Exercise shown to improve quality of life in people with multiple myeloma

24 November 2022

A supervised, targeted exercise program can improve the quality of life and health of people with multiple myeloma (MM) across all disease stages, according to new research.

The MyeEx Study tracked 60 volunteers who participated in a randomised waitlist-controlled trial investigating the impacts of a 12-week, individualised exercise intervention in MM, a type of bone marrow cancer arising from plasma cells.

Funded by a MRFF RART 2.2 grant distributed by Brisbane Diamantina Health Partners (now known as Health Translation Queensland), the 12-week program was found to improve health related quality of life (HRQoL), improve MM symptoms, lessen bone pain, and improve cardiorespiratory fitness.

There were no differences observed between the waitlist-controlled group and the group randomised to exercise group for general pain, fatigue, and neuromuscular strength.

The MyeEx project was a collaboration between QIMR Berghofer Medical Research Institute (Associate Professor Michelle Hill) and The University of Queensland School of Human Movement and Nutrition Sciences (Associate Professor Tina Skinner) and formed part of the PhD thesis of Dr Jennifer Nicol. It was developed after identifying a high interest in exercise for people with MM but very limited evidence of its safety, feasibility, and efficacy in this understudied population. Dr Nicol has continued to research on exercise in MM as a postdoctoral fellow at QIMR Berghofer Medical Research Institute, and recently presented the MyeEx trial outcomes at the Clinical Oncology Society of Australia Annual Scientific Meeting.

“This is a significant outcome for people who are living with MM, and the first study of its kind conducted in Australia,” said Associate Professor Skinner.

“MM is a devastating disease that impacts people’s quality of life, their physical function, and their mental health. People with MM experience fatigue, muscle wasting, bone pain, fractures and lesions, anaemia, low platelets, and peripheral neuropathy.”

“These findings support the inclusion of exercise as part of standard of care to improve the quality of life and health of people with MM.”

The MyeEx study recruitment occurred at myeloma clinics at the Greenslopes Private Hospital, Princess Alexandra and the Royal Brisbane and Women’s hospitals, and through Myeloma Australia, between 2019 and 2021. People at any stage of MM were randomised to exercise (EX) or wait-list control (CON). The 12-week individualised program included twice-weekly sessions supervised one-on-one by an accredited exercise physiologist, with one additional home-based session prescribed per week. Each 60-minute session consisted of high-intensity interval training, moderate-to-hard muscle strength and bone loading exercises. Outcomes were assessed using validated questionnaires and physical testing sessions at The University of Queensland. Blood samples were collected for biomarker studies conducted at QIMR Berghofer Medical Research Institute.

Trial participant Daniel Carter, who was diagnosed with MM in 2017 and has been in remission for four years, thoroughly recommended the study.

“I’ve recovered well from the treatments I’ve had, and I haven’t yet relapsed. I feel that the exercise I have been doing has been a big part of it.”

He said exercise had improved his overall wellbeing, improved his mental and physical health, and increased his social connections. Since the trial he has continued exercising – earlier this year he walked 500km from Portugal to Spain on the Camino de Santiago trail.

“I think some people may be hesitant to do exercise because of age or they have so many health issues with MM,” Mr Carter said. “The exercise physiologists are so good at finding ways for people to exercise even if they can’t walk 100 metres. No matter what your level is, they help you do exercise that’s appropriate to your abilities.”

Clinical Nurse Consultant for Myeloma at the Princess Alexandra Hospital, Carmel Woodrow, said patient feedback had been very positive.

“Participants said it was a great experience; they felt so safe and supported. Many patients with MM are fearful of exercise especially those that presented with bone lesions and fractures having that one-on-one support helped them gain their confidence and they generally had a much better outlook on their MM. They had a lot of fun too.”

Following the positive outcomes from the MyeEx study, the team hopes to secure more funding to develop an accredited, nationally available exercise program tailored for people living with MM. For further information on exercise programs for MM, contact Myeloma Australia.

The results

Outcomes were assessed using validated surveys (EORTC QLQ-C30 with MY20 module, FACT-BP, FACIT-F), cardiopulmonary exercise testing and dynamometry.

Between group improvements in HRQoL (EX vs CON)

  • improved EORTC QLQ-C30 summary score: +6.3 (95% CI 0.8, 11.9, p=0.03)
  • improved MM symptoms - EORTC QLQ-MY20: -7.4 (95% CI -15.2, 0.5, p=0.07)
  • improved bone pain - FACT-BP: +4.4 (95% CI 0.5, 8.3, p=0.03)
  • improved cardiorespiratory fitness - V̇O2peak: +3.1 mL/kg/min (95% CI 1.4, 4.8, p=0.001)

No between-group differences (p>0.05) (EX vs CON)

  • general pain
  • fatigue
  • neuromuscular strength

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