Strength in Motion: Improving Quality of Life in Multiple Myeloma Through Resistance Training With Janine Joseph, MS, MBA
Expert Perspectives · Keira Smith · 2024-12-16
At the 2024 American Society of Hematology (ASH) Annual Meeting, Janine Joseph, MS, MBA, a Senior Research Specialist in the Department of Cancer Prevention and Control at Roswell Park Comprehensive Cancer Center, presented promising findings on the role of exercise in improving quality of life for patients with multiple myeloma, providing valuable insights into the feasibility and benefits of resistance training for this unique population.
The Role of Exercise in Multiple Myeloma
Historically, physicians have hesitated to recommend exercise for patients with multiple myeloma due to the disease’s impact on bone health. Osteolytic lesions and bone fragility are common, leading to concerns that exercise, especially resistance training, could exacerbate pain or cause fractures. However, a growing body of evidence is shifting this paradigm.
“For a long time, resistance training and other forms of exercise have been contraindicated in this population,” Ms. Joseph explains. “But we’re finding that, when done properly, these patients can take advantage of the benefits of physical activity, particularly resistance training.”
Study Design and Interventions
Ms. Joseph’s presentation focused on the results of two trials. The first was a pilot study initiated during the COVID-19 pandemic, which included two intervention arms: an in-person supervised resistance training program and a home-based unsupervised walking program. The resistance training group participated in one-hour sessions twice weekly over six months under the guidance of a trained nurse and physical trainer. The walking group used Fitbits to track and gradually increase their physical activity.
In an ongoing study, the team is investigating the scalability of virtual resistance training using Microsoft Teams. Participants complete the same supervised program remotely, ensuring accessibility while maintaining safety and effectiveness.
Key Findings: Resistance Training Helped Reduce Fatigue and Pain
The results were compelling. In the supervised resistance training cohorts, patients reported significant reductions in pain and fatigue. Pain levels, assessed using two metrics, improved during the intervention and remained lower even after the program ended.
Fatigue, however, showed a different trajectory. Although fatigue levels decreased during the intervention, they returned to baseline six months post-intervention, underscoring the importance of sustained exercise.
The home-based walking intervention, in contrast, showed no significant changes in any measured outcomes. This highlights the unique benefits of supervised resistance training for this patient population.
Real-World Impact on Patients’ Lives
Beyond quantitative metrics, anecdotal evidence from participants illustrates the profound impact of the program. “We had patients tell us things like, ‘I was finally able to take my dog for a walk’ or ‘I can get the turkey in the oven again,’” Ms. Joseph shares. These small victories in daily living reflect meaningful improvements in quality of life.
Clinical Implications and Future Directions
The study underscores the need for clinicians to reconsider exercise as part of multiple myeloma care. However, Ms. Joseph emphasizes the importance of individualized guidance. “No exercise should be done without the supervision and direction of a doctor,” she advises. “A tailored plan ensures safety and maximizes benefits.”
Future research will explore ways to enhance the durability of these interventions, such as incorporating behavioral strategies to sustain exercise habits. The team is also investigating whether resistance training can prevent progression from precursor conditions like monoclonal gammopathy of undetermined significance to multiple myeloma.
A Call to Action
Ms. Joseph concludes with gratitude for the patients who made the research possible. “This study required immense commitment, and we can’t thank them enough,” she says. While the findings are encouraging, she acknowledges that more work is needed to establish exercise as a standard component of care for multiple myeloma. With continued research, she hopes to build a robust case for the transformative power of resistance training.
About Janine Joseph, MS, MBA
Janine Joseph, MS, MBA, is a Senior Research Specialist in the Department of Cancer Prevention and Control at Roswell Park Comprehensive Cancer Center in Buffalo, New York. She is also the Administrator of the Specialized Programs of Research Excellence (SPORE) Program at Roswell Park. Her research focuses on the roles of physical activity and lifestyle interventions for patients with cancer.