Relevant parameters for recommendations of physical activity in patients suffering from multiple myeloma

Abstract

Purpose This pilot study aimed to describe physical performance, self-reported physical activity, healthrelated quality of life, anxiety and depression in patients who were assigned from Austrian self-help groups for multiple myeloma patients. These parameters were then discussed in the context of clinical decision-making concerning the recommended type of regular physical activity and exercise. Methods Members of the self-help groups were invited to participate. Physical performance and physical activity were assessed with the 6 min walk test (6MWT), handgrip strength test, timed up and go test (TUG), Tinetti performance oriented mobility assessment (POMA), falls efficacy scale (FES), international physical activity questionnaire (IPAQ), health-related quality of life (EORTC QLQ-C30) and the hospital anxiety and depression scale (HADS). Results A total of 40 patients (female:male = 15:25, mean age: 63.8 ± 9.0 years, range 41-80 years) were identified. In total 20 (50%) reached the performance of healthy peers in the tests 6MWT, handgrip strength, TUG and POMA, while 50% showed at least 1 result below the reference value or cutoff point for each test. Self-reported activity levels were high. Patients showed a tendency to overestimate the risk of falling but a case by case analysis revealed a tendency for underestimating the actual performance in the respective tests (TUG, POMA).

Health-enhancing physical activity, exercise and sports—a never-ending success story

“…Today, the importance of physical activity, exercise and sports concerning health issues cannot be overestimated [1]. For the last decades, exercise in medicine, namely prevention, therapy and rehabilitation seem to have the touch of a never-ending success story [1][2][3]. It is a pleasure for me to highlight two current Viennese approaches concerning this relevant preventive, therapeutic and rehabilitative means within this issue [2,3].…”

“…Furthermore, there are benefits concerning the risk of atherosclerosis, metabolic syndrome, cardiovascular morbidity and mortality, but also concerning morbidity (prevention) and mortality in different cancer types (cancer-specific survival). Positive effects on metabolism, chronic inflammation, mental health, but also on risk of falls are only selected further benefits but of importance in all ages [1][2][3][4]. There are international and national recommendations, which should be followed by all of us [1].…”

“…Concerning chronic diseases, Cenik et al mention in this issue that patients suffering from advanced multiple myeloma-after checking individual contraindications and clinical considerations using a multiprofessional and interdisciplinary setting-are able to exercise. Only 25% of patients with notably impaired physical performance should exercise in an individual setting, but most patients seem to be able to exercise in groups [2]. We are now awaiting the future results of planned interventions focusing on the effects of exercise on these different settings.…”

Relevance of tumor boards for cancer rehabilitation

“…In this tumor board, very challenging and complex cases are discussed to plan their rehabilitation. Their most important issues are decreased physical performance and fatigue, metastatic or lytic bone lesions, brain lesions, chemotherapyinduced peripheral neuropathy, and also cardiovascular and pulmonary disease and/or side effects of necessary (cancer) treatment, metabolic dysregulation, and lymphedema [5][6][7][8][9]. Referring to specialists from different medical specialties such as oncology, physical and rehabilitation medicine, radiology, radiation oncology, surgery, cardiology, and orthopedics (and traumatology) attend the board.…”

“…Furthermore, nutritionists, sports scientists, physiotherapists, massage therapists, and psychologists complete this interdisciplinary and multiprofessional tumor board [3,4]. All of these tumor board members are involved in the rehabilitation process, and therefore, their decision helps to define individual rehabilitation concepts for challenging cancer patients with their individual functional deficits and medical conditions [5][6][7][8][9]. After the tumor board meeting, there results a decision with (1) a contraindication for the start of rehabilitation due to different dangerous clinical issues, but in most cases, there is (2) an individual rehabilitation concept with prescriptions concerning exercise and physiotherapy, and further treatment modalities such as extracorporeal shockwave therapy, other physical modalities, and additional prescriptions for pharmacological treatment (of pain), nutrition, and psychological interventions (psycho-oncology) [1,3,4,9].…”