti skorları dinamometre ile ölçüldü. 30-saniye Otur-Kalk Testi fonksiyonel performansı değerlendirmede kullanıldı. Uluslararası Fiziksel Aktivite Anketi, fiziksel aktivite düzeyini ölçmede kullanıldı.

Bulgular: Bireyler nakil tipine göre otolog (n=30) ve allojenik (n=31) olarak iki gruba ayrıldı. Katılımcıların tanısı dışında gruplar arasında demografik ve medikal karakteristikler açısından anlamlı bir fark yoktu (p˃0,05). Gruplar arasında kaydedilen sonuç ölçümleri karşılaştırıldığında; allojenik HKHN uygulanan bireylerin otolog HKHN uygulanan bireylere göre anlamlı ölçüde daha yüksek yorgunluğu var iken (p=0,027); Quadriceps femoris kas kuvveti (p=0,042) ve 30-saniye Otur-Kalk Testi sonuçları (p=0,006) anlamlı ölçüde daha düşüktü. Gruplar arasında diğer kaydedilen sonuç ölçümleri açısından anlamlı bir farklılık yoktu (p˃0,05).

Sonuç: Allojenik HKHN uygulanan bireyler otolog HKHN uygulanan bireylere göre daha fazla fiziksel problemlere sahiptir. Fizyoterapistler, nakil tipinin hastanın fonksiyonel defisitlerini artırabileceğinin farkında olup egzersiz programlarını nakil tipine göre ayarlayarak kişilerin en erken seviyede toparlanmalarına destek olmalıdırlar.

Keywords

• kök hücre nakli
• kas kuvveti
• fiziksel aktivite
• Ağrı
• Yorgunluk

Investigation of muscle strength, pain, fatigue, and physical activity levels by transplant type in individuals undergoing hematopoietic stem cell transplantation

Abstract

Purpose: The aim of the present study was to investigate muscle strength, pain, fatigue, and physical activity level in terms of transplantation type in individuals undergoing hematopoietic stem cell transplantation (HSCT).

Methods: A total of 61 indiviuals treated with HSCT at least 3 months ago were included in this study. Pain and fatigue level was assessed by using the Visual Analogue Scale. Grip strength and peripheral muscle strength of the participants were assessed by using dynamometer. The 30-second Sit to Stand Test was used to assess functional performance. The International Physical Activity Questionnaire was used to measure physical activity level.

Results: Individuals were assigned to two groups as autologous (n=30) and allogeneic (n=31) according to the transplantation type. There was no significant difference in terms of demographic and medical characteristics except for diagnosis participants between the groups (p˃0.05). When compared the recorded outcomes between the groups; patients treated with allogenic HSCT had significantly higher fatigue level (p=0.027), while significanly lower quadriceps femoris muscle strength (p=0.042) and the 30-second Sit to Stand test score (p=0.006) than patients treated with autologous HSCT. There was no significant difference between the groups in terms of the other recorded outcomes (p˃0.05).

Conclusion: Individuals treated with allogeneic HSCT have higher physical problems than individuals treated with autologous HSCT. Physiotherapist should consider that transplantation type may increase functional deficits and they should should support the recovery of people at the earliest phase by adjust exercise program according to the transplantation type.

Keywords

• stem cell transplantation
• Muscle strength
• Physical activity
• Pain
• Fatigue.

References

1. 1. Niederwieser D, Baldomero H, Szer J, et al. Hematopoietic stem cell transplantation activity worldwide in 2012 and a SWOT analysis of the Worldwide Network for Blood and Marrow Transplantation Group including the global survey. Bone Marrow Transplant. 2016;51:778-785.
2. 2. Yoshimi A, Suzuki R, Atsuta Y, et al. Hematopoietic SCT activity in Asia: a report from the Asia-Pacific Blood and Marrow Transplantation Group. Bone Marrow Transplant. 2010;45:1682-1691.
3. 3. Andrykowski MA, Bishop MM, Hahn EA, et al. Long-term health-related quality of life, growth, and spiritual well-being after hematopoietic stem-cell transplantation. J Clin Oncol. 2005;23:599-608.
4. 4. Wong FL, Francisco L, Togawa K, et al. Long-term recovery after hematopoietic cell transplantation: predictors of quality-of-life concerns. Blood. 2010;115:2508-2519.
5. 5. Ishikawa A, Otaka Y, Kamisako M, et al. Factors affecting lower limb muscle strength and cardiopulmonary fitness after allogeneic hematopoietic stem cell transplantation. Support Care Cancer. 2019;27:1793-1800.
6. 6. Majhail NS. Long-term complications after hematopoietic cell transplantation. Hematol Oncol Stem Cell Ther. 2017;10:220-227.
7. 7. Morishita S, Kaida K, Yamauchi S, et al. Relationship between corticosteroid dose and declines in physical function among allogeneic hematopoietic stem cell transplantation patients. Support Care Cancer. 2013;21:2161-2169.
8. 8. Morishita S, Kaida K, Yamauchi S, et al. Gender differences in health-related quality of life, physical function and psychological status among patients in the early phase following allogeneic haematopoietic stem cell transplantation. Psychooncol. 2013;22:1159-1166.

9. 9. Wingard JR, Huang IC, Sobocinski KA, et al. Factors associated with self-reported physical and mental health after hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2010;16:1682-1692.
10. 10. Garcia CM, Mumby PB, Thilges S, et al. Comparison of early quality of life outcomes in autologous and allogeneic transplant patients. Bone Marrow Transplant. 2012;47:1577-1582.
11. 11. Kroemeke A, Sobczyk-Kruszelnicka M, Kwissa-Gajewska Z. Everyday life following hematopoietic stem cell transplantation: decline in physical symptoms within the first month and change-related predictors. Qual Life Res. 2018;27:125-135.
12. 12. Abo S, Ritchie D, Denehy L, et al. A hospital and home-based exercise program to address functional decline in people following allogeneic stem cell transplantation. Support Care Cancer. 2018;26:1727-1736.
13. 13. Takekiyo T, Dozono K, Mitsuishi T, et al. Recovery of physical function and quality of life in patients undergoing hematopoietic stem cell transplantation: a 1-year follow-up. Bone Marrow Transplant. 2016;51:1127-1130.
14. 14. Langley G, Sheppeard H. The visual analogue scale: its use in pain measurement. J Rheumatol Int. 1985;5:145-148.
15. 15. Shahid A, Wilkinson K, Marcu S, et al. Visual analogue scale to evaluate fatigue severity (VAS-F). In: STOP, THAT and one hundred other sleep scales. Shahid A, Wilkinson K, Marcu S, Shapiro CM, eds. New York: Springer; 2011:399-402.
16. 16. Balogun JA, Akomolafe CT, Amusa LO. Grip strength: effects of testing posture and elbow position. Arch Phys Med Rehabil. 1991;72:280-283.
17. 17. Bohannon RW, Andrews AW. Interrater reliability of hand-held dynamometry. Phys Ther. 1987;67:931-933.
18. 18. Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport. 1999;70:113-119.
19. 19. Saglam M, Arikan H, Savci S, et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010;111:278-284.
20. 20. Majhail NS, Farnia SH, Carpenter PA, et al. Indications for Autologous and Allogeneic Hematopoietic Cell Transplantation: Guidelines from the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant. 2015;21:1863-1869.
21. 21. Prieto JM, Atala J, Blanch J, et al. Patient-rated emotional and physical functioning among hematologic cancer patients during hospitalization for stem-cell transplantation. Bone Marrow Transplant. 2005;35:307-314.
22. 22. Fife BL, Huster GA, Cornetta KG, et al. Longitudinal study of adaptation to the stress of bone marrow transplantation. J Clin Oncol. 2000;18:1539-1549.
23. 23. Bevans MF, Mitchell SA, Barrett JA, et al. Symptom distress predicts long-term health and well-being in allogeneic stem cell transplantation survivors. Biol Blood Marrow Transplant. 2014;20:387-395.
24. 24. Barğı G, Boşnak Güçlü M, Türköz Sucak AG. Differences in pulmonary and extra-pulmonary characteristics in severely versus non-severely fatigued recipients of allogeneic hematopoietic stem cell transplantation: a cross-sectional, comparative study. Hematology. 2019;24:112-122.
25. 25. Wiskemann J, Huber G. Physical exercise as adjuvant therapy for patients undergoing hematopoietic stem cell transplantation. Bone Marrow Transplant. 2008;41:321-329.
26. 26. Danaher EH, Ferrans C, Verlen E, et al. Fatigue and physical activity in patients undergoing hematopoietic stem cell transplant. Oncol Nurs Forum. 2006;33:614-624.
27. 27. Yildiz Kabak V, Goker H, Duger T. Effects of partly supervised and home-based exercise program in patients undergoing hematopoietic stem cell transplantation: a case-control study. Support Care Cancer. 2020;28:5851-5860.
28. 28. Mohammed J, Smith SR, Burns L, et al. Role of Physical Therapy before and after Hematopoietic Stem Cell Transplantation: White Paper Report. Biol Blood Marrow Transplant. 2019;25:191-198.