Preventing functional decline in allogeneic bone marrow transplant: the BOOST study

All participants will receive a protocolised exercise and education program for the duration of their inpatient admission for their allogeneic bone marrow transplant (alloBMT). The program will include both aerobic and resistance training, to maximise health benefits as per international exercise guidelines, provided by a physiotherapist in a supervised group setting. Each patient will receive individualised exercise based on their self-reported well-being and their objectively measured functional exercise capacity. A “traffic light” system will be used where patients can be grouped into three categories based on their self-rated well-being at each session (red, yellow and green) in order to tailor the exercise intervention (as described by Wiskemann et al, Blood, March 2011: 117; 9). The target intensity will be 3-5 on the Modified Borg scale of breathlessness for aerobic exercise, and 12-14 on the Rating of Perceived Exertion (RPE) scale for resistance exercise. The sessions will operate for up to 1-hour up to 5-days per week in the recreation room on the Bone Marrow Transplant hospital ward. Equipment to be used already exists on the ward and includes an exercise bike, treadmill, hand weights, steps and arm ergometer. Adherence to the exercise program will be recorded by the physiotherapist in the participant's exercise log; participant's will have their own exercise diary to encourage compliance with the program during their hospital stay and upon discharge from hospital. Education will be integrated into the program through a weekly session facilitated by a different member of the multi-disciplinary team for approximately 20-minutes after the exercise session. Topics will include nutrition, staying motivated, return to work.