An Individualized Exercise Intervention for People with Multiple Myeloma—Study Protocol of a Randomized Waitlist-Controlled Trial

Abstract

People with multiple myeloma (MM) are second only to people with lung cancer for the poorest reported health-related quality of life (HRQoL) of all cancer types. Whether exercise can improve HRQoL in MM, where bone pain and lesions are common, requires investigation. This trial aims to evaluate the efficacy of an exercise intervention compared with control on HRQoL in people with MM. Following baseline testing, people with MM (n = 60) will be randomized to an exercise (EX) or waitlist control (WT) group. EX will complete 12-weeks of supervised (24 sessions) and unsupervised (12 sessions) individualized, modular multimodal exercise training. From weeks 12–52, EX continue unsupervised training thrice weekly, with one optional supervised group-based session weekly from weeks 12–24. The WT will be asked to maintain their current activity levels for the first 12-weeks, before completing the same protocol as EX for the following 52 weeks. Primary (patient-reported HRQoL) and secondary (bone health and pain, fatigue, cardiorespiratory fitness, muscle strength, body composition, disease response, and blood biomarkers) outcomes will be assessed at baseline, 12-, 24- and 52-weeks. Adverse events, attendance, and adherence will be recorded and cost-effectiveness analysis performed. The findings will inform whether exercise should be included as part of standard myeloma care to improve the health of this unique population.

Myeloma Spine and Bone Damage Score (MSBDS) on Whole-Body Computed Tomography (WBCT): Multiple Reader Agreement in a Multicenter Reliability Study

“…In addition, the complementary CT imaging atlas is expected to enhance unified interpretations of the grading scales between radiologists and clinicians across countries and departments. Indeed, MM-associated bone disease impacts quality of life, with increases in both morbidity and mortality [ 3 , 25 , 26 , 27 , 28 , 29 ]. CT, as well MRI, is important when diagnosing MM, especially in the detection of bone lesions when they are small and when they are amenable to intervention, even to prevent pathological fractures or neurological complications due to the compression of the medulla or nerves [ 3 , 5 , 7 , 10 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ].…”

“…Indeed, MM-associated bone disease impacts quality of life, with increases in both morbidity and mortality [ 3 , 25 , 26 , 27 , 28 , 29 ]. CT, as well MRI, is important when diagnosing MM, especially in the detection of bone lesions when they are small and when they are amenable to intervention, even to prevent pathological fractures or neurological complications due to the compression of the medulla or nerves [ 3 , 5 , 7 , 10 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. CT-proven MM lesions were tested in a web-based exercise with substantial to excellent agreement.…”

Safety, Feasibility, and Acceptability of a Multisite Individualized Exercise Intervention for People with Multiple Myeloma

“…The study design, recruitment, and procedures have been described elsewhere (28). Written informed consent was obtained from all individual participants included in the study.…”

Psychometric properties of the Chilean version of the quality of life questionnaire for multiple myeloma

“…Survivors of MM experience substantial long-term quality of life issues and are second only to lung cancer patients in terms of the worst HRQoL across all cancer types (10) . It has also been shown that MM patients have the lowest HRQoL scores compared to patients with other hematological cancers (11) .…”