The majority of patients with multiple myeloma (MM) experience treatment-related fatigue, pain and muscle weakness. Exercise may alleviate these symptoms, however the high prevalence of lytic lesions and subsequent concerns about safety can inhibit participation. This study presents an interim analysis of the safety and feasibility of an exercise program, the MyeEx Study, for people with MM.
Patients with MM were randomly assigned to an exercise group or wait-list control. The 12-week individualised exercise program included twice weekly sessions supervised one-on-one by an accredited exercise physiologist, with one additional home-based session per week. Each 60-minute session consisted of high intensity interval training, moderate-to-hard intensity muscular strengthening activities, balance and bone loading exercises. Safety was determined by adverse and serious adverse events. Feasibility was determined by number consented, attrition rate, program interruptions and enjoyment determined by the 8-item Physical Activity Enjoyment Scale.
Thirty-seven patients (mean age 65±9 years; range 45-79 years; 76% male) consented to participate. Three participants withdrew from the study, due to a secondary cancer diagnosis (1), cardiac investigations (1) and one prior to program commencement. Lytic lesions were present in 73%, with a further 22% experiencing other skeletal complications (low back pain, osteoporosis, osteoarthritis). Of the 682 hours of exercise sessions completed (100% attendance), only one adverse event occurred due to a hypotensive episode during a low intensity task. Six program interruptions have occurred, due to relapsed disease (2), stem cell transplantation (2), hospitalisation for infection (1), and instability from peripheral neuropathy (1). Enjoyment of the program was high (85% [95% CI 79-92]).
A supervised, individualised exercise program for people with MM is safe and feasible, with high rates of participant enjoyment. Interruptions due to disease complications and relapse require personalised program adaptations by exercise specialists to enhance participation in patients with MM.