Feasibility and benefits of a structured prehabilitation programme prior to autologous stem cell transplantation (ASCT) in patients with myeloma; a prospective feasibility study.
Susan Mawson, Carol Keen, Julie Skilbeck and 7 others
PMID 34563917WHAT IT FOUND
Before stem cell transplant, myeloma patients completed a supervised exercise programme and walked farther at follow-up.
The programme was acceptable and had no serious adverse events, but too few stayed in the study to confirm a larger trial is ready.
Key findings
01Thirteen patients completed both baseline and follow-up walking assessments, and their mean walking distance increased by 105 metres.
02There were no serious adverse events across 136 exercise sessions.
03Retention was 57%, below the study target of 80%.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 13 patients had both baseline and follow-up walking scores, and retention was 57%, so the sample is small and the feasibility targets were not all met. The study was a feasibility study, not a powered trial, so the walking increase cannot be treated as proof of benefit. Some patients could not complete all sessions because transplant timing was earlier than planned. Qualitative interviews involved few participants and did not reach saturation. The programme was delivered in one hospital gym, so it may not suit patients who live far away or have many clinic appointments. The authors suggest local or digitally supported models, but those were not tested in this study.
Declared interests
The study was funded by NIHR Research for Patient Benefit. One author declared honoraria for speaker fees at educational events organised by Sanofi, Jazz Pharma, Janssen, Mallinckrodt and Actelion; no competing interests were declared by other authors.
The easy way to misread this
Do not read the walking increase as proof the programme works. The study was not powered to detect differences, and retention was below target.