School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, AUSTRALIA.
Haematology Department, Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, AUSTRALIA.
Med Sci Sports Exerc. 2023 Dec 1;55(12):2214-2227. doi: 10.1249/MSS.0000000000003267. Epub 2023 Aug 2.
High rates of disease- and treatment-related symptoms, such as bone lesions, in people with multiple myeloma (MM) create uncertainty on the safety and feasibility of exercise. This study determined the safety, feasibility, and acceptability of an individualized exercise medicine program for people with MM at any disease stage.
A multisite, randomized waitlist-controlled trial was conducted of an individualized, high-intensity aerobic, resistance, and impact-loading exercise program. The exercise sessions were supervised twice weekly by accredited exercise physiologists, with one additional unsupervised session per week, for 12 wk. Safety was determined by number of adverse and serious adverse events. Feasibility outcome measures were study eligibility, recruitment, adherence, and attrition. Acceptability was determined by qualitative interviews and subjective levels of enjoyment.
Of 203 people with MM screened, 88% were eligible, with 34% accepting participation (60 people) and 20% attrition for the between-group analysis, meeting a priori criteria (≥25% and <25%, respectively). No adverse or serious adverse events attributed to testing and/or exercise training were reported. Attendance at supervised exercise sessions was 98%, with 45% completion of the home-based exercise sessions. Adherence rates were 35%, 63%, and 34% for the aerobic, resistance, and impact-loading protocols, with 55%, 80%, and 37% of participants meeting a priori criteria (75% of protocol). Acceptability of the exercise program was high (mean, 82%; 95% confidence interval, 78%-87%) and highly supported by qualitative responses.
An individualized, high-intensity aerobic, resistance, and impact-loading exercise medicine program is safe and acceptable, and feasible by some measures for people with MM. Adherence to the prescribed exercise protocols was limited by comorbidities and disease symptoms. Strategies to improve unsupervised exercise completion are warranted in this population.
多发性骨髓瘤（MM）患者存在大量与疾病和治疗相关的症状，如骨病变，这给运动的安全性和可行性带来了不确定性。本研究旨在确定个体化运动医学方案在任何疾病阶段的 MM 患者中的安全性、可行性和可接受性。
进行了一项多中心、随机等待对照试验，研究对象为接受个体化、高强度有氧运动、抗阻运动和冲击负荷运动的患者。运动课程由经过认证的运动生理学家每周监督两次，并额外提供每周一次的非监督课程，共 12 周。通过不良事件和严重不良事件的数量来确定安全性。可行性的评估指标包括研究的纳入、招募、依从性和脱落率。通过定性访谈和主观享受水平来确定可接受性。
在接受筛查的 203 名 MM 患者中，88%符合条件，34%（60 人）接受了参与研究的邀请，20%的患者（20 人）因组间分析而脱落，达到了预先设定的标准（分别为≥25%和<25%）。没有报告任何归因于测试和/或运动训练的不良或严重不良事件。监督下的运动课程出席率为 98%，在家完成的运动课程完成率为 45%。有氧运动、抗阻运动和冲击负荷运动的依从率分别为 35%、63%和 34%，55%、80%和 37%的参与者达到了预先设定的标准（分别为 75%的方案）。运动方案的可接受性很高（平均值为 82%；95%置信区间为 78%-87%），定性结果也高度支持。
个体化、高强度有氧运动、抗阻运动和冲击负荷运动医学方案对 MM 患者是安全且可接受的，在某些方面是可行的。遵守规定的运动方案受到合并症和疾病症状的限制。在该人群中，需要采取策略来提高非监督运动的完成率。
