STEPS to Enhance Physical Activity After Hematopoietic Cell Transplantation for Multiple Myeloma.

Abstract

BACKGROUND\nFinding effective ways to increase physical activity immediately following high-dose chemotherapy and autologous hematopoietic cell transplantation (HCT) for treatment of multiple myeloma (MM) is challenging.\n\n\nOBJECTIVE\nThis pilot randomized clinical trial tested the acceptability, feasibility, and preliminary effects of a free-living physical activity intervention (STEPS) compared with usual care (UC) on physical activity, fatigue, muscle strength, functional ability, sleep, and quality of life following treatment for MM with HCT.\n\n\nMETHODS\nUsing a 2-group pretest/posttest design (N = 32), this study compared the 6-week STEPS intervention to UC. Data were collected using self-report questionnaires, functional performance tests, and wrist actigraphy before HCT and 7 weeks following hospital discharge.\n\n\nRESULTS\nThe STEPS group achieved their physical activity goals on 53% of intervention days. The STEPS group experienced greater appetite loss, more diarrhea, and slept more than UC regardless of time point. Both groups reported improvements in mental fatigue, emotional functioning, pain, sleep disturbance, anger, anxiety, and depression but climbed stairs slower and had weaker hand grips after intervention. Both groups subjectively reported fewer sleep disturbances but objectively experienced more wakefulness after sleep onset and an increased number of awakenings postintervention.\n\n\nCONCLUSIONS\nThe STEPS intervention is acceptable and feasible for people with MM treated with HCT. Both groups reported some improved symptoms but experienced some declines in physical performance postintervention.\n\n\nIMPLICATIONS FOR PRACTICE\nNurses strive to optimize health and promote well-being. Helping people increase their physical activity after treatment for MM with HCT may improve symptoms, but additional studies are needed.