Exercise prehabilitation for people with myeloma undergoing autologous stem cell transplantation: results from PERCEPT pilot randomised controlled trial

Authors

  • Orla McCourt a Therapies & Rehabilitation, University College London Hospitals NHS Foundation Trust, London, UK; b Department of Haematology, UCL Cancer Institute, University College London, London, UK
  • Abigail Fisher c UCL Department of Behavioural Science and Health, University College London, London, UK
  • Gita Ramdharry d Queens Square Centre for Neuromuscular Diseases, National Hospital for Neurology & Neurosurgery, UCLH NHS Trust/UCL Institute of Neurology, University College London, London, UK
  • Joanne Land b Department of Haematology, UCL Cancer Institute, University College London, London, UK; c UCL Department of Behavioural Science and Health, University College London, London, UK
  • Anna L. Roberts c UCL Department of Behavioural Science and Health, University College London, London, UK
  • Neil Rabin e Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
  • Kwee Yong b Department of Haematology, UCL Cancer Institute, University College London, London, UK

DOI:

https://doi.org/10.1080/0284186X.2023.2178326

Keywords:

Myeloma, haematopoietic stem cell transplantation, prehabilitation, rehabilitation, exercise, physiotherapy

Abstract

Background

Autologous stem cell transplant (ASCT) is first line treatment for newly diagnosed patients with myeloma but often results in functional deficits and reduced quality of life (QOL). Physically active myeloma patients have better QOL, less fatigue and reduced morbidity. This trial aimed to investigate the feasibility of a physiotherapist-led exercise intervention delivered across the continuum of the myeloma ASCT pathway at a UK centre. Initially designed and delivered as a face-to-face trial, the study protocol was adapted to virtual delivery in response to the COVID-19 pandemic.

Material and methods

A pilot randomised controlled trial of a partly supervised exercise intervention with incorporated behaviour change techniques delivered before, during and for 3 months following ASCT compared to usual care. Face-to-face delivery of the pre-ASCT supervised intervention was adapted to virtually-supervised group classes via video conferencing. Primary outcomes related to feasibility; recruitment rate, attrition and adherence. Secondary outcomes included patient reported measures of QOL (EORTC C30, FACT-BMT, EQ5D), and fatigue (FACIT-F), measures of functional capacity (six-minute walk test (6MWT), timed sit-to-stand (TSTS), hand grip strength, self-reported and objective physical activity (PA).

Results

Over 11 months 50 participants were enrolled and randomised. Overall, uptake to the study was 46%. The attrition rate was 34%, mainly related to failure to undergo ASCT. Loss of follow-up for other reasons was low. Secondary outcomes demonstrate potential for the benefit of exercise prior to, during and after ASCT with improvements in QOL, fatigue, functional capacity and PA evident on admission for ASCT and 3 months post-ASCT.

Discussion

Results indicate acceptability and feasibility of delivering exercise prehabilitation, in person and virtually within the ASCT pathway in myeloma. The effects of prehabilitation and rehabilitation provision as a component of the ASCT pathway warrants further investigation.

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Published

2023-07-03

How to Cite

McCourt, O., Fisher, A., Ramdharry, G., Land, J., Roberts, A. L., Rabin, N., & Yong, K. (2023). Exercise prehabilitation for people with myeloma undergoing autologous stem cell transplantation: results from PERCEPT pilot randomised controlled trial. Acta Oncologica, 62(7), 696–705. https://doi.org/10.1080/0284186X.2023.2178326

Issue

Vol. 62 No. 7 (2023): Acta Oncologica

Section

Articles