Stem Cell Transplant Patients' Activity Decline, Outpatient Resumption, and Intervention Effectiveness Identified by...

We compared 16-wk wearable activity monitor trajectories of patients receiving hematopoietic stem cell transplants (SCT) engaged in an activity intervention trial.

Forty adults with hematological malignancy scheduled to undergo SCT were randomized to an exercise and sedentary behavior intervention (INT; n = 22) or usual care ( n = 19). Participants were observed continuously for the duration of inpatient hospitalization for SCT (approximately 4 wk) and outpatient (12 wk) care. Between-group differences were determined by 16-wk trajectories of Fitbit-derived variables of physical activity and sedentary time (ST).

Inpatient hospitalization for SCT led to higher levels of ST and lower levels of physical activity in both groups relative to preadmission. Across the ~16-wk period, the INT group had significantly higher physical activity and lower ST. During the 16-wk study period and independent of INT group assignment, a higher prehospitalization cardiorespiratory fitness was associated with higher levels of moderate-to-vigorous intensity physical activity; being female had stronger associations with step counts; older age and myeloablative SCT were associated with higher ST; and higher proportions of lean mass were associated with higher levels of light-intensity physical activity.

Wearable activity monitors can continuously assess the behavioral impacts of SCT and the efficacy of activity INT in patients receiving hospital treatment for hematological malignancy. Tracker data showed that the activity INT protected against declines in physical activity and increases in ST with usual hospital care in SCT. Higher prehospitalization cardiorespiratory fitness and proportion of lean mass were associated with preservation and recuperation of activity levels.