Exercise in allogeneic bone marrow transplantation: a qualitative representation of the patient perspective

• Published in: Supportive care in cancer Vol. 30; no. 6; pp. 5389 - 5399
• Main Authors: Abo, Shaza, Parry, Selina M., Ritchie, David, Sgro, Gabriella, Truong, Dominic, Denehy, Linda, Granger, Catherine L.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-06-2022; Springer; Springer Nature B.V
• Subjects: Adult; Bone marrow; Bone Marrow Transplantation; Content analysis; Exercise; Exercise - psychology; Exercise Therapy - methods; Health behavior; Health psychology; Hematopoietic Stem Cell Transplantation; Humans; Medicine; Medicine & Public Health; Motivation; Nursing; Nursing Research; Oncology; Original; Original Article; Pain Medicine; Qualitative Research; Rehabilitation Medicine; Stem cell transplantation; Survivor; Transplantation; Stem cell transplantation; Exercise; Survivorship; Allogeneic bone marrow transplantation; Patient experience; Quality of life
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-022-06931-9

Purpose
Exercise is emerging as a vital aspect of care to alleviate the physical and psychosocial symptom burden associated with allogeneic bone marrow transplantation (BMT). Understanding the patient perspective regarding exercise is important to move towards implementation. This study aimed to characterise experiences and views regarding participation in an exercise program in adults receiving treatment for haematological disease with allogeneic BMT.
Methods
Individual semi-structured interviews were conducted with 35 participants from either an early- or late-commencing supervised group-based exercise program. Using an inductive, conventional approach to qualitative content analysis data were independently analysed by two researchers.
Results
Six major themes and 33 sub-themes were identified: this encompassed motivation, physical opportunity and capability to exercise; psychosocial effects of group-based exercise; experienced impact of participation in an exercise program; and intervention design considerations. Key barriers to exercise included symptom severity and fluctuating health and distance or difficult access to an exercise facility or equipment, whilst facilitators included encouragement from staff; peer support in the group-based setting; flexibility; education; and ability to measure change.
Conclusion
This study highlights the importance of a flexible approach to exercise with consideration of individual symptoms and preferences. The perceived psychological impact of exercise should not be underestimated; future exercise programs should be designed in partnership with patients, with consideration of group-based activities to reduce social isolation if this is feasible in the treatment context. Intervention design should also acknowledge the individual’s physical and psychological capability, opportunity and automatic and reflective motivation to direct and sustain exercise behaviours following BMT.