Effects of Pulmonary Rehabilitation in Hematopoietic Stem Cell Transplantation Recipients: A Randomized Controlled Study

Background: Exercise capacity and quality of life (QOL) deteriorate in hematopoietic stem cell transplantation (HSCT) recipients. To maintain cardiorespiratory fitness during HSCT, exercise training is highly recommended. Aims: To investigate the effects of two different pulmonary rehabilitation (PR) programs on pulmonary function, exercise capacity, respiratory muscle strength, endurance and QOL. Methods: A randomized controlled, triple blind study. Thirty patients were randomly assigned to the PR (upper extremity aerobic and progressive resistance exercise) and PR+IMT (inspiratory muscle training) groups, interventions were applied (16 autologous, 14 allogeneic) during HSCT hospital stay. Pulmonary function (spirometry), exercise capacity (cardiopulmonary exercise testing), respiratory muscle strength (mouth pressure device, (MIP, MEP)), and endurance (threshold loading test), QOL (European Organization for Research and Treatment of Cancer) were evaluated before HSCT and after discharge. Results: Pulmonary function, respiratory muscle strength, endurance and QOL changes were similar between groups. Respiratory exchange ratio, minute ventilation (VE) at peak did not change in between and within the groups (p>0.05). In groups, the MEP and peak-VO2 were significantly decreased, FVC%, breathing reserve, ventilatory equivalent for VCO2 (VE/VCO2) and VO2 (VE/VO2) increased in the PR+IMT group (p<0.05). Conclusions: Although pulmonary function, inspiratory muscle strength, endurance, QOL were preserved, exercise capacity and expiratory muscle strength were decreased hospital stay. PR should be applied to HSCT patients according to their clinical and hematologic state.