Development of an Evidence-Based Exercise Program for Patients Undergoing Hematopoietic Stem Cell Transplantation

PURPOSE Although the efficacy of different exercise programs on different outcomes of hematopoietic stem cell transplantation (HSCT) patients have been examined, the details of process of exercise program development has not been described previously. In this study, we described the systematic development process of an evidence-based exercise program for HSCT patients. METHODS We developed the exercise program for HSCT patients using eight steps: (1) a literature review, (2) understanding patient characteristics, (3) first expert group discussion, (4) development of the first draft of the exercise program, (5) a pre-test, (6) second expert group discussion, (7) a pilot study, and (8) a focus group interview. RESULTS Through six systematic steps, tailored exercise program was developed based on patients’ physical and hospital room conditions, which varies in intensity (three different intensities) and exercise positions (supine, sitting, and standing). Then, a pilot randomized trial was conducted on 21 patients with HSCT patients. The adherence rate to exercise program was 44.7% and significantly better timed up and go and symptom scale were seen in the exercise group compared than those of control group. Through the last step, three barriers and four facilitators of exercise during HSCT were identified. CONCLUSION A safe and feasible tailored unsupervised exercise program for patients during HSCT was developed and tested. In the future, the efficacy of the exercise program should be tested with RCT with implementation strategies to reduce exercise barriers and maximize facilitators of exercise identified in the current study.