Mobilization and Exercise Intervention for Patients With Multiple Myeloma: Clinical Practice Guidelines Endorsed by the Canadian Physiotherapy Association

Abstract

Objective Individuals with multiple myeloma (MM) often have reduced functional performance due to the cancer itself or as a direct side effect of cancer treatments. Physical therapy is a part of cancer rehabilitation; however, no guidelines are available to provide information and direction for physical therapists managing patients with MM. The goal of this guideline is to provide recommendations based on a systematic review and consensus process that physical therapists can use to manage patients with MM. Methods A systematic review of the literature published until August 2018 was performed in eight databases with two independent reviewers assessing quality. Seventeen articles were identified as relevant and a draft guideline was developed in the form of action statements. A total of 10 physical therapists with hematology experience and 10 patients with MM were recruited for consensus process. A priori threshold of 80% agreement was used to establish a consensus for each statement. The draft guidelines were reviewed externally by four methodologists using the AGREE II tool and a stakeholder representing OH (Cancer Care Ontario) Program in Evidence Based Care (PEBC), McMaster University. The final guideline was reviewed and officially endorsed by the Canadian Physiotherapy Association. Results A total of 30 action statements were developed that achieved consensus, indicating physical therapy recommendations based on physiological markers (ie, hemoglobin, platelet count), complete patient presentation, and the stage of medical treatment. Conclusion These clinical practice guidelines were developed to aid physical therapists in implementing evidence-based and best-practice care for patients with MM in order to optimize rehabilitation outcomes.

Psychosocial and supportive care needs of individuals with advanced myeloma

“…However, expanding access to appropriate and effective interventions to address any concerns identified through such assessment is also needed. This may include myeloma-specific patient education, self-management support, or supportive care services to address physical and psychological issues including symptom control, physical fitness, emotional health, and social well-being (Jeevanantham et al, 2020;Shapiro et al, 2021;Snowden et al, 2017). Specialized oncology nurses and nurse practitioners may be well positioned to lead innovations in this area.…”

In-hospital rehabilitation in the treatment of multiple myeloma

“…Although MM in most cases responds to chemotherapy and radiotherapy, bone changes may still progress, leading to pathological fractures. In order to maintain fracture stability, surgical intervention is often required, involving internal fixation or arthroplasty [16,17,18]. The aim of this study was to provide guidelines for inpatient rehabilitation in the treatment of pathological fractures resulting from the course of multiple myeloma.…”

Physical Activity in Multiple Myeloma: A Review of the Current Literature

“…Of these, two reported that it would be preferable to have guidelines, and three suggested general strategies and procedures. Only one article, published by the Canadian Physical Therapy Association, provided practical recommendations developed by physical therapists in conjunction with myeloma patients ( Jeevanantham et al, 2021 ). The guidelines provide 30 action statements for the safe and optimized application of physical exercise and management of the specific challenges that this patient group faces.…”