Prehabilitation to improve function after autologous stem cell transplantation: A pilot randomized controlled trial...

Exercise and nutrition interventions are not part of routine care for those undergoing autologous stem cell transplant (autoSCT). We aimed to explore estimates of effect, safety and feasibility of multidisciplinary prehabilitation for improving physical capacity after autoSCT.

This single-blinded, parallel, two-armed pilot randomized trial included adults receiving autoSCT. Participants were randomized to twice-weekly, supervised, tailored exercise and fortnightly telephone-based nutrition education, for up to 8-weeks prior to autoSCT (n = 11) or usual care (n = 11). Blinded assessments occurred at baseline (T0), pre-transplant (T1), and 4-weeks post-transplant (T2). The primary outcome was physical capacity (6-min walk test). Secondary measures included recruitment rate, adverse events, exercise adherence, physical status, nutritional status, health-related quality of life, and health service outcomes.

Positive estimates of effect for walking capacity in favour of the experimental group were demonstrated at T2 (MD + 141 m, 95% CI 24 to 257 m). There was high recruitment (81%) and adherence and no major adverse events. At T2 there were large estimates of effect favoring the experimental group for higher bodyweight, and less dyspnea and gastrointenstinal symptoms. There were no between-group differences in other outcomes.

Prehabilitation is safe, feasible and may improve walking capacity after autoSCT. Findings support a future fully-scaled trial of prehabilitation for autoSCT.

Australian New Zealand Clinical Trials Registry ACTRN12620000496910. Registered April 20, 2020.