Factors Influencing Life Space Mobility in Cancer Survivors Following Hematopoietic Stem Cell Transplantation - Physical Function, Depression, Fatigue, Neighborhood Walkability, and Employment Status

Abstract

Background/objective: The level of physical activity in the daily lives of cancer survivors following hematopoietic stem cell transplantation (HSCT) is crucial for maintaining their physical and mental health. Considering that life space mobility (LSM) may limit physical activity, maintaining and expanding LSM is particularly essential for post-HSCT survivors. This study aimed to identify factors influencing LSM in post-HSCT survivors. Methods: Thirty cancer survivors after HSCT (14 women, mean age 52.0 ± 12.3 years, 196e3017 days post-HSCT) were included in this cross-sectional study. The assessment encompassed patient characteristics, employment status, life space (Life Space Assessment; LSA), physical function (handgrip strength, isometric knee extension strength, 5 chair standing test, walking speed), depression (Self-rating Depression Scale; SDS), fatigue (Cancer Fatigue Scale), and neighborhood walkability (Walk Score®). The association between LSA and each factor was compared by correlation analysis. Subsequently, multiple regression analysis was conducted, with LSA as the dependent variable and independent variables being outcome measures exhibiting a significant correlation with LSA. Results: Variables significantly correlated with LSA included SDS (r ¼ ¡0.65, p < .01), employment status (r ¼ ¡0.60, p < .01), handgrip strength (r ¼ 0.43, p ¼ .02), and isometric knee extension strength (r ¼ 0.40, p ¼ .03). Results of multiple regression analysis show that SDS (b ¼ ¡0.53, p < .01), employment status (b ¼ 0.48, p < .01), and isometric knee extension strength (b ¼ 0.27, p ¼ .02) were significantly associated with LSA (R2 ¼ 0.74). Conclusion: Depression, employment status, and isometric knee extension strength were identified as factors related to LSM in post-HSCT survivors.