Knols 2011.

Study characteristics
Methods	Study design: RCT Number randomized: 131; 64 to the exercise group and 67 to the control group Study start and stop dates: enrolment from January 2005 to November 2008 Length of intervention: 12 weeks Length of follow‐up: 3 months from end of the intervention
Participants	Type cancer, n (%): exercise group: leukemia (AML), 19 (29.7%); chronic lymphocytic leukemia, 5 (7.8%); leukemia (ALL), 0 (0%); HL, 5 (7.8%); NHL, 11 (17.2%); multiple myeloma, 17 (26.6%); osteomyelofibrosis, 3 (4.7%); amyloidosis, 1 (1.6%); testicular cancer, 3 (4.7%) control group: leukemia (AML), 12 (17.9%), chronic lymphocytic leukemia, 9 (13.4%); leukemia (ALL), 2 (3%); HL, 9 (13.4%); NHL, 14 (20.9%); multiple myeloma, 20 (29.9%); osteomyelofibrosis, 1 (1.5%); amyloidosis, 0 (0%); testicular cancer, 0 (0%) Time since cancer diagnosis: not reported Time between HSCT and study, mean (SD) days: exercise group: 81 (36) days control group: 78 (35) days  Inclusion criteria: male or females ≥ 18 years old basic fluency in the German language 3 weeks up to 6 months after autologous or allogenic HSCT Eligibility criterion related to interest or ability to exercise, or both: none reported Exclusion criteria: GVHD (except for grade I not requiring treatment) painful joints unstable osteolyses chronic pain lesions in the central or peripheral nervous system uncontrolled cardiovascular disease, thyroid disease, or diabetes. Gender, n (%): exercise group: male, 38 (59.4%); female, 26 (40.6%) control group: male, 39 (58.2%); female, 28 (41.8%) Current age, mean (SD) years: exercise group: 46.7 (13.7) years control group: 56.6 (12.0) years Age at cancer diagnosis: not reported Ethnicity/race: not reported Education level, n (%): exercise group: secondary school, 8 (12.5%); vocational, 26 (40.6%); higher professional, 12 (18.8%); college/university, 18 (28.1%) control group: secondary school, 10 (14.9%); vocational, 30 (44.8%); higher professional, 9 (13.4%); college/university, 18 (26.9%) SES: not reported Employment status: not reported Comorbidities: not reported Past exercise history, n (%): exercise group: almost completely inactive, 25 (39.1%); minimum 20 minutes walking/cycling per day, 39 (60.9%). control group: almost completely inactive, 19 (28.4%); minimum 20 minute walking/cycling per day, 48 (71.6%) On hormone therapy: not reported Other, BMI, mean (SD, range): exercise group: 22.9 (4.3, 15 to 38) control group: 23.9 (4.0, 14 to 34)
Interventions	64 participants assigned to the exercise intervention, including a supervised physical exercise program with: endurance exercises, including ergometer cycling, starting with a 10‐minute warm‐up and maintenance of aerobic performance for at least 20 minutes progressive resistance training using dumbbells and a standard strength program including squats, step‐ups and ‐downs, barbell rotations and upright rowing. The program could be extended with chest press, triceps extension, biceps curl, modified curl ups, and calf raises Type exercise (aerobic/anaerobic): aerobic and anaerobic Intensity of experimental exercise intervention: 20 minutes at a predefined individual HR (from 50% to 60%, increasing up to 70% to 80% of the estimated maximum HR) Frequency: twice per week Duration of individual sessions: 10 minutes warm‐up, 20 minutes maintenance plus time for resistance training Duration of exercise program: 12 weeks Total number of exercise sessions: 24 Format: unclear if individual or group Facility: facility base in a physical therapy practice or fitness center Professionally led by physiotherapist or a physical trainer 67 participants assigned to the control group, including: usual care Adherence: average participation in the physical exercise program was 85% (range = 21% to 100%), representing about 20.5 of 24 training sessions. 22 patients attended all (100%) of the sessions; 37.5% attended > 80% of the sessions; 17.2% attended ≥ 66% of the sessions; and 10.9% attended < 66% of the sessions Contamination of control group: 7.5% of the control group patients reported a minimum of 20 physical exercise sessions
Outcomes	Primary outcome included QoL and physical outcomes, including: physical functioning, measured using the physical function subscale of the EORTC QLQ‐C30 physical function measures, including knee extension, grip strength, walking speed, and functional exercise capacity Secondary QoL outcomes included: fatigue, measured using the German language version of the fatigue subscale of FACT‐An fatigue, measured using the QLQ‐C30 subscale role function, measured using the QLQ‐C30 subscale cognitive function, measured using the QLQ‐C30 subscale social function, measured using the QLQ‐C30 subscale pain, measured using the QLQ‐C30 subscale insomnia, measured using the QLQ‐C30 subscale Secondary physical function outcomes included: body composition quantified walking activity physical activity, measured using the International Physical Activity Questionnaire (IPAQ) short form, telephone‐version Outcomes were measured at baseline, 12 weeks, and 3 months: exercise group: n = 64 at baseline, n = 57 at 12 weeks, n = 51 at 3 months control group: n = 62 at baseline, n = 57 at 12 weeks, n = 54 at 3 months Subgroup analysis: several subgroup analyses were prespecified and conducted Adverse events: none reported
Notes	Country: Switzerland Funding: Zurcher Kresliga (Zurich) and the Eidenossiche Sportkommission (Magglingen)
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Sequence generated using a minimization procedure
Allocation concealment (selection bias)	Low risk	Results of the randomisation were "...stored in opaque envelopes. The allocation sequence and contents of the envelopes were concealed by study personnel"
Blinding of participants and personnel (performance bias) All outcomes	High risk	Owing to the nature of the intervention, participants and study personnel could not be masked or blinded to the allocation to the intervention
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Independent assessors of physical outcomes were blinded to group assignments and carried out the assessments
Incomplete outcome data (attrition bias) All outcomes	Low risk	In the exercise group, 7 participants lost by end of intervention and additional 6 from end of intervention to end of the follow‐up. In control group, 10 participants lost by end of 12 weeks and additional 3 at end of follow‐up. Investigators included all study participants in the ITT analyses
Selective reporting (reporting bias)	Low risk	There appears to be no selective reporting of outcomes
Other bias	Low risk	The trial appears to be free of other problems that could put it at a high risk of bias