Hämatrain-Hybrid movement therapy during inpatient and outpatient hematological treatment: correlations with physical and psychological parameters.

Abstract

Background: Prior research indicates that engaging in physical activity during chemotherapy can positively influence both physical and psychological parameters in individuals with hematological neoplasms. However, the most effective type, level, intensity, and frequency of exercise remains unclear.

Patients and methods: We enrolled 53 patients to a clinical trial assessing a partly supervised hybrid training program including both strength and endurance components, commencing at onset of induction therapy (T0) for hematological malignancies, including AML (n = 29), ALL (n = 5), and NHL (n = 19). Endpoints to evaluate efficacy included muscle strength in kg, cardiovascular fitness in steps, balance in scores, quality of life (QoL), and fatigue. Data were compared at three time points: the beginning of treatment (T0), during consolidation (T1), and 12 ± 2 weeks later (T2).

Results: Average adherence to protocol specified activities was 63.2% (± 40.0% s.d.) for participants without a stem cell transplant (No-SCT) and 51.5% (± 29.3% s.d.) for participants with AML between T0 and T2. No serious adverse reactions related to the exercise program were reported. Positive correlations were found between adherence and hand strength (T0-T1: left: r = 0.48, p < 0.05; right: r = 0.56, p < 0.05) for patients without stem cell transplant as therapy, as well as a strong association between higher adherence and lower appetite loss between T1 and T2 (No-SCT: r = -0.67, p = 0.001; AML: r = -0,49, p = 0,03). In participants with AML, it was also shown that higher adherence at T2 was associated with reduced symptom burden due to financial problems (r = -0,65, p = 0,004). However, other aspects of quality of life and fatigue showed only weak to moderate correlations with adherence.

Conclusion: This partly supervised hybrid exercise program during inpatient and outpatient care of patients with hematological cancer was safe and feasible. While useful in maintaining hand strength and reducing appetite loss in some patients, as well as reducing symptom burden due to financial problems in other patients, ambiguity was likely due to confounding factors, such as underlying disease biology and response to treatment. Corresponding author: Johanna Huesmann (johuesmann@gmx.de) (TRN: DRKS00034396, Date of registration: 07.06.2024; retrospectively registered).