Changes in Borg scale for resistance training and test of exercise tolerance in patients undergoing allogeneic hematopoietic stem cell transplantation

  • Shinichiro Morishita
  • Tatsushi Wakasugi
  • Takashi Tanaka
  • Tetsuya Harada
  • Katsuji Kaida
  • Kazuhiro Ikegame
  • Hiroyasu Ogawa
  • Kazuhisa Domen
Original Article

Abstract

Purpose

We aimed to investigate the relationship between Borg scale and intensity of resistance training in patients who had undergone allogeneic hematopoietic stem cell transplantation (allo-HSCT). Furthermore, the relationship between Borg scale, heart rate (HR), and intensity of exercise tolerance test was also studied.

Methods

The study included 28 patients (19 men and 9 women) who had undergone allo-HSCT between June 2015 and February 2017. Their knee extension strengths and exercise tolerances were evaluated. Patients were asked to grade between 0 and 10 on Borg scale based on the level of difficulty experienced during exercising, after 10 repetitions in randomized 20, 40, and 60% resistance training for knee extension. Additionally, we evaluated Borg scale, HR, and load intensity during exercise tolerance test, every minute of the exercise for 2 weeks before and 3 weeks after HSCT.

Results

Knee extension strength and exercise tolerance were significantly decreased 3 weeks after HSCT from those before HSCT (p < 0.01). Additionally, rise in Borg scale with increase in load intensity during knee extension resistance training, both before and after HSCT (p < 0.01), was noted. Furthermore, Borg scale was found to be associated with HR and load intensity during exercise tolerance test in patients both before and after HSCT (p < 0.01).

Conclusions

A correlation was found between Borg scale with intensity of resistance training and exercise tolerance in patients who had undergone allo-HSCT. Therefore, Borg scale could be useful to determine the intensity of physical exercise in patients who have undergone allo-HSCT.

Keywords

Cancer Rehabilitation Resistance training Exercise tolerance Borg scale Hematopoietic stem cell transplantation 

Notes

Acknowledgments

The authors are grateful to the study participants and physical therapists in the Rehabilitation Department and physicians in the Division of Hematology of the Hyogo College of Medicine Hospital. This study was partly supported by a Grant-in-Aid for Young Scientists (B) and the Japan Society for the Promotion of Science (KAKENHI 15K20719).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Disclosure statement

The authors have no disclosures.

References

  1. 1.
    Copelan EA (2006) Hematopoietic stem-cell transplantation. N Engl J Med 354:1813–1826CrossRefPubMedGoogle Scholar
  2. 2.
    Gyurkocza B, Rezvani A, Storb RF (2010) Allogeneic hematopoietic cell transplantation: the state of the art. Expert Rev Hematol 3:285–299CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Morishita S, Kaida K, Yamauchi S, Wakasugi T, Yoshihara S, Taniguchi K, Ishii S, Ikegame K, Kodama N, Ogawa H, Domen K (2013) Gender differences in health-related quality of life, physical function and psychological status among patients in the early phase following allogeneic haematopoietic stem cell transplantation. Psychooncology 22:1159–1166CrossRefPubMedGoogle Scholar
  4. 4.
    Wiskemann J, Kleindienst N, Kuehl R, Dreger P, Schwerdtfeger R, Bohus M (2015) Effects of physical exercise on survival after allogeneic stem cell transplantation. Int J Cancer 137:2749–2756CrossRefPubMedGoogle Scholar
  5. 5.
    Morishita S, Kaida K, Setogawa K, Kajihara K, Ishii S, Ikegame K, Kodama N, Ogawa H, Domen K (2013) Safety and feasibility of physical therapy in cytopenic patients during allogeneic haematopoietic stem cell transplantation. Eur J Cancer Care (Engl). 22:289–299CrossRefGoogle Scholar
  6. 6.
    Kuehl R, Schmidt ME, Dreger P, Steindorf K, Bohus M, Wiskemann J (2016) Determinants of exercise adherence and contamination in a randomized controlled trial in cancer patients during and after allogeneic HCT. Support Care Cancer 24:4327–4337CrossRefPubMedGoogle Scholar
  7. 7.
    Tanaka H, Monahan KD, Seals DR (2001) Age-predicted maximal heart rate revisited. J Am Coll Cardiol 37:153–156CrossRefPubMedGoogle Scholar
  8. 8.
    Jenkins ND, Housh TJ, Buckner SL et al (2016) Neuromuscular adaptations after 2 and 4 weeks of 80% versus 30% 1 repetition maximum resistance training to failure. J Strength Cond Res 30:2174–2185CrossRefPubMedGoogle Scholar
  9. 9.
    Dimeo FC, Thomas F, Raabe-Menssen C, Pröpper F, Mathias M (2004) Effect of aerobic exercise and relaxation training on fatigue and physical performance of cancer patients after surgery. A randomised controlled trial. Support Care Cancer 12:774–779CrossRefPubMedGoogle Scholar
  10. 10.
    Borg GA (1982) Psychophysical bases of perceived exertion. Med Sci Sports Exerc 14:377-381Google Scholar
  11. 11.
    Borg G, Hassmén P, Lagerström M (1987) Perceived exertion related to heart rate and blood lactate during arm and leg exercise. Eur J Appl Physiol Occup Physiol 56:679–685CrossRefPubMedGoogle Scholar
  12. 12.
    Álvarez C, Ramírez-Campillo R, Ramírez-Vélez R, Martínez C, Castro-Sepúlveda M, Alonso-Martínez A, Izquierdo M (2018) Metabolic effects of resistance or high-intensity interval training among glycemic control-nonresponsive children with insulin resistance. Int J Obes (Lond) 42:79–87CrossRefGoogle Scholar
  13. 13.
    Buckley JP, Borg GA (2011) Borg’s scales in strength training; from theory to practice in young and older adults. Appl Physiol Nutr Metab 36:682–692CrossRefPubMedGoogle Scholar
  14. 14.
    Myers J, Bellin D (2000) Ramp exercise protocols for clinical and cardiopulmonary exercise testing. Sports Med 30:23–29CrossRefPubMedGoogle Scholar
  15. 15.
    Okada M, Fujimori Y, Misawa M, Kai S, Nakajima T, Okikawa Y, Satake A, Itoi H, Takatsuka H, Itsukuma T, Nishioka K, Tamaki H, Ikegame K, Hara H, Ogawa H (2008) Unrelated umbilical cord blood transplantation using a TBI/FLAG conditioning regimen for adults with hematologic malignancies. Biol Blood Marrow Transplant 14:896–903CrossRefPubMedGoogle Scholar
  16. 16.
    Ogawa H, Ikegame K, Yoshihara S, Kawakami M, Fujioka T, Masuda T, Taniguchi Y, Hasei H, Kaida K, Inoue T, Kim EH, Kawase I (2006) Unmanipulated HLA 2-3 antigen-mismatched (haploidentical) stem cell transplantation using nonmyeloablative conditioning. Biol Blood Marrow Transplant 12:1073–1084CrossRefPubMedGoogle Scholar
  17. 17.
    Ogawa H, Ikegame K, Kaida K, Yoshihara S, Fujioka T, Taniguchi Y, Tamaki H, Inoue T, Hasei H, Iiboshi Y, Tazuke Y, Kawakami M, Kim EH, Soma T, Inoue T, Kawase I (2008) Unmanipulated HLA 2-3 antigen-mismatched (haploidentical) bone marrow transplantation using only pharmacological GVHD prophylaxis. Exp Hematol 36:1–8CrossRefPubMedGoogle Scholar
  18. 18.
    van de Port IG, Kwakkel G, Wittink H (2015) Systematic review of cardiopulmonary exercise testing post stroke: are we adhering to practice recommendations? J Rehabil Med 47:881–900CrossRefPubMedGoogle Scholar
  19. 19.
    Jacquinot Q, Meneveau N, Chatot M, Bonnetain F, Degano B, Bouhaddi M, Dumoulin G, Vernerey D, Pivot X, Mougin F (2017) A phase 2 randomized trial to evaluate the impact of a supervised exercise program on cardiotoxicity at 3 months in patients with HER2 overexpressing breast cancer undergoing adjuvant treatment by trastuzumab: design of the CARDAPAC study. BMC Cancer 17:425CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Diaz O, Villafranca C, Ghezzo H, Borzone G, Leiva A, Milic-Emil J, Lisboa C (2000) Role of inspiratory capacity on exercise tolerance in COPD patients with and without tidal expiratory flow limitation at rest. Eur Respir J 16:269–275CrossRefPubMedGoogle Scholar
  21. 21.
    Caraccio N, Natali A, Sironi A, Baldi S, Frascerra S, Dardano A, Monzani F, Ferrannini E (2005) Muscle metabolism and exercise tolerance in subclinical hypothyroidism: a controlled trial of levothyroxine. J Clin Endocrinol Metab 90:4057–4062CrossRefPubMedGoogle Scholar
  22. 22.
    Marcora SM, Staiano W (2010) The limit to exercise tolerance in humans: mind over muscle? Eur J Appl Physiol 109:763–770CrossRefPubMedGoogle Scholar
  23. 23.
    Wiskemann J, Dreger P, Schwerdtfeger R, Bondong A, Huber G, Kleindienst N, Ulrich CM, Bohus M (2011) Effects of a partly self-administered exercise program before, during, and after allogeneic stem cell transplantation. Blood 117:2604–2613CrossRefPubMedGoogle Scholar
  24. 24.
    Teodozio CGC, Chaves GV, Arcuri IP, Frajacomo FT (2018) Does grip strength decrease in the very early stages of hematological treatment? Support Care Cancer 26:333–335CrossRefPubMedGoogle Scholar
  25. 25.
    Takekiyo T, Dozono K, Mitsuishi T, Murayama Y, Maeda A, Nakano N, Kubota A, Tokunaga M, Takeuchi S, Takatsuka Y, Utsunomiya A (2015) Effect of exercise therapy on muscle mass and physical functioning in patients undergoing allogeneic hematopoietic stem cell transplantation. Support Care Cancer 23:985–992CrossRefPubMedGoogle Scholar
  26. 26.
    Morishita S, Kaida K, Yamauchi S, Wakasugi T, Ikegame K, Ogawa H, Domen K (2017) Relationship of physical activity with physical function and health-related quality of life in patients having undergone allogeneic haematopoietic stem-cell transplantation. Eur J Cancer Care (Engl) 26.  https://doi.org/10.1111/ecc.12669
  27. 27.
    Pincivero DM (2011) Older adults underestimate RPE and knee extensor torque as compared with young adults. Med Sci Sports Exerc 43:171–180CrossRefPubMedGoogle Scholar
  28. 28.
    Pincivero DM, Coelho AJ, Campy RM (2003) Perceived exertion and maximal quadriceps femoris muscle strength during dynamic knee extension exercise in young adult males and females. Eur J Appl Physiol 89:150–156CrossRefPubMedGoogle Scholar
  29. 29.
    Tiggemann CL, Korzenowski AL, Brentano MA, Tartaruga MP, Alberton CL, Kruel LF (2010) Perceived exertion in different strength exercise loads in sedentary, active, and trained adults. J Strength Cond Res. 24:2032–2041CrossRefPubMedGoogle Scholar
  30. 30.
    Morishita S, Kaida K, Ikegame K, Yoshihara S, Taniguchi K, Okada M, Kodama N, Ogawa H, Domen K (2012) Impaired physiological function and health-related QOL in patients before hematopoietic stem-cell transplantation. Support Care Cancer 20:821–829CrossRefPubMedGoogle Scholar
  31. 31.
    Morishita S, Kaida K, Yamauchi S, Sota K, Ishii S, Ikegame K, Kodama N, Ogawa H, Domen K (2013) Relationship between corticosteroid dose and declines in physical function among allogeneic hematopoietic stem cell transplantation patients. Support Care Cancer 21:2161–2169CrossRefPubMedGoogle Scholar
  32. 32.
    Noble BJ, Borg GA, Jacobs I, Ceci R, Kaiser P (1983) A category-ratio perceived exertion scale: relationship to blood and muscle lactates and heart rate. Med Sci Sports Exerc 15:523-528Google Scholar
  33. 33.
    Borg G, Ljunggren G, Ceci R (1985) The increase of perceived exertion, aches and pain in the legs, heart rate and blood lactate during exercise on a bicycle ergometer. Eur J Appl Physiol Occup Physiol 54:343–349CrossRefPubMedGoogle Scholar
  34. 34.
    Mukaka MM (2012) Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J 24:69–71PubMedPubMedCentralGoogle Scholar
  35. 35.
    Ishida S, Doki N, Shingai N, Yoshioka K, Kakihana K, Sakamaki H, Ohashi K (2016) The clinical features of fatal cyclophosphamide-induced cardiotoxicity in a conditioning regimen for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Ann Hematol 95:1145–1150CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Shinichiro Morishita
    • 1
    • 2
  • Tatsushi Wakasugi
    • 3
  • Takashi Tanaka
    • 3
  • Tetsuya Harada
    • 3
  • Katsuji Kaida
    • 4
  • Kazuhiro Ikegame
    • 4
  • Hiroyasu Ogawa
    • 4
  • Kazuhisa Domen
    • 2
  1. 1.Institute for Human Movement and Medical SciencesNiigata University of Health and WelfareNiigataJapan
  2. 2.Department of Physical Medicine and RehabilitationHyogo College of MedicineNishinomiyaJapan
  3. 3.Department of RehabilitationHyogo College of Medicine HospitalNishinomiyaJapan
  4. 4.Division of Hematology, Department of Internal MedicineHyogo College of MedicineNishinomiyaJapan

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