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. 2019 Jan 31;2019(1):CD009075. doi: 10.1002/14651858.CD009075.pub3

Bryant 2018.

Methods Randomisation
  • Randomised controlled trial

  • 2 arms: individualised prescriptive exercise intervention 2 to 4 times per week for a period of the induction chemotherapy/in‐hospital recovery vs usual care


Recruitment period
  • May 2014 to November 2015


Median follow‐up time
  • 6 weeks


Sample size calculation
  • Not reported

Participants Eligibility criteria
  • Newly diagnosed with acute leukaemia by pathology report

  • Admitted for induction chemotherapy within in the previous 96 hours or +/‐ 3 days from initiation of induction chemotherapy

  • An expected hospital stay of 3 to 4 weeks or longer

  • Participation in the study must be approved by the physician directly responsible for the patient's care

  • Age ≥ 21 years

  • Ability to speak and understand English

  • Ability to use a computer

  • No severe comorbidity that would not allow physical training

  • Give written informed consent


Participants (N = 17)
  • Intervention group (N = 8)

  • Control group (N = 9)


Mean age
  • Interventions group: 52 years

  • Control group: 49 years


Stage of disease
  • Intervention group: not reported

  • Control group: not reported


Country
  • USA

Interventions Exercise group
  • Individualised prescriptive exercise intervention 2 to 4 times per week for a period of the induction chemotherapy/in‐hospital recovery

  • The exercise intervention began on week 1 of the study, the day after the first batteries of initial assessments were concluded

  • Each exercise session was divided into two parts. One part was administered in the morning and the second one late in the afternoon. There was a period of rest of at least 36 hours between each exercise session


Control group
  • Standard care

Outcomes Reported
  • Anthropometric measurements

  • Physical performance

  • Fatigue

  • Quality of sleep

  • Anxiety

  • Depression

  • Quality of life


Not reported but relevant
  • Overall survival


Reported but not relevant
  • none


Primary outcome
  • Fatigue

Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote:"The randomization sequence was generated by the study’s statistician. The statistician and research outcome assessors were blinded to the randomization allocation"
Allocation concealment (selection bias) Low risk Quote:"The randomization sequence was generated by the study’s statistician. The statistician and research outcome assessors were blinded to the randomization allocation"
Blinding of participants and personnel (performance bias) 
 All outcomes High risk Blinding in this context is not feasible
Blinding of outcome assessor (primary endpoint; mortality) Low risk The review authors judge that the outcome mortality in this unblinded trial is unlikely to be influenced by lack of blinding
Blinding of outcome assessor (patient‐reported outcomes) High risk Blinding in this context is not feasible
Blinding of outcome assessor (physical performance, AEs, SAEs) Unclear risk Quote:"The randomization sequence was generated by the study’s statistician. The statistician and research outcome assessors were blinded to the randomization allocation"
Incomplete outcome data (attrition bias) 
 All outcomes High risk Quote:"1 dropped before the intervention started" (intervention group)
Selective reporting (reporting bias) Low risk All outcomes mentioned in the protocol are reported
Other bias Low risk None