The effect of physical activity on health outcomes in patients receiving allogeneic stem cell transplants

The physical activity intervention will consist of 2 components: i. A program to reduce sedentary time, and ii. A structured exercise program combining aerobic and resistance exercises. The exercise intervention was informed by current cancer care position statements published by the Australian College of Sports Medicine and the Clinical Oncology Society of Australia (COSA) (Cormie et al., 2018; Schmitz et al., 2010). Participants allocated to the intervention will receive individualised sedentary behaviour reduction and exercise prescription. To facilitate the delivery of the intervention and monitoring of participants all individuals will be provided a non-invasive wrist worn device to monitor their daily physical activity. The devices are compatible with smart phones (iPhone and Android). If participants do not have a smart phone, a smart phone will be provided to them to facilitate the activity monitoring. Sedentary Time Reduction Program: Alongside and independent of the purposeful physical activity program, participants will receive hourly prompts to interrupt their sedentary time (e.g. bed rest or sitting) with light physical activity. Participants will track their activity using their wearable device and smartphone. Each hour (up to 10 times per day) participants will be prompted to perform either a light walk or a short circuit based activity break, totalling 3 minutes of activity. These types of breaks have been found to have favourable effects on markers of cardio-metabolic health (Dempsey et al., 2017). Structured Exercise Program: An individualised and supervised exercise program will begin as soon as participants are admitted to hospital for their transplant (once an inpatient, prior to transplant). The intervention will be performed within their hospital room and participants will be provided with the necessary equipment to facilitate this. Three supervised sessions of 30-45 minutes per session will be prescribed per week for the duration of the inpatient hospital stay. Participants will complete as many of the three prescribed sessions per week as possible. The sessions will include aerobic and resistance exercise, plus warm up and cool down. The exercise workload (quantified in Watts) corresponding to the required intensity will be individualised for each participant based on their performance in the baseline cardiopulmonary exercise test. Ratings of perceived exertion (RPE) will also be used to monitor exercise intensity. For phase 2, after discharge from hospital, participants will complete two supervised exercise sessions per week and at least one-home based session. Supervised sessions will include an aerobic and resistance component, while the home-based session will be aerobic only. RPE will be used throughout this period to monitor training intensity. Adherence to the intervention program will be assessed by researchers via a checklist that is recorded in the database. Cormie, P., et al. (2018). Clinical Oncology Society of Australia position statement on exercise in cancer care. Medical Journal of Australia, 209(4), 184-187. Dempsey, P. C., et al (2017). Interrupting prolonged sitting in type 2 diabetes: nocturnal persistence of improved glycaemic control. Diabetologia, 60(3), 499-507. Schmitz, K. H., et al (2010). American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Medicine & Science in Sports & Exercise, 42(7), 1409-1426.