Aims:
People with multiple myeloma (MM) experience the lowest quality of life (QoL) of all cancer populations. Physical activity (PA) and exercise have been shown to improve outcomes in other cancers. This cross-sectional study aimed to explore the associations between PA, neuromuscular strength and fitness and QoL, disease symptoms, bone pain and fatigue in MM.
Methods:
Baseline characteristics were collected for participants with MM using validated surveys (EORTC QLQ-C30 with MY20 module, FACT-BP, FACIT-F, Godin LTPAQ), neuromuscular fitness (5-times (5STS) or 30-sec sit-to-stand test (30STS)) and dynamometry.
Results:
Participants with MM (n=120; mean age 64±9years, 68% male) predominantly presented with lytic lesions (78%) and other skeletal complications (13%; back pain, osteoporosis, osteoarthritis). Most participants (66%) were insufficiently active (<150min moderate-to-vigorous PA). Almost half (47%) reported clinical fatigue (FACIT-F<34; mean 30.9; 95%CI 28.6,33.3), with high incidence (84%) of bone pain (FACT-BP: mean 47.8; 95%CI 45.6,49.9).
Overall QoL (EORTC QLQ-C30: mean 79.5; 95%CI 77.1,81.8) and disease symptoms (EORTC QLQ-MY20: mean 21.7; 95%CI 18.6,24.8) were marginally better than typically observed at diagnosis. Mean grip strength (males: 40.5kg; 95%CI 38.7,42.3; females: 24.6kg; 95%CI 22.8,26.4) reflected normative values for healthy older adults, in contrast to poorer scores for neuromuscular fitness (5STS: 14.8sec; 95%CI 13.1,16.5; 30STS: 10.6reps; 95%CI 9.9,11.3).
Physically active participants reported better QoL (p=0.009), with decreased fatigue (p=0.02), bone pain (p=0.002) and symptom burden (p=0.002), compared to insufficiently active. Associations (r 0.23-0.54; p<0.05) were observed between neuromuscular fitness and improved outcomes, though no associations (>0.05) were observed with upper body strength.
Conclusion:
Participants experience high levels of clinical fatigue and bone pain but report low levels of PA. Those with higher levels of PA had improved QoL and disease symptoms. These findings highlight a significant need for targeted interventions to increase PA and neuromuscular fitness to optimise QoL and disease symptoms in MM.