Wiskemann 2011.

Study characteristics
Methods	Study design: Multicenter RCT Number randomized: 112; 57 to the exercise group and 55 to the control group Study start and stop dates: recruitment took place starting in May 2007 and the last participant completed the trial in February 2009 Length of intervention: at least 7 to 12 weeks Length of follow‐up: to end of the intervention
Participants	Type cancer, n: exercise group: AML, 12; ALL, 6; CML, 2; chronic lymphocytic leukemia, 2; myelodysplastic syndrome, 7; secondary AML, 6; myeloproliferative syndrome, 7; multiple myeloma, 2; other lymphomas, 7; aplastic anemia, 1 control group: AML, 10; ALL, 8; CML, 2; chronic lymphocytic leukemia, 2; myelodysplastic syndrome, 5; secondary AML, 5; myeloproliferative syndrome, 6; multiple myeloma, 1; other lymphomas, 13; aplastic anemia, 1 Time since cancer diagnosis: not reported Time in active treatment, median (range) days: exercise group: outpatient before HSCT, 21 (5 to 112) days; duration of hospitalization, 45 (24 to 92) days; outpatient after HSCT, 49 (39 to 63) days control group: outpatient before HSCT, 15 (5 to 90) days; duration of hospitalization, 43 (22 to 120) days; outpatient after HSCT, 52 (40 to 83) days Inclusion criteria: scheduled for allogenic stem cell transplant Eligibility criteria related to interest or ability, or both, to exercise: not reported Exclusion criteria: not reported Gender, n (%): exercise group: male, 32 (45%); female, 21 (62%) control group: male, 39 (55%); female, 13 (38%) Current age, mean (range) years: exercise group: 47.6 (18 to 70) years control group: 50 (20 to 71) years Age at cancer diagnosis: not reported Ethnicity/race: not reported Education level: not reported SES: not reported Employment status: not reported Comorbidities: none reported Past exercise history, sedentary (< once per week physically active) at baseline, n (%): exercise group: 38 (48%) control group: 41 (52%)
Interventions	57 participants assigned to the exercise intervention, including: endurance training, recommended primarily as (brisk) walking in the outpatient setting; bicycling and treadmill walking during hospitalization. If patients had experience in Nordic walking (walking with specially designed poles imitating the motion of cross‐country skiing) or jogging, these techniques were also recommended strength training included exercises for the upper and lower extremities with and without a set of color‐coded stretch bands with different levels of resistance. 3 different strength‐training protocols were used: (1) focused on extremities, (2) the entire body, or (3) bed exercises (limited to inpatient period) Type exercise (aerobic/anaerobic): aerobic and anaerobic Intensity of the experimental exercise intervention: Borg scale target scores of 12 to 14 for endurance and 14 to 16 for resistance exercises Frequency: 3 endurance (up to 5 during hospitalization) and 2 resistance training sessions per week Duration of individual sessions: endurance training, brisk walking for 20 to 40 minutes strength training, 8 to 20 repetitions, 2 or 3 sets Duration of exercise program: length of treatment Total number of exercise sessions: 21 to 36 endurance sessions and 14 to 24 resistance training sessions Format: individual Facility: home and facility based Professionally supervised during the inpatient period and unsupervised during the outpatient period Adherence: from baseline (medical check‐up) until admission = 87.5%; during hospitalization, 83.0%; outpatient period from discharge until study end (6 to 8 weeks later), 91.3% 55 participants assigned to control group, including: pedometer wearing and told that moderate physical activity is favorable during the treatment period Contamination of control group: not reported
Outcomes	Primary outcome was fatigue, assessed using: MFI fatigue subscale of the POMS fatigue subscale of the EORTC QLQ‐C30 Secondary outcomes included: global HRQoL, assessed using the EORTC QLC‐C30 and subscales of: physical functioning role function cognitive functioning social functioning pain insomnia anxiety assessed using the HADS depression assessed using HADS POMS depression scale emotional functioning, assessed using QLQ‐C30 emotional functioning subscale POMS anger/hostility subscale stress, assessed using the National Comprehensive Cancer Network Distress thermometer physical outcomes, including endurance performance assessed using the 6MWT maximal isometric voluntary muscle strength assessed with a hand‐held dynameter Outcomes were measured at baseline, at admission to hospital (second baseline), at discharge from hospital, and at 6 to 8 weeks after discharge: exercise group: n = 57 at baseline (T0), n = 52 at admission to the hospital (second baseline) (T1), n = 40 at discharge from hospital (T2), n = 40 at 6 to 8 weeks after discharge (T3) control group: n = 55 at baseline (T0), n = 53 at admission to the hospital (second baseline) (T1), n = 41 at discharge from hospital (T2), n = 40 at 6 to 8 weeks after discharge (T3) Subgroup analysis: none reported Adverse events: 24 participants (11 in the exercise and 13 in the control group) died
Notes	Country: Germany Funding: German Jose Carreras Leukemia Foundation
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Allocation sequence was generated using the minimization procedure
Allocation concealment (selection bias)	Unclear risk	Whether the treatment assigned was concealed from study personnel and participants was not described
Blinding of participants and personnel (performance bias) All outcomes	High risk	Owing to the nature of the intervention, it was not possible to conceal allocation to the intervention from the participants
Blinding of outcome assessment (detection bias) All outcomes	High risk	Allocation to the intervention was not concealed from the study personnel
Incomplete outcome data (attrition bias) All outcomes	High risk	Analyses were not conducted on an ITT basis and the treatment of missing data was not described. Although the authors used last observation carried forward for the participants who did not complete the last study visit, they excluded randomized individuals who were considered ineligible after randomization (missing donor, revised diagnosis, contraindications in check‐up, dropped out)
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