Cancer Institute, University College London, 72 Huntley Street, WC1E 6DD, London, UK.
BMC Cancer. 2013 Jan 24;13:31. doi: 10.1186/1471-2407-13-31.
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.
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.
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.
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.
运动方案对癌症患者有益,然而,在多发性骨髓瘤(MM)患者中,证据有限,MM 是一种以溶骨性骨病为特征的癌症,导致高骨发病率,包括骨折和骨痛。
我们对一项治疗后的 MM 患者康复的运动方案(EP)进行了单臂 2 期研究,以评估其可行性、对生活质量和生理参数的影响。患者接受个体化方案,包括伸展、有氧运动和阻力运动,在监督下进行 3 个月,然后在家中再进行 3 个月。
研究参与率高,75 名患者中有 60 名(80%)同意参加研究。筛选失败(11 例,由于骨折风险和疾病复发)和患者退出(12 例)导致最终有 37 名患者参加该方案。这 37 名患者在监督课程中的出勤率很高(87%),在家中锻炼的依从性也很高(73%)。患者报告 EP 后生活质量改善,FACT-G 和疲劳评分随时间从基线开始改善(均为 p<0.01,单向重复测量方差分析)至 6 个月。EP 还改善了上下肢力量,从基线到 6 个月(均为 p<0.01)。没有不良反应。
MM 患者的 EP 是可行和安全的,具有较高的出勤率和依从性。在随机研究中,EP 在生活质量、疲劳和肌肉力量方面的益处有待证实,这促使我们迫切需要评估 EP 在 MM 患者康复中的益处。