PROGRESS OF MOTOR FUNCTIONS IN PATIENTS POST HEMATOPOIETIC STEM CELL TRANSPLANTATION

DOI IR Open Access
  • HOSAKA Yutaro
    Rehabilitation center, Showa University Hospital
  • SAITOH Bungo
    Division of Hematology, Department of Medicine, Showa University School of Medicine
  • YOSHIKAWA Akira
    Department of Physiology, Showa University School of Medicine
  • YANAGISAWA Kouji
    Division of Hematology, Department of Medicine, Showa University School of Medicine
  • HATTORI Norimichi
    Division of Hematology, Department of Medicine, Showa University School of Medicine
  • NAKAMAKI Tsuyoshi
    Division of Hematology, Department of Medicine, Showa University School of Medicine
  • SEKIYA Noboru
    Department of Physical Therapy, Showa University School of Nursing and Rehabilitation Sciences

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Other Title
  • 造血幹細胞移植患者の運動機能の経時的変化

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Abstract

The purpose of this study was to clarify the progress of motor functions in patients with hematological disorders who underwent hematopoietic stem cell transplantation （HSCT） and the effects of physical therapy programs. This study included 41 ［35 males and 16 females; median age52 years （range 22-72）］ out of 60 patients who survived to discharge post allo-HSCT. Data were collected from medical records retrospectively. Muscle strength （grip strength and knee extension strength）, endurance （6-minute walking distance）, balance function （Berg balance scale）, flexibility （finger floor distance in deep forward bow）, and physical activities ［Barthel index, ECOG Performance status scale, subjective activity （Visual Analogue scale）］ were used to analyze the progress of motor functions. The measurements were performed at 3 time points: shortly before HSCT, immediately after engraftment, and at discharge. Muscle strength decreased significantly immediately after engraftment and reduced strength existed at discharge. Endurance, flexibility, and physical activity decreased immediately after engraftment but improved to the initial level shortly at discharge. Balance function was not affected after HSCT. Although therapeutic exercises were performed throughout the period of hospitalization post HSCT in this study, muscle strength reduced immediately after engraftment and the exercises did not restore the strength to the former state at discharge. These results suggest that current therapeutic exercises are effective in restoring endurance, flexibility, and physical activities, but not muscle strength. Insufficient muscle strength restoration might be due to muscle atrophy induced by factors other than inactivity and/or inappropriate muscle strength exercises.

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