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Published in: BMC Cancer 1/2013

Open Access 01-12-2013 | Research article

A mixed exercise training programme is feasible and safe and may improve quality of life and muscle strength in multiple myeloma survivors

Authors: Lara Groeneveldt, Gill Mein, Rachel Garrod, Andrew P Jewell, Ken Van Someren, Richard Stephens, Shirley P D’Sa, Kwee L Yong

Published in: BMC Cancer | Issue 1/2013

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Abstract

Background

Exercise programmes are beneficial for cancer patients however evidence is limited in patients with multiple myeloma (MM), a cancer that is characterised by osteolytic bone disease, giving rise to high levels of bone morbidity including fractures and bone pain.

Methods

We conducted a single arm phase 2 study of an exercise programme (EP) as rehabilitation for treated MM patients, to evaluate feasibility, effects on QOL and physiological parameters. Patients were given individualised programmes, comprising stretching, aerobic and resistance exercises, carried out under supervision for 3 months then at home for a further 3 months.

Results

Study uptake was high, 60 of 75 (80%) patients approached consented to the study. Screen failures (11, due to fracture risk and disease relapse) and patient withdrawals (12) resulted in a final 37 patients enrolling on the programme. These 37 patients demonstrated high attendance rates in the supervised classes (87%), and high levels of adherence in home exercising (73%). Patients reported better QOL following the EP, with improvement in FACT-G and Fatigue scores over time from baseline (p<0.01 for both, one-way repeated measures ANOVA) to 6 months. Upper and lower limb strength also improved on the EP, from baseline to 6 months (p<0.01 for both). There were no adverse reactions.

Conclusions

An EP in MM patients is feasible and safe, with high attendance and adherence. Benefits in QOL, fatigue and muscle strength await confirmation in randomized studies, prompting urgent evaluation of the benefits of EP in the rehabilitation of MM patients.
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Literature
2.
go back to reference Roodman GD: Pathogenesis of myeloma bone disease. Leukemia. 2009, 23: 435-441. 10.1038/leu.2008.336.CrossRefPubMed Roodman GD: Pathogenesis of myeloma bone disease. Leukemia. 2009, 23: 435-441. 10.1038/leu.2008.336.CrossRefPubMed
3.
go back to reference Kumar SK, Rajukumar SV, Dispenzieri A: Improved survival in multiple myeloma and the impact of novel therapies. Blood. 2008, 111: 2516-2520. 10.1182/blood-2007-10-116129.CrossRefPubMedPubMedCentral Kumar SK, Rajukumar SV, Dispenzieri A: Improved survival in multiple myeloma and the impact of novel therapies. Blood. 2008, 111: 2516-2520. 10.1182/blood-2007-10-116129.CrossRefPubMedPubMedCentral
4.
go back to reference Gulbrandsen N, Hjermstad MJ, Wisloff F: Interpretation of quality of life scores in multiple myeloma by comparison with a reference population and assessment of the clinical importance of score differences. Eur J Haematol. 2004, 72 (3): 172-180. 10.1046/j.0902-4441.2003.00195.x.CrossRefPubMed Gulbrandsen N, Hjermstad MJ, Wisloff F: Interpretation of quality of life scores in multiple myeloma by comparison with a reference population and assessment of the clinical importance of score differences. Eur J Haematol. 2004, 72 (3): 172-180. 10.1046/j.0902-4441.2003.00195.x.CrossRefPubMed
5.
go back to reference Poulos AR, Gertz MA, Pankratz VS, Post-White J: Pain, mood disturbance, and quality of life in patients with multiple myeloma. Oncol Nurs Forum. 2001, 28 (7): 1163-1171.PubMed Poulos AR, Gertz MA, Pankratz VS, Post-White J: Pain, mood disturbance, and quality of life in patients with multiple myeloma. Oncol Nurs Forum. 2001, 28 (7): 1163-1171.PubMed
6.
go back to reference Sherman AC, Simonton S, Latif U, Plante TG, Anaissie EJ: Changes in quality-of-life and psychosocial adjustment among multiple myeloma patients treated with high-dose melphalan and autologous stem cell transplantation. Biol Blood Marrow Transplant. 2009, 15 (1): 12-20. 10.1016/j.bbmt.2008.09.023.CrossRefPubMed Sherman AC, Simonton S, Latif U, Plante TG, Anaissie EJ: Changes in quality-of-life and psychosocial adjustment among multiple myeloma patients treated with high-dose melphalan and autologous stem cell transplantation. Biol Blood Marrow Transplant. 2009, 15 (1): 12-20. 10.1016/j.bbmt.2008.09.023.CrossRefPubMed
7.
go back to reference Knobf MT, Musanti R, Dorward J: Exercise and quality of life outcomes in patients with cancer. Semin Oncol Nurs. 2007, 23 (4): 285-296. 10.1016/j.soncn.2007.08.007.CrossRefPubMed Knobf MT, Musanti R, Dorward J: Exercise and quality of life outcomes in patients with cancer. Semin Oncol Nurs. 2007, 23 (4): 285-296. 10.1016/j.soncn.2007.08.007.CrossRefPubMed
8.
go back to reference Schmitz KH, Holtzman J, Courneya KS, Masse LC, Duval S, Kane R: Controlled physical activity trials in cancer survivors: A systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2005, 14: 1588-1595. 10.1158/1055-9965.EPI-04-0703.CrossRefPubMed Schmitz KH, Holtzman J, Courneya KS, Masse LC, Duval S, Kane R: Controlled physical activity trials in cancer survivors: A systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2005, 14: 1588-1595. 10.1158/1055-9965.EPI-04-0703.CrossRefPubMed
9.
go back to reference Galvao DA, Newton RU: Review of exercise intervention studies in cancer. J Clin Oncol. 2005, 23: 900-909.CrossRef Galvao DA, Newton RU: Review of exercise intervention studies in cancer. J Clin Oncol. 2005, 23: 900-909.CrossRef
10.
go back to reference Lakoski SG, Eves ND, Douglas PS, Jones LW: Exercise rehabilitation in patients with cancer. Nat Rev Clin Oncol. 2012, 9: 288-296. 10.1038/nrclinonc.2012.27.CrossRefPubMedPubMedCentral Lakoski SG, Eves ND, Douglas PS, Jones LW: Exercise rehabilitation in patients with cancer. Nat Rev Clin Oncol. 2012, 9: 288-296. 10.1038/nrclinonc.2012.27.CrossRefPubMedPubMedCentral
11.
go back to reference Wolin Ky R, Tuchman H, Lucia A: Exercise in adult and pediatric hematological cancer survivor: an intervention review. Leukemia. 2012, 24: 1113-1120.CrossRef Wolin Ky R, Tuchman H, Lucia A: Exercise in adult and pediatric hematological cancer survivor: an intervention review. Leukemia. 2012, 24: 1113-1120.CrossRef
12.
go back to reference Chang P-H, Lai Y-H, Shun S-C, Lin L-Y: Effects of a Walking Intervention on Fatigue-related Experiences of Hospitalized Acute Myelogenous Leukemia Patients Undergoing Chemotherapy: a Randomized Controlled Trial. J Pain Symptom Manage. 2008, 35: 524-534. 10.1016/j.jpainsymman.2007.06.013.CrossRefPubMed Chang P-H, Lai Y-H, Shun S-C, Lin L-Y: Effects of a Walking Intervention on Fatigue-related Experiences of Hospitalized Acute Myelogenous Leukemia Patients Undergoing Chemotherapy: a Randomized Controlled Trial. J Pain Symptom Manage. 2008, 35: 524-534. 10.1016/j.jpainsymman.2007.06.013.CrossRefPubMed
13.
go back to reference Hayes SC, Davies PS, Parker TW, Bashford J, Green A: Role of a Mixed Type, Moderate Intensity Exercise Programme After Peripheral Blood Stem Cell Transplantation. Br J Sports Med. 2004, 38: 304-309. 10.1136/bjsm.2002.003632.CrossRefPubMedPubMedCentral Hayes SC, Davies PS, Parker TW, Bashford J, Green A: Role of a Mixed Type, Moderate Intensity Exercise Programme After Peripheral Blood Stem Cell Transplantation. Br J Sports Med. 2004, 38: 304-309. 10.1136/bjsm.2002.003632.CrossRefPubMedPubMedCentral
14.
go back to reference Courneya KS, Sellar CM, Stevinson C, McNeely ML: Randomized controlled trial of the effects of aerobic exercise on physical functioning and quality of life in lymphoma patients. J Clin Oncol. 2009, 27: 4605-4612. 10.1200/JCO.2008.20.0634.CrossRefPubMed Courneya KS, Sellar CM, Stevinson C, McNeely ML: Randomized controlled trial of the effects of aerobic exercise on physical functioning and quality of life in lymphoma patients. J Clin Oncol. 2009, 27: 4605-4612. 10.1200/JCO.2008.20.0634.CrossRefPubMed
15.
go back to reference Coleman EA, Coon S, Hall-Barrow J, Richards K, Gaylor D, Stewart B: Feasibility of exercise during treatment for multiple myeloma. Cancer Nurs. 2003, 26 (5): 410-419. 10.1097/00002820-200310000-00012.CrossRefPubMed Coleman EA, Coon S, Hall-Barrow J, Richards K, Gaylor D, Stewart B: Feasibility of exercise during treatment for multiple myeloma. Cancer Nurs. 2003, 26 (5): 410-419. 10.1097/00002820-200310000-00012.CrossRefPubMed
16.
go back to reference Coleman EA, Coon SK, Kennedy RL: Effects of exercise in combination with epoetin alfa during high-dose chemotherapy and autologous peripheral blood stem cell transplantation for multiple myeloma. Onc Nurs Forum. 2008, 35: 1-9. 10.1188/08.ONF.E1-E11.CrossRef Coleman EA, Coon SK, Kennedy RL: Effects of exercise in combination with epoetin alfa during high-dose chemotherapy and autologous peripheral blood stem cell transplantation for multiple myeloma. Onc Nurs Forum. 2008, 35: 1-9. 10.1188/08.ONF.E1-E11.CrossRef
17.
go back to reference Knols RH, de Bruin ED, Uebelhart D, Aufdemkampe G, Schanz U, Stenner-Liewen F: Effects of an outpatient physical exercise programme on hematopoietic stem-cell transplantation recipients: a randomized clinical trial. Bone Marrow Transplant. 2011, 46: 1245-1255. 10.1038/bmt.2010.288.CrossRefPubMed Knols RH, de Bruin ED, Uebelhart D, Aufdemkampe G, Schanz U, Stenner-Liewen F: Effects of an outpatient physical exercise programme on hematopoietic stem-cell transplantation recipients: a randomized clinical trial. Bone Marrow Transplant. 2011, 46: 1245-1255. 10.1038/bmt.2010.288.CrossRefPubMed
18.
go back to reference Jones LW, Courneya KS, Vallance JK, Ladha AB, Mant MJ, Belch AR: Association between exercise and quality of life in multiple myeloma cancer survivors. Support Care Cancer. 2004, 12 (11): 780-788. 10.1007/s00520-004-0668-4.CrossRefPubMed Jones LW, Courneya KS, Vallance JK, Ladha AB, Mant MJ, Belch AR: Association between exercise and quality of life in multiple myeloma cancer survivors. Support Care Cancer. 2004, 12 (11): 780-788. 10.1007/s00520-004-0668-4.CrossRefPubMed
19.
go back to reference Chen MJ, Fan X, Moe ST: Criterion-related validity of the Borg ratings of perceived exertion scale in healthy individuals: a meta-analysis. J Sports Sci. 2002, 20 (11): 873-899. 10.1080/026404102320761787.CrossRefPubMed Chen MJ, Fan X, Moe ST: Criterion-related validity of the Borg ratings of perceived exertion scale in healthy individuals: a meta-analysis. J Sports Sci. 2002, 20 (11): 873-899. 10.1080/026404102320761787.CrossRefPubMed
20.
go back to reference Webster K, Cella D, Yost K: The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System: properties, applications, and interpretation. Health Qual Life Outcomes. 2003, 1: 79-10.1186/1477-7525-1-79.CrossRefPubMedPubMedCentral Webster K, Cella D, Yost K: The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System: properties, applications, and interpretation. Health Qual Life Outcomes. 2003, 1: 79-10.1186/1477-7525-1-79.CrossRefPubMedPubMedCentral
21.
go back to reference Guyatt GH, Norman GR, Juniper EF, Griffith LE: A critical look at transition ratings. J Clin Epidemiol. 2002, 55 (9): 900-908. 10.1016/S0895-4356(02)00435-3.CrossRefPubMed Guyatt GH, Norman GR, Juniper EF, Griffith LE: A critical look at transition ratings. J Clin Epidemiol. 2002, 55 (9): 900-908. 10.1016/S0895-4356(02)00435-3.CrossRefPubMed
22.
go back to reference Cella D, Eton DT, Lai JS, Peterman AH, Merkel DE: Combining anchor and distribution-based methods to derive minimal clinically important differences on the Functional Assessment of Cancer Therapy (FACT) anemia and fatigue scales. J Pain Symptom Manage. 2002, 24 (6): 547-561. 10.1016/S0885-3924(02)00529-8.CrossRefPubMed Cella D, Eton DT, Lai JS, Peterman AH, Merkel DE: Combining anchor and distribution-based methods to derive minimal clinically important differences on the Functional Assessment of Cancer Therapy (FACT) anemia and fatigue scales. J Pain Symptom Manage. 2002, 24 (6): 547-561. 10.1016/S0885-3924(02)00529-8.CrossRefPubMed
24.
go back to reference Ebbeling CB, Ward A, Puleo EM, Widrick J, Rippe JM: Development of a single-stage submaximal treadmill walking test. Med Sci Sports Exerc. 1991, 23 (8): 966-973.CrossRefPubMed Ebbeling CB, Ward A, Puleo EM, Widrick J, Rippe JM: Development of a single-stage submaximal treadmill walking test. Med Sci Sports Exerc. 1991, 23 (8): 966-973.CrossRefPubMed
25.
go back to reference Marshall C, Rossman G: Designing Qualitative Research. 1995, London: Sage publications, 2 Marshall C, Rossman G: Designing Qualitative Research. 1995, London: Sage publications, 2
26.
go back to reference Green J, Thorogood N: Qualitative Methods in Health Research. 2006, London: Sage Publications Green J, Thorogood N: Qualitative Methods in Health Research. 2006, London: Sage Publications
27.
go back to reference Dimeo F, Fetscher S, Lange W, Mertelsmann R, Keul J: Effects of aerobic exercise on the physical performance and incidence of treatment-related complications after high-dose chemotherapy. Blood. 1997, 90 (9): 3390-3394.PubMed Dimeo F, Fetscher S, Lange W, Mertelsmann R, Keul J: Effects of aerobic exercise on the physical performance and incidence of treatment-related complications after high-dose chemotherapy. Blood. 1997, 90 (9): 3390-3394.PubMed
28.
go back to reference Maddocks M, Mockett S, Wilcock A: Is exercise an acceptable and practical therapy for people with or cured of cancer? A systematic review. Cancer Treat Rev. 2009, 35 (4): 383-390. 10.1016/j.ctrv.2008.11.008.CrossRefPubMed Maddocks M, Mockett S, Wilcock A: Is exercise an acceptable and practical therapy for people with or cured of cancer? A systematic review. Cancer Treat Rev. 2009, 35 (4): 383-390. 10.1016/j.ctrv.2008.11.008.CrossRefPubMed
29.
go back to reference Zehnacker CH, Bemis-Dougherty A: Effect of weighted exercises on bone mineral density in post menopausal women. A systematic review. J Geriatr Phys Ther. 2007, 30 (2): 79-88. 10.1519/00139143-200708000-00007.CrossRefPubMed Zehnacker CH, Bemis-Dougherty A: Effect of weighted exercises on bone mineral density in post menopausal women. A systematic review. J Geriatr Phys Ther. 2007, 30 (2): 79-88. 10.1519/00139143-200708000-00007.CrossRefPubMed
30.
go back to reference Hourigan SR, Nitz JC, Brauer SG, O'Neill S, Wong J, Richardson CA: Positive effects of exercise on falls and fracture risk in osteopenic women. Osteoporos Int. 2008, 19 (7): 1077-1086. 10.1007/s00198-007-0541-7.CrossRefPubMed Hourigan SR, Nitz JC, Brauer SG, O'Neill S, Wong J, Richardson CA: Positive effects of exercise on falls and fracture risk in osteopenic women. Osteoporos Int. 2008, 19 (7): 1077-1086. 10.1007/s00198-007-0541-7.CrossRefPubMed
31.
go back to reference Segal RJ, Reid RD, Courneya KS: Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol. 2009, 27 (3): 344-351.CrossRefPubMed Segal RJ, Reid RD, Courneya KS: Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol. 2009, 27 (3): 344-351.CrossRefPubMed
33.
go back to reference Reed J, Payton VR: Focus groups: issues of analysis and interpretation. J Adv Nurs. 1997, 26 (4): 765-771. 10.1046/j.1365-2648.1997.00395.x.CrossRefPubMed Reed J, Payton VR: Focus groups: issues of analysis and interpretation. J Adv Nurs. 1997, 26 (4): 765-771. 10.1046/j.1365-2648.1997.00395.x.CrossRefPubMed
34.
go back to reference Mutrie N, Campbell AM, Whyte F, McConnachie A, Emslie C, Lee L: Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial. BMJ. 2007, 334 (7592): 517-10.1136/bmj.39094.648553.AE.CrossRefPubMedPubMedCentral Mutrie N, Campbell AM, Whyte F, McConnachie A, Emslie C, Lee L: Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial. BMJ. 2007, 334 (7592): 517-10.1136/bmj.39094.648553.AE.CrossRefPubMedPubMedCentral
35.
go back to reference Schwartz AL: Understanding and treating cancer-related fatigue. Oncology (Williston Park). 2007, 21 (11): 30-34. discussion 34–5 Schwartz AL: Understanding and treating cancer-related fatigue. Oncology (Williston Park). 2007, 21 (11): 30-34. discussion 34–5
36.
go back to reference Dimeo FC, Stieglitz R, Novelli-Fischer U, Keul J: Effects of physical activity on the fatigue and psychological status of cancer patients during chemotherapy. Cancer. 1999, 85: 2273-2277. 10.1002/(SICI)1097-0142(19990515)85:10<2273::AID-CNCR24>3.0.CO;2-B.CrossRefPubMed Dimeo FC, Stieglitz R, Novelli-Fischer U, Keul J: Effects of physical activity on the fatigue and psychological status of cancer patients during chemotherapy. Cancer. 1999, 85: 2273-2277. 10.1002/(SICI)1097-0142(19990515)85:10<2273::AID-CNCR24>3.0.CO;2-B.CrossRefPubMed
37.
go back to reference Daley A, Crank H, Saxton JM, Mutrie N, Coleman R, Roalfe A: Randomized trial of exercise therapy in women treated for breast cancer. J Clin Oncol. 2007, 25: 1713-1725. 10.1200/JCO.2006.09.5083.CrossRefPubMed Daley A, Crank H, Saxton JM, Mutrie N, Coleman R, Roalfe A: Randomized trial of exercise therapy in women treated for breast cancer. J Clin Oncol. 2007, 25: 1713-1725. 10.1200/JCO.2006.09.5083.CrossRefPubMed
38.
go back to reference Dimeo F, Schwartz S, Wesel N, Voigt A, Thiel E: Effects of an endurance and resistance exercise program on persistent cancer-related fatigue after treatment. Ann Oncol. 2008, 19 (8): 1495-1499. 10.1093/annonc/mdn068.CrossRefPubMed Dimeo F, Schwartz S, Wesel N, Voigt A, Thiel E: Effects of an endurance and resistance exercise program on persistent cancer-related fatigue after treatment. Ann Oncol. 2008, 19 (8): 1495-1499. 10.1093/annonc/mdn068.CrossRefPubMed
39.
go back to reference Young-McCaughan S, Mays MZ, Arzola SM, Yoder LH, Dramiga SA, Leclerc KM: Research and commentary: Change in exercise tolerance, activity and sleep patterns, and quality of life in patients with cancer participating in a structured exercise program. Oncol Nurs Forum. 2003, 30 (3): 441-454. 10.1188/03.ONF.441-454. discussion 41–54CrossRefPubMed Young-McCaughan S, Mays MZ, Arzola SM, Yoder LH, Dramiga SA, Leclerc KM: Research and commentary: Change in exercise tolerance, activity and sleep patterns, and quality of life in patients with cancer participating in a structured exercise program. Oncol Nurs Forum. 2003, 30 (3): 441-454. 10.1188/03.ONF.441-454. discussion 41–54CrossRefPubMed
40.
go back to reference Tang M-F, Liou T-H, Lin C-C: Improving sleep quality for cancer patients: benefits of a home-based exercise intervention. Support Care Cancer. 2010, 18: 1329-1339. 10.1007/s00520-009-0757-5.CrossRefPubMed Tang M-F, Liou T-H, Lin C-C: Improving sleep quality for cancer patients: benefits of a home-based exercise intervention. Support Care Cancer. 2010, 18: 1329-1339. 10.1007/s00520-009-0757-5.CrossRefPubMed
Metadata
Title
A mixed exercise training programme is feasible and safe and may improve quality of life and muscle strength in multiple myeloma survivors
Authors
Lara Groeneveldt
Gill Mein
Rachel Garrod
Andrew P Jewell
Ken Van Someren
Richard Stephens
Shirley P D’Sa
Kwee L Yong
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2013
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-13-31

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