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Gender differences in physical function and muscle mass change in patients undergoing allogeneic hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 52, pages 1460–1462 (2017)Cite this article

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Rehabilitation for patients who have undergone hematopoietic stem cell transplantation (HSCT) is recommended to prevent muscle weakness, reduced flexibility, and cardiorespiratory dysfunction.1 The effectiveness of exercise therapy has been reported in many previous studies,2, 3, 4 and in some studies, gender differences in physical function and quality of life (QOL) have been reported. Holzne et al.5 reported that women have lower global QOL than men. Cohen et al.6 reported that men have less fatigue than women. In contrast, Morishita et al.7 reported that there were no gender differences in the decline of physical function in the early phase after allogeneic HSCT (allo-HSCT). Thus, previous reports on gender differences in physical function and QOL have been evaluated, but these studies did not evaluate the change of physical function between genders. The aim of this retrospective study was to evaluate gender differences in physical function and muscle mass change in allo-HSCT patients at the time of discharge from the hospital.

This is a retrospective study that investigated gender differences in physical function and muscle mass change. We analyzed 125 patients who had undergone first allo-HSCT at our hospital and evaluated them for the physical function test before allo-HSCT between February 2010 and May 2015. In our hospital, all HSCT patients received one-on-one exercise therapy from physical therapists for 20−40 min/day, 5−6 days/week for 2 weeks before HSCT and until the patient was discharged from the hospital. It included stretching, resistance training and walking training. In the case of nausea and fatigue the intensity of exercise was reduced. Adherence to exercise therapy was defined as the percentage of the days when more than 20 min of exercise was completed on the planned exercise days. The details of the exercise intervention program are provided in our previous report.4 An adjustable handle dynamometer (TKK 5101; TAKEI Scientific Instruments Co. Ltd., Niigata, Japan) was used to measure the handgrip strength of the patient in a standing position with shoulders at approximately 30° of abduction. We measured right- and left-side handgrip strengths twice each, counting only the higher value for each side, and averaged both sides to produce the handgrip strength index. The 6-min walk test (6MWT) was conducted in accordance with the American Thoracic Society guidelines.8 The 6MWT was carried out in a straight corridor (25 m). As clinical factors, the levels of serum albumin, total protein (TP), and hemoglobin and the doses of the administered steroids were determined. These blood data were obtained from the patients’ medical records at the time of the physical function tests. The total cumulative steroid dose was expressed as mg prednisolone/kg (1 mg methylprednisolone=1.25 mg prednisolone and 1 mg hydrocortisone=0.25 mg prednisolone). Acute GvHD was graded according to the consensus grading scale.9 The Imamura Bun-in Hospital ethical committees approved this study.

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Acknowledgements

We are grateful to the study participants, the physical therapists in the rehabilitation department and the physicians in Hematology and Rehabilitation Medicine at Imamura Bun-in Hospital.

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Authors and Affiliations

  1. Department of Rehabilitation, Imamura Bun-in Hospital, Kagoshima, Japan

    T Takekiyo, Y Murayama & N Minamihama

  2. Department of Rehabilitation Medicine, Imamura Bun-in Hospital, Kagoshima, Japan,

    K Dozono & S Nara

  3. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan

    N Nakano, A Kubota, M Tokunaga, T Miyazono, S Takeuchi, Y Takatsuka & A Utsunomiya

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  1. T Takekiyo
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Correspondence to T Takekiyo.

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Takekiyo, T., Dozono, K., Nara, S. et al. Gender differences in physical function and muscle mass change in patients undergoing allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 52, 1460–1462 (2017). https://doi.org/10.1038/bmt.2017.156

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