{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:26:13Z","timestamp":1789565173995,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T00:00:00Z","timestamp":1744070400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple myeloma (MM) is the second most common haematological malignancy. The predominantly older patients often suffer from comorbidities that impair their quality of life (QoL). Physical activity (PA) can be beneficial for cancer patients, but less evidence exists in MM. This randomized controlled trial (RCT) compared an exercise group with World Health Organization (WHO)\u2013compliant PA (150\u2009min aerobic exercise and 2 resistance training\u2010sessions\/week) vs. activity as usual (control group).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty\u2010four newly diagnosed consecutive MM patients were randomized 1:1 to exercise vs. control groups. Guided training (2\u00d7\/week) was performed for 3\u2009months during bortezomib\u2013cyclophosphamide\u2013dexamethasone (VCd) induction. PA was monitored using smartwatches and diaries. Demographics, osteolytic lesions, infections, fatigue, depression, and biomarkers (albumin, creatine kinase, C\u2010reactive protein, high\u2010density lipoprotein, low\u2010density lipoprotein and pro\u2010brain natriuretic peptide) were compared in exercise vs. control cohorts. VCd\u2010tolerance, response, \u2018timed\u2010up\u2010and\u2010go\u2010test\u2019 (TUGT), Revised Myeloma Comorbidity Index (R\u2010MCI), QoL (SF\u201012 questionnaire), event\u2010free survival and trainer assignment during the training period were assessed (13 tests at baseline, during VCd and end of treatment [EOT]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The exercise group was more than twice as active as the control group, with an average aerobic activity of 162 versus 68\u2009min\/week, respectively. Trainer\u2010guided muscle\u2010strengthening exercises were performed 2\u00d7\/week in the exercise group, in line with WHO recommendations. These data were monitored via smartwatches and training diaries. PA proved to be safe: No exercise\u2010related SAEs or accidents occurred. The study adherence was 94% (32\/34). In the exercise versus control group, AEs to VCd induction (6% vs. 25%), therapy intolerance (6% vs. 25%) and hospitalization (31% vs. 50%, respectively) occurred less frequently. VCd\u2010dose adjustments in the exercise vs. control group were significantly less needed (6.3% vs. 37.5%, respectively). At EOT, patients in the exercise group showed less fatigue (6% vs. 75%), less depression (6% vs. 44%), better TUGT (6 vs. 11\u2009s, respectively), improved R\u2010MCI and QoL compared to the control group. Grip strength (right hand: 73\u201382\u2009lb; left hand: 68\u201372\u2009lb) significantly improved from baseline to EOT in the exercise group. Biomarkers did not significantly differ in both groups, but response to VCd\u2010induction and event\u2010free survival were improved in the exercise group, however, without reaching statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PA in MM patients during induction is feasible and can improve fatigue, depression, TUGT, grip strength, comorbidities and QoL. More sport intervention offers are warranted to advance exercising in MM.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      drks.de: DRKS00022250\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.13793","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T08:20:08Z","timestamp":1744100408000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["A Randomized Controlled \u2018REAL\u2010FITNESS\u2019 Trial to Evaluate Physical Activity in Patients With Newly Diagnosed Multiple Myeloma"],"prefix":"10.1002","volume":"16","author":[{"given":"Esther","family":"Dreyling","sequence":"first","affiliation":[{"name":"Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center University of Freiburg, Faculty of Medicine University of Freiburg  Freiburg 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sina","family":"Wenger","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center University of Freiburg, Faculty of Medicine University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Pahl","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center University of Freiburg, Faculty of Medicine University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jann","family":"Arends","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center University of Freiburg, Faculty of Medicine University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Herget","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, Faculty of Medicine University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Deibert","sequence":"additional","affiliation":[{"name":"Institute for Movement and Occupational Medicine, Faculty of Medicine University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"W\u00e4sch","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center University of Freiburg, Faculty of Medicine University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0405-1676","authenticated-orcid":false,"given":"Monika","family":"Engelhardt","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center University of Freiburg, Faculty of Medicine University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,8]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"2420","article-title":"Functional Cure and Long\u2010Term Survival in Multiple Myeloma: How to Challenge the Previously Impossible","volume":"109","author":"Engelhardt 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