Home-based, telehealth, and hybrid exercise interventions for adults undergoing or recovering from hematopoietic stem cell transplantation: a systematic review of randomized controlled trials.
Manar Eid, Haytham Alkerdasy, Maha Metwally and 2 others
PMID 42245618WHAT IT FOUND
Home, telehealth and hybrid exercise for adults having a stem cell transplant appeared feasible and generally safe, with adherence often above 80%.
Walking capacity improved most consistently; effects on fatigue, quality of life and muscle strength were mixed across just seven small trials.
Key findings
01Physical capacity, measured mainly by walking distance and peak oxygen uptake, was the outcome where exercise showed the most consistent positive signal. One trial found significant improvement in 6-minute walk distance, while another found no significant difference in peak oxygen uptake or walking distance and was limited by a small evaluable sample.
02Adherence was generally high, often above 80%, and exercise-related serious adverse events were rare, which the authors read as support for feasibility and tolerability when monitoring and individual adaptation are in place.
03Muscle strength findings were less consistent than functional capacity: one trial found no significant difference in handgrip strength despite improvements in functional capacity, and the authors suggest hospitalisation and treatment burden may partly explain this.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only seven trials were included and several were pilot or feasibility studies with small samples, so the review is not able to show whether these programmes actually work. The trials differed too much in transplant type, timing, exercise content, supervision and outcomes to combine statistically, so the conclusions rest on comparing separate small studies by eye. Two trials were at high risk of bias and four had some concerns, mostly about how patients were allocated, missing outcome data and reporting. Most programmes were multimodal, so any benefit cannot be attributed to exercise alone. Publication bias could not be assessed because fewer than 10 studies were included. Only English-language publications were included and grey literature was excluded, which may have skewed which studies were found.
Declared interests
The authors declared that financial support was received for the work and its publication. One author was funded by the Ministry of Health, Czech Republic (research organisation development, FNBr 65269705) and by Ministry of Health grant NU23-09-00048. The authors state the funders had no role in the design of the study, data collection, analysis or interpretation, writing the manuscript, or the decision to submit it.
The easy way to misread this
Do not read this review as proof that home or telehealth exercise works after a stem cell transplant. No results were pooled, several included trials were small feasibility studies, two were at high risk of bias, and only physical capacity showed a consistent signal. The message is that these programmes are workable and safe to offer, not that they are proven to improve fatigue, strength or quality of life.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →