Hematological Malignancy Clinical Trial
Official title:
Evaluating Effects on Quality of Life of a Partially Supervised Exercise Program Following Allogeneic Stem Cell Transplantation
Although allogeneic haematopoietic stem cell transplant (AlloHSCT) is a curative treatment
option for malignant hematological diseases, it is also associated with significant
morbidity such as graft versus host disease, infections, and immune complications. Moreover,
long-term survivors are likely to have reduced physical performance and functioning due to
deconditioning, sarcopenia, and bone loss, and particularly high levels of fatigue and
psycho-social stress, all of which negatively impact patients' quality of life.
Purpose: To conduct a randomized controlled, single site trial investigating whether a
partially supervised exercise intervention in the first 100 days post alloHSCT patients will
result in improved quality of life at Day 100 post-transplant compared to standard of care
treatment. Secondary objectives will investigate the effect of an exercise intervention on
muscle strength, cardiorespiratory fitness, mobility, bone mineral density, body
composition, exercise, and immunological/inflammatory biomarkers compared to standard of
care.
Procedure: 120 patients receiving alloHSCT will be baseline tested, and then randomized into
an Exercise Intervention Group or Standard of Care Control Group.
This is a randomized non-blinded single centre prospective clinical trial designed to
evaluate the efficacy and safety of a partially-supervised progressive exercise intervention
among patients undergoing alloHSCT compared to a self-directed exercise program.
Approximately 120 patients will be enrolled. Following completion of all baseline data
collection, participants will be randomized 1:1 to the intervention group or the control
group.
Patients in the intervention group will receive an exercise manual with background
information, descriptions for different resistance and aerobic exercises, and instructions
for tailoring the intensity of exercise. All patients will receive Therabands™ for
resistance exercises and have access to a stationary bicycle for aerobic exercises with
practical introduction by an exercise specialist. The partially supervised intervention is a
progressive program with a goal of three aerobic and two resistance exercise sessions per
week.
Aerobic exercise will consist of 10-30 minutes of bicycling using a stationary bike
(supervised or unsupervised) or brisk walking, following the Borg Scale of Rate of Perceived
Exertion (RPE). Resistance exercise will include exercise for the upper and lower
extremities with Therabands™. Exercise will be adapted based on the participant's clinical
status for safety and ability to perform exercises. At the weekly supervised session, the
exercise specialist will provide adequate progression of exercises, and review adherence to
the intervention and provide support for questions and overcoming identified barriers to
adherence.
Participants assigned to the control group will receive our current standard of care. They
will be reviewed by the ward physiotherapist on admission to hospital and encouraged to
maintain physical activity by walking around the inpatient unit during their inpatient
hospitalization. As per standard of care, the physiotherapist will be available on an as
needed basis in both the inpatient and outpatient settings.
Timely assessments of outcome measures outlined in the "Outcome Measures" section will be
conducted for both groups.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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