Feasibility of early-commencing group-based exercise in allogeneic bone marrow transplantation: the BOOST study

Increasing evidence supports that individualised exercise is safe and beneficial for adults treated with allogeneic bone marrow transplantation (alloBMT), although this is not part of standard care and no research has investigated group-based interventions. This study aimed to determine safety, feasibility and exploratory effects of a supervised group-based inpatient and subsequent home-based exercise programme in alloBMT. This single-site prospective cohort study included consecutive adults treated with alloBMT for haematological disease. All participants received usual care in addition to the protocolised exercise programme pre-transplant until 60 days post transplant. The primary outcome was feasibility; secondary outcomes included exercise capacity, frailty, health-related quality of life and strength. Consent rate was 100% (n = 42); 83% (n = 35) completed all aspects of the intervention and outcome testing; of those, 83% (n = 29) attended ≥2 group-exercise sessions per week; no adverse events occurred. Emotional well-being significantly improved over time, which may highlight benefits of group-based intervention. Other outcomes significantly declined from pre-BMT to hospital discharge, with some improvement at 60 days post-BMT. Participants with early signs of frailty demonstrated the greatest decline in outcomes. Group-based exercise was safe and feasible; observations from this study highlight the importance of baseline identification of frailty to target intervention at those who need it most.