| What it is | Home‑based remote aerobic and resistance exercise plus nicotinamide riboside supplementation | Home‑based remote aerobic and resistance exercise with placebo capsules | Nicotinamide riboside supplementation without exercise | Placebo capsules without exercise intervention | Guideline‑recommended moderate‑intensity aerobic and resistance exercise as part of survivorship rehabilitation |
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| Role in trial | One of four randomized arms in a 2×2 factorial design | Control arm for NR effect while receiving exercise | Control arm for exercise effect while receiving NR | Placebo control with no exercise intervention | Represents typical exercise guidance outside of trial |
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| Primary use | To examine combined effect of NR and exercise on muscle strength and fitness | To measure effect of exercise alone on strength and fitness | To assess effect of NR supplementation alone on outcomes | Serves as control for both interventions | Represents typical rehabilitation exercise recommended during survivorship |
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| How it is given or performed | Home‑based aerobic and resistance training plus daily NR capsules for 16 weeks | Home‑based aerobic and resistance training plus daily placebo capsules for 16 weeks | Daily NR capsules without exercise for 16 weeks | Daily placebo capsules without exercise for 16 weeks | Home‑based moderate aerobic (150 min/week) and resistance training (≥2 days/week) per survivorship guidelines |
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| Evidence status | Effectiveness not yet established; trial is ongoing | Exercise alone improves strength and physical function in HSCT survivors per systematic reviews | NR supplementation effect on muscle outcomes in this population is unproven | Placebo control; no active intervention tested | Aerobic and resistance training are supported to improve strength and walking distance in HSCT and cancer survivors |
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| Important risks | Safety of NR with exercise in HCT survivors not yet established | Exercise is generally safe in HSCT survivors when supervised | Safety of NR alone in this population unknown | Placebo is inert and expected to have no physiological risks | Moderate aerobic and resistance exercise is considered safe for cancer survivors with appropriate guidance |
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| Important limitations | Mechanistic trial without efficacy or safety results yet; generalizability unclear | Effect may reflect supervised setting and may differ in real-world self‑guided exercise | NR dosing and effect on muscle outcomes post‑HCT not established | Design control arm only, provides no intervention benefit | Survivorship guidelines are general and may not address HCT‑specific needs |
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