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Inspiratory muscle training in addition to conventional physical rehabilitation in hospitalized patients undergoing hematopoietic stem cell transplantation: a randomized controlled trial

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Abstract

Purpose

To investigate the effect of inspiratory muscle training (IMT) in addition to conventional physical rehabilitation on muscle strength, functional capacity, mobility, hemodynamics, fatigue, and quality of life in hospitalized patients undergoing hematopoietic stem cell transplantation (HSCT).

Methods

We conducted a randomized controlled trial in 57 inpatients with hematological diseases undergoing HSCT. Conventional inpatient physical rehabilitation was delivered to the IMT (n = 27) and control (CON; n = 30) groups according to usual care, and the first group additionally performed IMT. The IMT was prescribed according to clinical and laboratory parameters at 40% of maximal inspiratory pressure (MIP), 5 days/week throughout the hospitalization, in sessions of 10–20 min. The primary outcome was MIP and the secondary outcomes were maximal expiratory pressure (MEP), peripheral muscle strength (handgrip and sit-to-stand tests), functional capacity (6-min step test), mobility (timed up and go test), blood pressure, quality of life (EORTC-QLQ-C30), and fatigue (FACT-F) at admission and hospital discharge.

Results

The population was predominately autologous HSCT. The IMT group significantly increased the MIP (P < 0.01) and decreased both fatigue (P = 0.01) and blood pressure (P < 0.01) compared with control. No differences were found between admission and hospital discharge in peripheral and expiratory muscle strength, functional capacity, mobility, and quality of life in both groups (P > 0.05).

Conclusions

Our results support the effectiveness of IMT as part of rehabilitation for HSCT inpatients, improving inspiratory muscle strength, and reducing fatigue and blood pressure.

Trial registration

NCT03373526 (clinicaltrials.gov).

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Data availability

All data and materials are available.

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Acknowledgements

The authors would like to thank the BMT team for their assistance.

Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001, the Research Support Foundation of the State of Minas Gerais – FAPEMIG (APQ-00435–18, recipient DGM; APQ-02877–18, recipient MCL), and the Brazilian Council for the Scientific and Technological Development – CNPq (425702/2018–9, recipient DGM; 313152/2020–9, recipient MUPBR).

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Authors and Affiliations

  1. Cardiovascular Research Unit and Exercise Physiology, Federal University of Juiz de Fora, José Lourenço Kelmer, s/n, Martelos, Juiz de Fora, 36036-900, Brazil

    Leonardo Barbosa Almeida, Mateus Camaroti Laterza, Patricia Fernandes Trevizan & Daniel Godoy Martinez

  2. School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil

    Maria Urbana Pinto Brandão Rondon

  3. Hospital Israelita Albert Einstein, São Paulo, Brazil

    Luciana Diniz Nagem Janot de Matos

  4. Department of Physiotherapy, University of Melbourne, Melbourne, Australia

    Catherine L. Granger & Linda Denehy

  5. Postgraduate Research Program On Rehabilitation Sciences and Physical Function Performance, Federal University of Juiz de Fora, Juiz de Fora, Brazil

    Cristino Carneiro Oliveira

Authors
  1. Leonardo Barbosa Almeida
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  2. Mateus Camaroti Laterza
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  3. Maria Urbana Pinto Brandão Rondon
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  8. Patricia Fernandes Trevizan
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  9. Daniel Godoy Martinez
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by LBA and DGM. The first draft of the manuscript was written by LBA and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Leonardo Barbosa Almeida.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (University Hospital of Federal University of Juiz de Fora, Brazil – 2.354.808) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Almeida, L.B., Laterza, M.C., Rondon, M.U.P.B. et al. Inspiratory muscle training in addition to conventional physical rehabilitation in hospitalized patients undergoing hematopoietic stem cell transplantation: a randomized controlled trial. Support Care Cancer 30, 9393–9402 (2022). https://doi.org/10.1007/s00520-022-07373-z

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