Exercise capacity and handgrip strength following dumbbell-assisted diaphragmatic breathing training in patients with bronchiolitis obliterans syndrome after allogeneic hematopoietic stem cell transplantation: a prospective single-arm study
- 1Department of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
- 2Department of Respiratory and Critical Care Medicine, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
Abstract
Background: Bronchiolitis obliterans syndrome (BOS) is a severe complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and is associated with impaired exercise capacity. Feasible rehabilitation strategies for this population remain limited.
Objectives: To evaluate changes in functional exercise capacity and handgrip strength following a 12-week dumbbell-assisted diaphragmatic breathing training program in patients with BOS after allo-HSCT and to explore associations of these changes with selected baseline characteristics.
Methods: This prospective, single-center, single-arm pre–post interventional study included 31 patients with BOS after allo-HSCT. Participants completed a 12-week dumbbell-assisted diaphragmatic breathing training program. Six-minute walk distance (6MWD) and bilateral handgrip strength were assessed at baseline and week 12. Within-participant changes were evaluated using paired tests according to the distribution of change scores. Associations with selected baseline characteristics were examined in exploratory analyses.
Results: Following the 12-week intervention, mean 6MWD increased from 406.3 m at baseline to 425.9 m at week 12, corresponding to a mean within-participant increase of 19.6 m (95% CI: 9.3–29.9 m; p < 0.001). Mean bilateral handgrip strength increased from 23.2 kg to 25.0 kg, corresponding to a mean increase of 1.8 kg (95% CI: 1.3–2.3 kg; p < 0.001). The change in 6MWD did not differ significantly between women and men (p = 0.282), whereas the increase in handgrip strength was greater in women than in men (p = 0.021). Baseline heart-rate response during the 6MWT and supplemental oxygen requirement were not clearly associated with the magnitude of functional change. No serious training-related adverse events were observed.
Conclusions: Twelve weeks of dumbbell-assisted diaphragmatic breathing training was associated with improvements in 6MWD and handgrip strength in patients with BOS after allo-HSCT. However, the single-arm design precludes causal attribution of these improvements to the intervention, and the exploratory subgroup findings should be interpreted cautiously. Larger controlled studies are needed to establish efficacy and characterize potential differences in response.
Related
- Membranous obliterans bronchitis after hematopoietic stem cell transplantation: case report.
- Bronchiolitis Obliterans Syndrome After Allogeneic HSCT: Clinical Characteristics and Survival Outcomes in a Single Center Cohort
- Development of a clinical and bronchoalveolar lavage fluid biomarker model for predicting post-infectious bronchiolitis obliterans in hospitalized children
- Early Patient-Reported Outcomes and Graft-Versus-Host Disease as Indicators of Long-Term Quality of Life and Fatigue After Allogeneic Hematopoietic Stem Cell Transplantation: A 24-Month Prospective Study
- Population pharmacokinetics and model-informed precision dosing of busulfan in Chinese pediatric allogeneic hematopoietic stem cell transplantation: a prospective real-world cohort study
BibTeX
@article{yuan2026exercise,
title = {{Exercise capacity and handgrip strength following dumbbell-assisted diaphragmatic breathing training in patients with bronchiolitis obliterans syndrome after allogeneic hematopoietic stem cell transplantation: a prospective single-arm study}},
author = {Xinyu Yuan and Wei Ge and Xiaojie Zhu and Yunxia Chen and Junhong Jiang and Huijun Zhang},
journal = {Frontiers in Medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1948656},
url = {https://doi.org/10.3389/fmed.2026.1948656},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Exercise capacity and handgrip strength following dumbbell-assisted diaphragmatic breathing training in patients with bronchiolitis obliterans syndrome after allogeneic hematopoietic stem cell transplantation: a prospective single-arm study
AU - Xinyu Yuan
AU - Wei Ge
AU - Xiaojie Zhu
AU - Yunxia Chen
AU - Junhong Jiang
AU - Huijun Zhang
PY - 2026
DA - 2026/10/13
JO - Frontiers in Medicine
DO - 10.3389/fmed.2026.1948656
UR - https://doi.org/10.3389/fmed.2026.1948656
AB - Background: Bronchiolitis obliterans syndrome (BOS) is a severe complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and is associated with impaired exercise capacity. Feasible rehabilitation strategies for this population remain limited. Objectives: To evaluate changes in functional exercise capacity and handgrip strength following a 12-week dumbbell-assisted diaphragmatic breathing training program in patients with BOS after allo-HSCT and to explore associations of these changes with selected baseline characteristics. Methods: This prospective, single-center, single-arm pre–post interventional study included 31 patients with BOS after allo-HSCT. Participants completed a 12-week dumbbell-assisted diaphragmatic breathing training program. Six-minute walk distance (6MWD) and bilateral handgrip strength were assessed at baseline and week 12. Within-participant changes were evaluated using paired tests according to the distribution of change scores. Associations with selected baseline characteristics were examined in exploratory analyses. Results: Following the 12-week intervention, mean 6MWD increased from 406.3 m at baseline to 425.9 m at week 12, corresponding to a mean within-participant increase of 19.6 m (95% CI: 9.3–29.9 m; p < 0.001). Mean bilateral handgrip strength increased from 23.2 kg to 25.0 kg, corresponding to a mean increase of 1.8 kg (95% CI: 1.3–2.3 kg; p < 0.001). The change in 6MWD did not differ significantly between women and men (p = 0.282), whereas the increase in handgrip strength was greater in women than in men (p = 0.021). Baseline heart-rate response during the 6MWT and supplemental oxygen requirement were not clearly associated with the magnitude of functional change. No serious training-related adverse events were observed. Conclusions: Twelve weeks of dumbbell-assisted diaphragmatic breathing training was associated with improvements in 6MWD and handgrip strength in patients with BOS after allo-HSCT. However, the single-arm design precludes causal attribution of these improvements to the intervention, and the exploratory subgroup findings should be interpreted cautiously. Larger controlled studies are needed to establish efficacy and characterize potential differences in response.
SN - 2296-858X
ER -