Imaging, QoL and Patient-Reported Outcome and Supportive Care
Category: Imaging, QoL and Patient-Reported Outcome and Supportive Care
A randomized controlled trial of bone-targeted exercise for people with multiple myeloma: The MyeEx-Impact study
Tracy King, PhD, MSc, RN (she/her/hers)
Myeloma Clinical Nurse Consultant, Clinical Associate Professor
Institute of Haematology, Royal Prince Alfred Hospital
The University of Sydney
Level 1 evidence supports the safety and feasibility of exercise for people with multiple myeloma (MM). Our recent work identified individualized targeted exercise can reduce bone pain; however, research is yet to explore the potential effect of exercise on bone health. Preclinical models using osteogenic exercise have demonstrated mechanical load-induced changes delay osteolytic activity and rescue bone loss. Therefore, the MyeEx-Impact multi-site randomized controlled trial aims to examine whether bone-targeted exercise can improve bone health in people with MM.
Methods:
People with MM (n=78) residing in Queensland and New South Wales in Australia are invited to participate in this study. Following baseline testing, participants are randomized to exercise (EX) or control (CON). The EX group performs two supervised and one unsupervised sessions of individualized bone-targeted exercise each week over 9 months. The CON group receives usual care and a copy of the Myeloma Australia physical activity recommendations. Primary outcomes (bone density and microarchitecture measured via dual-energy x-ray absorptiometry and peripheral quantitative computed tomography) and secondary outcomes (bone pain, quality of life, fatigue, physical function, psychological constructs, gut microbiome, disease response, biomarkers of bone health, immune function, and disease progression) are assessed at baseline, 3-, and 9-months. Adverse events, and adherence to the exercise program are monitored.
Results: The MyeEx-Impact trial is on track to reach its a priori recruitment target. Participants have had high adherence to the resistance and impact loading exercises. Seven low-grade (Grade 1 and 2) adverse events have been reported; none of which have impacted subsequent exercise or study participation.
Conclusions: The findings of this study will identify whether bone-targeted exercise is safe, feasible, and can improve bone health in people with MM. Furthermore, this study will provide evidence of the effects of bone-targeted exercise on common MM- and treatment-related side-effects, as well as the potential mechanisms underpinning these effects. Collectively, this novel study will identify the potential role of exercise as an adjuvant therapy for the management of bone health for people with MM.