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Allogeneic hematopoietic stem cell transplantation (allo-HSCT) causes various toxic effects in many body tissues, organs and systems such as immune, cardiovascular, pulmonary, gastrointestinal, neuroendocrine and musculoskeletal systems, liver, kidneys and skin.Available limited numbers of studies showed that inspiratory muscle weakness in allo-HSCT candidates and recipients. Although meta-analysis, systematic reviews and studies demonstrated beneficial effects of inspiratory muscle training on several outcomes in different disease groups; chronic obstructive pulmonary disease, bronchiectasis and heart failure, no published paper reported the effects of IMT in allo-HSC recipients.
Thirty-eight allo-HSCT recipients (˃100 days past post-transplant status) were included. Before and after 6-week IMT, maximal and submaximal exercise capacity, respiratory and peripheral muscle strength, pulmonary functions, dyspnea and fatigue perception, depression and quality of life were evaluated. Primary outcome measurement was respiratory muscle strength, secondary outcomes were exercise capacity, dyspnea, peripheral muscle strength, quality of life, fatigue and depression.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment group | Active Comparator | Intervention: Treatment group received inspiratory muscle training (IMT) using POWERbreathe Classic threshold loading device. |
|
| Control group | Sham Comparator | Sham: Control group received sham inspiratory muscle training (IMT) using POWERbreathe Classic threshold loading device . |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Inspiratory muscle training | Device | Treatment group received inspiratory muscle training using threshold loading device (POWERbreathe Classic, IMT Technologies Ltd. Birmingham, England) at 40% of maximal inspiratory pressure (MIP). The MIP was measured at supervised session each week, and 40% of measured MIP value was the new training workload. The treatment group trained for 30 min-per/day, 7 days/week, for 6 weeks. Six sessions at home and 1 session were performed at department. |
| Measure | Description | Time Frame |
|---|---|---|
| Inspiratory and expiratory muscle strength (MIP, MEP) | Mouth pressure device | 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Fatigue | Fatigue Impact Scale (FIS) | 6 weeks |
| Pulmonary function | Spirometry | 6 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Gülşah Barğı, MSc. | Gazi University | Study Chair |
| Meral Boşnak Güçlü, PhD. | Gazi University | Study Director |
| Zeynep Arıbaş, MSc. | Gazi University | Principal Investigator |
| Zeynep Şahika Akı, MD, PhD. | Gazi University | Principal Investigator |
| Gülsan Türköz Sucak, MD, PhD. | Gazi University | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 9128987 | Result | Dimeo FC, Tilmann MH, Bertz H, Kanz L, Mertelsmann R, Keul J. Aerobic exercise in the rehabilitation of cancer patients after high dose chemotherapy and autologous peripheral stem cell transplantation. Cancer. 1997 May 1;79(9):1717-22. | |
| 1611601 | Result | Ferrell B, Grant M, Schmidt GM, Rhiner M, Whitehead C, Fonbuena P, Forman SJ. The meaning of quality of life for bone marrow transplant survivors. Part 1. The impact of bone marrow transplant on quality of life. Cancer Nurs. 1992 Jun;15(3):153-60. |
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| Sham inspiratory muscle training | Device | Control group received sham inspiratory muscle training using threshold loading device (POWERbreathe Classic IMT Technologies Ltd. Birmingham, England) at fixed workload, 5% of MIP. The control group trained for 30 min-per/day, 7 days/week, for 6 weeks. Six sessions at home and 1 session were performed at department. |
|
| Peripheral muscle strength | Hand held dynamometer | 6 weeks |
| Dyspnea | Modified Borg and Modified Medical Research Council (MMRC) dyspnea scales, | 6 weeks |
| Depression | Montgomery Asberg Depression Rating Scale (MADRS) | 6 weeks |
| Quality of life | European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C-30 version 3.0 (Turkish versions of all scales) | 6 weeks |
| Submaximal exercise capacity | Six-minute walk test (6MWT) | 6 weeks |
| Maximal exercise capacity | Modified incremental shuttle walk test (ISWT) | 6 weeks |
| 16002928 | Result | White AC, Terrin N, Miller KB, Ryan HF. Impaired respiratory and skeletal muscle strength in patients prior to hematopoietic stem-cell transplantation. Chest. 2005 Jul;128(1):145-52. doi: 10.1378/chest.128.1.145. |
| 18264142 | Result | Kovalszki A, Schumaker GL, Klein A, Terrin N, White AC. Reduced respiratory and skeletal muscle strength in survivors of sibling or unrelated donor hematopoietic stem cell transplantation. Bone Marrow Transplant. 2008 Jun;41(11):965-9. doi: 10.1038/bmt.2008.15. Epub 2008 Feb 11. |
| 26135532 | Derived | Bargi G, Guclu MB, Aribas Z, Aki SZ, Sucak GT. Inspiratory muscle training in allogeneic hematopoietic stem cell transplantation recipients: a randomized controlled trial. Support Care Cancer. 2016 Feb;24(2):647-659. doi: 10.1007/s00520-015-2825-3. Epub 2015 Jul 2. |