Recommended Exercise Protocol to Decrease Cancer-related Fatigue and Muscle Wasting in Patients With Multiple Myeloma

Strong, Aisha; Karavatas, Spiridon G.; Reicherter, E. Anne

doi:10.1097/00013614-200604000-00009

Cited by 13 publications

(11 citation statements)

References 22 publications

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“…Based on a systematic review of 20 exercise studies relevant to fatigue and muscle wasting in multiple myeloma, Strong et al 198 summarized weight-bearing precautions for bone metastases and exercise guidelines for adults with solid tumors and hematologic cancers, older cancer survivors, and individuals with CRF. An exercise protocol for multiple myeloma that incorporated aerobic, resistance, and flexibility exercises was also recommended.…”

Section: Interventions For Patients At the End Of Lifementioning

confidence: 99%

Cancer-Related Fatigue, Version 2.2015

Berger¹,

Mooney²,

Alvarez-Perez³

et al. 2015

J Natl Compr Canc Netw

648

511

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Cancer-related fatigue is defined as a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning. It is one of the most common side effects in patients with cancer. Fatigue has been shown to be a consequence of active treatment, but it may also persist into posttreatment periods. Furthermore, difficulties in end-of-life care can be compounded by fatigue. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Cancer-Related Fatigue provide guidance on screening for fatigue and recommendations for interventions based on the stage of treatment. Interventions may include education and counseling, general strategies for the management of fatigue, and specific nonpharmacologic and pharmacologic interventions. Fatigue is a frequently underreported complication in patients with cancer and, when reported, is responsible for reduced quality of life. Therefore, routine screening to identify fatigue is an important component in improving the quality of life for patients living with cancer.

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Section: Interventions For Patients At the End Of Lifementioning

confidence: 99%

Cancer-Related Fatigue, Version 2.2015

Berger¹,

Mooney²,

Alvarez-Perez³

et al. 2015

J Natl Compr Canc Netw

648

511

View full text Add to dashboard Cite

show abstract

“…Evidence supports the benefit of exercise in managing fatigue during and after treatment for patients with breast cancer and other solid tumors (Courneya & Friedenreich, 1999;Galvao & Newton, 2005;Knols, Aaronson, Uebelhart, Fransen, & Aufdemkampe, 2005;Oldervoll, Kaasa, Hjermstad, Lund, & Loge, 2004;Schmitz et al, 2005;Stevinson, Lawlor, & Fox, 2004;Stricker, Drake, Hoyer, & Mock, 2004), as well as for those receiving hematopoietic stem cell transplantations, including patients with multiple myeloma (Strong, Karavatas, & Reicherter, 2006). Although limited by small sample size, results from a recent randomized controlled trial (Drouin et al, 2006) suggest that exercise increases hemoglobin levels.…”

Section: Key Pointsmentioning

confidence: 99%

Effects of Exercise in Combination With Epoetin Alfa During High-Dose Chemotherapy and Autologous Peripheral Blood Stem Cell Transplantation for Multiple Myeloma

Coleman

Coon²,

Kennedy³

et al. 2008

Oncology Nursing Forum

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Purpose/Objectives-To determine the effect of aerobic and strength resistance training and epoetin alfa (EPO) therapy on transfusions, stem cell collections, transplantation recovery, and multiple myeloma treatment response. Design-Randomized clinical trial.Setting-A myeloma research and therapy center in the south central United States.Sample-135 patients with multiple myeloma, 120 evaluable.Methods-Random assignment to exercise or usual care groups. All patients received EPO based on an algorithm. Aerobic capacity, using the six-minute walk test, was assessed prior to induction chemotherapy, prior to stem cell mobilization, and following stem cell collection for all patients and before and after transplantation for patients continuing in the study. Data analysis included analysis of variance to compare other outcome variables by groups.Main Research Variables-Number of red blood cell and platelet transfusions during transplantation, number of attempts at and total number of days of stem cell collection, time to recovery after transplantation, and response to intensive therapy for multiple myeloma.Findings-Recovery and treatment response were not significantly different between groups after transplantation. The exercise group had significantly fewer red blood cell transfusions and fewer attempts at stem cell collection. Serious adverse events were similar in each group.Conclusions-Exercise with prophylactic EPO therapy reduces the number of RBC transfusions and attempts at stem cell collection for patients receiving intensive treatment for multiple myeloma.Implications for Nursing-Exercise is safe and has many physiologic benefits for patients receiving multiple myeloma treatment. Key Points • Exercise in combination with epoetin alfa therapy reduced the number of transfusions and the number of attempts at stem cell collection while improving aerobic capacity.• Patients receiving chemotherapy and autologous peripheral blood stem cell transplantation can exercise safely.• Nurses should use exercise as an intervention to reduce the need for transfusions and improve stem cell collection.At least 60% of patients with multiple myeloma are anemic (hemoglobin less than 12 g/dl) at diagnosis (Multiple Myeloma Research Foundation, 2002), and almost all become anemic during treatment, often requiring red blood cell (RBC) transfusions (Knight, Wade, & Balducci, 2004). Epoetin alfa (EPO) increases hemoglobin levels and reduces the need for RBC transfusions in diverse groups of patients with cancer-related anemia (Henry, 2005), particularly patients with multiple myeloma receiving chemotherapy treatment (Barlogie & Beck, 1993).Evidence supports the benefit of exercise in managing fatigue during and after treatment for patients with breast cancer and other solid tumors (Courneya & Friedenreich, 1999;Galvao & Newton, 2005 (Drouin et al., 2006) suggest that exercise increases hemoglobin levels. Women receiving radiation treatment for breast cancer (N = 20) were randomly assigned to aerobic exercise or to placebo stretc...

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“…35 The improvements in muscle performance and lean muscle mass are also associated with decreased complaints of fatigue. 29,36,37 Coon and Coleman 38 investigated the strategies used by patients with multiple myeloma to implement a home-based aerobic and resistancetraining exercise program while undergoing the previously mentioned HSCT treatment. Intrinsic factors that facilitated exercise adherence included a belief that exercise would be beneficial, commitment to taking responsibility for one's health, keeping a routine, and setting goals.…”

Section: Benefits Of Exercise For Those With Hematologic Malignanciesmentioning

confidence: 99%

Rehabilitation and Exercise Considerations in Hematologic Malignancies

Paul

2011

American Journal of Physical Medicine &Amp; Rehabilitation

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Patients facing hematologic malignancy and its treatment are highly vulnerable to profound physiologic, functional, and cognitive disability and often experience a significant increase in psychosocial stress. For optimal outcomes, this incredibly vulnerable oncology population will need earlier and more comprehensive involvement of rehabilitation services, including exercise strategies.Exercise interventions for those with cancer have not been well studied, particularly in those with hematologic malignancies. Of the research available to date, significant methodologic limitations exist. There is a strong need for further investigation into the effects of and guidelines for exercise interventions in this population of patients, particularly among those undergoing or having undergone hematopoietic stem cell transplantation, as this has historically been a difficult population to study because of the high morbidity and potential for medical complications. From the limited data available to date, exercise seems to be generally safe, feasible, efficacious, and capable of providing functional improvements for those with hematologic cancers.

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Recommended Exercise Protocol to Decrease Cancer-related Fatigue and Muscle Wasting in Patients With Multiple Myeloma

Cited by 13 publications

References 22 publications

Cancer-Related Fatigue, Version 2.2015

Cancer-Related Fatigue, Version 2.2015

Effects of Exercise in Combination With Epoetin Alfa During High-Dose Chemotherapy and Autologous Peripheral Blood Stem Cell Transplantation for Multiple Myeloma

Rehabilitation and Exercise Considerations in Hematologic Malignancies

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