How we're helping stem cell transplant patients stay active

After receiving a stem cell transplant, Judy Waxman faced a long road to recovery. She knew she would have to rely on her inner strength to stay motivated. But it was a small incentive she found through our inpatient stem cell transplant program that made the biggest difference during her hospitalization.

Colorful bandanas and strips of paper from an incentive-based mobility initiative called the Motivated and Moving Program kept Waxman encouraged.

The Motivated and Moving Program encourages patients to engage in physical activity and structured exercise three times a day by using an incentive-based model that uses stars, flags and other indicators to mark patients' progress. The program has become a catalyst for combating cancer-related fatigue and accelerating positive outcomes.

"No matter how tired I was, the Motivated and Moving Program was a reminder to want to improve each day," Judy says. "It created a positive environment that lifted my spirits and helped me focus on my health by challenging me to get out of my hospital room to exercise daily."

How the program keeps patients motivated and moving
Before beginning any physical activity, patients participating in the program obtain a colored piece of paper called a marker from a unit staff member. After finishing the activity, the patients document on the marker the time they just spent outside the room. The markers are then placed on the patients' doors.
Each marker equals one point. For every 15 markers collected, patients are awarded a color-coded pennant to display, along with a bandana.

"It became a competition to meet my daily goals and receive those incentives," explains Judy, who earned three bandanas and numerous markers.

"Everyone on the unit cheered me on, and the confidence that brought made all the difference in being discharged earlier than expected."

Incorporating other forms of exercise
Another benefit of the Motivated and Moving Program is its flexibility. Patients who are bored with walking or believe they have an increased endurance level can participate in other activities such as yoga or riding stationary exercise bikes. The inpatient stem cell transplant unit includes a gym where a structured exercise class is available to patients who have physicians' orders. The class is conducted by physical and occupational therapists and includes stretching, resistance and muscle-strengthening activities.

"Because the program is self-initiated, patients get to move at their own pace, whether that's participating in a 60-minute exercise class or taking a short walk in the hall," says Kelly Brassil, Ph.D., associate director of Nursing Programs. "It's fascinating to see these patients regaining their health and inspiring each other along the way."

Helping patients recover faster
Walking our corridors is a common exercise for many patients. And our research has found that the program's benefits for patients who have lengthier hospital stays are significant.

The multidisciplinary team recently collaborated on a study to examine the impact of program participation on fatigue, performance ability and quality of life in patients who were hospitalized to undergo allogeneic stem cell transplants.

"The study showed that it's helping participants recover faster and heal physically and emotionally," says Roxy Blackburn, associate director on the stem cell transplant unit. "And patients who accrued higher numbers of activity points were discharged earlier than those who had earned fewer points."

Judy says she's living proof.

"The program had such a positive impact on me that my daughter asked her company to donate 1,000 bandanas," Judy adds. "Now even more patients can be motivated to move."

Those bandanas will be put to good use later this year, when the Motivated and Moving
Program expands to serve patients on the lymphoma unit.

A longer version of this blog post originally appeared in Messenger, MD Anderson's bimonthly publication for employees.