Physical Activity in People with Multiple Myeloma: Associated Factors and Exercise Program Preferences

Nicol, Jennifer; Woodrow, Carmel; Burton, Nicola W.; Mollee, Peter; Nicol, Andrew; Hill, Michelle M.; Skinner, Tina L.

doi:10.3390/jcm9103277

Cited by 17 publications

(25 citation statements)

References 19 publications

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“…There is a paucity of research examining the patient perspective regarding physical activity or exercise in BMT. Qualitative research in BMT has predominantly been in multiple myeloma and/or autologous BMT [14][15][16][17] and that in allogeneic BMT has focused on symptoms rather than participation in an exercise program [18,19]. In allogeneic BMT, patients perceive physical incapacity and/or reduced self-efficacy as key issues post-transplant hence increased access to specialised exercise support is required [18,19].…”

Section: Introductionmentioning

confidence: 99%

Exercise in allogeneic bone marrow transplantation: a qualitative representation of the patient perspective

Abo

Parry

Ritchie

et al. 2022

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Purpose Exercise is emerging as a vital aspect of care to alleviate the physical and psychosocial symptom burden associated with allogeneic bone marrow transplantation (BMT). Understanding the patient perspective regarding exercise is important to move towards implementation. This study aimed to characterise experiences and views regarding participation in an exercise program in adults receiving treatment for haematological disease with allogeneic BMT. Methods Individual semi-structured interviews were conducted with 35 participants from either an early- or late-commencing supervised group-based exercise program. Using an inductive, conventional approach to qualitative content analysis data were independently analysed by two researchers. Results Six major themes and 33 sub-themes were identified: this encompassed motivation, physical opportunity and capability to exercise; psychosocial effects of group-based exercise; experienced impact of participation in an exercise program; and intervention design considerations. Key barriers to exercise included symptom severity and fluctuating health and distance or difficult access to an exercise facility or equipment, whilst facilitators included encouragement from staff; peer support in the group-based setting; flexibility; education; and ability to measure change. Conclusion This study highlights the importance of a flexible approach to exercise with consideration of individual symptoms and preferences. The perceived psychological impact of exercise should not be underestimated; future exercise programs should be designed in partnership with patients, with consideration of group-based activities to reduce social isolation if this is feasible in the treatment context. Intervention design should also acknowledge the individual’s physical and psychological capability, opportunity and automatic and reflective motivation to direct and sustain exercise behaviours following BMT.

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Section: Introductionmentioning

confidence: 99%

Exercise in allogeneic bone marrow transplantation: a qualitative representation of the patient perspective

Abo

Parry

Ritchie

et al. 2022

Support Care Cancer

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“…Exercising in the presence of bone lesions has been identified as a major safety concern by hematologists [ 24 ] and patients [ 25 ] alike, particularly during resistance training and impact loading activities. Bone involvement occurs more frequently in MM than in any other cancer [ 26 ], with up to 85% of patients with MM developing lytic lesions during the course of their disease [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

“…Bone involvement occurs more frequently in MM than in any other cancer [ 26 ], with up to 85% of patients with MM developing lytic lesions during the course of their disease [ 27 ]. Bone pain is commonly experienced in people with MM, with 45% experiencing bone pain in the vertebrae and 27% experiencing bone pain in other sites, such as the ribs and pelvis [ 25 ]. Reductions in bone mineral density and degradation of bone microarchitecture are frequent manifestations in people with MM due to inflammation secondary to myelo-suppressive treatments [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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.

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“…Moderate to vigorous physical activity (PA) has been shown to be beneficial in patients with haematological cancer, both during and following treatment, with significant positive effects on anxiety, depression, healthrelated quality of life and physical function [8]. People with MM report a high interest in receiving physical activity and exercise advice, as well as participating in an exercise program, with a preference for guidance by an exercise professional [9]. However, people with MM have low levels of physical activity, with only 12% sufficiently active after diagnosis [9].…”

Section: Introductionmentioning

confidence: 99%

“…People with MM report a high interest in receiving physical activity and exercise advice, as well as participating in an exercise program, with a preference for guidance by an exercise professional [9]. However, people with MM have low levels of physical activity, with only 12% sufficiently active after diagnosis [9].…”

Section: Introductionmentioning

confidence: 99%

Promoting exercise for patients with multiple myeloma: attitudes and practices of clinical haematologists

et al. 2021

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To explore the attitudes and practices of clinical haematologists towards promoting physical activity (PA) and exercise for patients with multiple myeloma (MM). MethodsUsing a quantitative cross-sectional survey, clinical haematologists reported on the perceived benefits and acceptability of PA and exercise and frequency, and confidence and barriers to providing exercise advice. ResultsClinical haematologists, (n=34; 68% response rate) who cumulatively treated ~340 patients with MM each week, completed the survey. Almost all (97%) agreed that PA was important, with benefits for quality of life, activities of daily living, mental health and fatigue. Whilst 88% discussed PA at least occasionally with their patients, approximately two thirds were not confident advising specific exercises (68%) or identifying PA resources (62%). Despite this, 44% never referred patients to exercise professionals, with 18% only doing so if the patient asked. Over half did not recommend exercise when patients had spine fractures or were physically unwell. No differences were observed in individual factors (age, gender, practice type and own PA participation) and promotion of PA. ConclusionsClinical haematologists perceive PA as important, but lack confidence on what exercise/s to recommend and if exercise is appropriate for specific disease complications. They tend to not refer patients to exercise professionals. Implications for Cancer SurvivorsPatients with MM often suffer from symptoms and toxicities that may be alleviated through PA. However PA participation rates are low. Support for clinical haematologists for when and how to discuss exercise and clearer referral pathways to exercise professionals may improve PA uptake and hence ensure access to optimal care, thereby improving patient outcomes

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Physical Activity in People with Multiple Myeloma: Associated Factors and Exercise Program Preferences

Cited by 17 publications

References 19 publications

Exercise in allogeneic bone marrow transplantation: a qualitative representation of the patient perspective

Exercise in allogeneic bone marrow transplantation: a qualitative representation of the patient perspective

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

Promoting exercise for patients with multiple myeloma: attitudes and practices of clinical haematologists

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