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The Feasibility and Acceptability of a Virtually-Supported Home Exercise Program for People with Multiple Myeloma
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- Author / Creator
- Purdy, Graeme Macdonald
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Introduction: Exercise could help alleviate the significant morbidity experienced by people with multiple myeloma (MM). It is unclear if current cancer-specific exercise guidelines are appropriate for this unique population. Supervision, tailoring, and flexibility are proposed as key program elements in this population, but no studies to date have evaluated the acceptability of an intervention that employs these components.
Objectives: The purpose of this study was to determine the feasibility and acceptability of a 12-week tailored virtually-supported home exercise program for people with MM that progresses towards the 2019 Exercise Guidelines for Cancer Survivors.
Methods: A single group multi-method pre/post feasibility study was conducted. The program involved live group classes, independent home workouts, and additional aerobic exercise. Prescriptions were progressed as recommended by the 2019 Exercise Guidelines for Cancer Survivors. Participants completed a virtual fitness assessment and questionnaires at baseline (BL) and week 12 (12WK). Based on a qualitative description method, a sub-set of participants completed one-on-one interviews after the exercise program.
Data Analysis: Feasibility measures were analyzed descriptively. Secondary effectiveness outcomes were analyzed using either a Wilcoxon Signed Rank Test (if distribution not normal) or a Paired t-test (if distribution normal). A team of four coders analyzed transcripts from qualitative interviews using content analysis.
Results: 29 participants consented and 26 completed all follow-up testing (89.7%). Participants completed 89.9% of live group classes, 82.7% of independent home workouts, and 89.7% of independent aerobic exercise. No serious adverse events (grade ≥ 3) occurred in the study. Minor adverse events related to the intervention included grade 1 back pain (n=2), grade 2 back pain (n=1), and grade 2/3 back pain (n=1). One compression fracture unrelated to the intervention occurred during the study. Quality of life (FACT-MM) significantly improved (BL: 111±23 vs 12WK: 118±19, p=0.0332). Thirty-second sit-to-stand score significantly improved (BL: 13.1±4.5 repetitions vs 12WK: 15.8±4.3 repetitions, p<0.0001). Plank duration significantly improved (BL: 78.3±46.0 seconds vs 12WK: 119.9±73.4 seconds, p=0.0002). Timed single leg stance significantly improved (BL: 23.1±13.3 seconds vs 12WK: 31.8±12.6 seconds, p=0.0002). 20 participants completed the post-program interviews. Three themes emerged related to program strengths/limitations: One Size Does Not Fit All, App Usability, and Sustainability. One Size Does Not Fit All contained two sub-themes: Supportive and Responsive Programming and Diverse Exercise Opportunities.
Conclusion: The 12-week virtually-supported home exercise program was feasible and acceptable but associated with a higher than anticipated rate of musculoskeletal events. Tailoring, supervision, active support, knowledgeable and empathetic personnel, multiple delivery formats, and a user-friendly eHealth application appear to be key components in facilitating feasibility and acceptability. The findings from this study warrant further investigation with a larger scale, randomized controlled trial. Future studies should continue to work with people with MM as partners to create sustainable programs that meet the needs and priorities of the patient population.
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- Subjects / Keywords
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- Graduation date
- Fall 2021
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- Type of Item
- Thesis
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- Degree
- Master of Science
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- License
- This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.