JMIR Publications

ABSTRACT

Background:

mhealth-delivered exercise programs may improve physical function and frailty among cancer survivors; however, evidence in hematologic malignancies remains limited.

Objective:

This randomized controlled trial aimed to evaluate the effects of a 16-week mhealth-supported exercise intervention on frailty and physical function in patients with multiple myeloma (MM) who had recently (<180 days) undergone autologous hematopoietic cell transplantation (HCT).

Methods:

Participants were randomized to a mhealth exercise group (n = 16) or a control group (n = 16). Remote assessments were conducted at baseline (week 0), midpoint (week 9), and follow-up (week 17). The intervention consisted of 8 weeks of supervised tele-exercise sessions followed by 8 weeks of unsupervised home-based exercise. Primary endpoints were changes in frailty phenotype (5-component scale) and physical function measures, including chair-stand performance.

Results:

The mean age of the participants was 64.6±7.1 years. Mean time from HCT to study enrollment was 136±36.3 days. The 16-week intervention significantly improved the 5-component frailty phenotype (3.94±1.1 to 2.79±0.7 [exercise] vs 3.88±1.1 to 3.93±0.9 [control]; P<.0001) and chair stand performance (16.8±8.7 to 12.0±4.6 seconds [exercise] vs 12.4±3.1 to 12.7±3.6 seconds [control]; P=.002). No significant changes were observed in the control group at week 9 and 17.

Conclusions:

A 16-week mhealth exercise intervention effectively improved frailty status and functional mobility in MM survivors recently treated with autologous HCT. These results support the feasibility and efficacy of early, sustained tele-exercise rehabilitation in hematologic cancer survivorship. Further studies should explore the underlying mechanisms, compare mhealth- and center-based approaches, and evaluate long-term outcomes. Clinical Trial: Trial Registration: ClinicalTrials.gov NCT05142371; registered October 29, 2021.