Exercise & Nutrition consideration when going for HSCT (Hematopoietic Stem Cell Transplant).

This article aims to discuss the benefits of exercise and a well structured nutrition plan in order to promote sucessful recovery. We'll look at how to increase strength, balance and general wellbeing leading up to and after treatment. We'll also look at the best approaches when it comes to exercise in order to maximise recovery and maintain general wellbeing.

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dom thorpe - health & fitness expert for people with disabilities & chronic illnesses 

Working in my field has meant that I've had to prescribe exercise regimes for a number of people who are recovering from HSCT (Hematopoietic stem cell transplant). Unsurprisingly this raises many complications, however the majority of these are issues which I'm dealing with on a daily basis. In many ways the approach is similar to the aproach I use with my clients who have chronic illnesses.

The first question people ask is "is it ok/safe to exercise post treatment?". In most cases the answer is "yes" however each case needs to be invididually assessed.

The evidence based research regarding exercise for blood cancer patients, who represent the vast majority of stem cell treatment cases, is promising and has been looked into for some time now. The general consensus is that exercise is a good way to manage recovery and will benefit the individual long term. The evidence which focuses specifically on Multiple Sclerosis is not so established. This is due to smaller volumes of people having this treatment and the length of time since it has become more prevalent.

When data is minimal we tend to see recommendations from the medical professionals using logic & experieince to establish sensible guidelines.

Exercise

Every individual has a different experience when embarking on their HSCT journey and the state in which people leave the treatment centres can vary massively.

One person may come away feeling great with their bloods in order and be ready for exercise, whereas the next person may come away feeling incredibly fatigued and still have some time to go before their bloods are back to where they need to be.

Specificity

Consequently we can't just distribute generic exercise regimes for everybody to pick up as soon as they leave the treatment centres. Careful consideration needs to take place to ensure that the regime in question is specific to the individual. The programme must also be delivered at the correct pace and intensity. This is essential to maximise the potential of the individual, without pushing them too hard, too fast.

We must also consider the goals of the individual beyond simple "recovery". Are there things they want to acheive or acitivites that they want to prepare for? Are they simply training for recovery, or are they hoping to get back to the slopes for their next skiing trip?

Exercise history will aslo factor into the equation. A regime for someone who has previously been very active when it comes to exercise will differ from one designed for a "newby".

The data

Before we delve any deeper into to the benefits and best approaches it's important to look at the research behind these recommendations rather than just focusing on anecdotal evidence from my experieinces working with these patients. It's fair to say that the research into the type of exercise and the type of nutriton is fairly limited, and specifics will differ depending on where you go for treatment. My aim is to find common themes among these guidelines and present them in a way which gives the reader enough balanced and unbiased information to exercise with confidence.

The evidence based research regarding exercise for blood cancer patients, who represent the vast majority of stem cell treatment cases, is promising and has been looked into for some time now. The general consensus is that exercise is a good way to manage recovery and will benefit the individual long term. The evidence which focuses specifically on Multiple Sclerosis is not so established due to smaller volumes of people having this treatment.

When data is minimal we tend to see recommendations from the medical professionals using logic combined with their knowledge of the way in which the body works to establish sensible guidelines.

What's the best approach for exercise post HSCT?

First of all, you shouldn't expect to be able to simply pick up where you left off prior to treatment. By far the safst approach is to start off with something incredibly light and to monitor how your body responds.

As with any exercise regime, the goal should be to progressively increase the workload over time. If you carry out a workout and you feel good it may be time to increase the workload slightly. An incremental, step by step approach is less likely to cause any injury or harm to your body than jumping in at the deep end and pushing yourself to the limit.

As I mentioned previously, the regime will vary depending on your goals but a sensible approach is the cover the 4 most important aspects of fitness which are:

  • strength
  • cardiovascular fitness
  • flexibility
  • function/mobility
Strength

The strength component of your exercise is important for multiple reasons. Firstly, it's likely you will have lost muscle mass throughout the treatment and strength training is the best way to rebuild this lost tissue. Secondly, strength training is proven to encourage an effectively functioning immune system, which is imperative post HSCT. Thirdly, the strength aspect of a training regime is the best way to strengthen not just your muscles, but bones, ligaments, tendons and if done correctly, the cardiovascular system.

 

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