Effects of Exercise Interventions and Physical Activity Behavior on Cancer Related Cognitive Impairments: A Systematic Review

Abstract

This systematic review analyzes current data on effects of exercise interventions and physical activity behavior on objective and subjective cancer related cognitive impairments (CRCI). Out of the 19 studies which met all inclusion criteria, five RCTs investigated rodents, whereas the other 14 trials explored humans and these included six RCTs, one controlled trial, two prospective noncontrolled trials, one case series, one observational study, and three cross-sectional studies. The results from animal models revealed positive effects of exercise during and after chemotherapy or radiation on structural alterations of the central nervous system, physiological as well as neuropsychological outcomes. The overall study quality in patient studies was poor. The current data on intervention studies showed preliminary positive effects of Asian-influenced movement programs (e.g., Yoga) with benefits on self-perceived cognitive functions as well as a reduction of chronic inflammation for breast cancer patients in the aftercare. Exercise potentially contributes to the prevention and rehabilitation of CRCI. Additional RCTs with standardized neuropsychological assessments and controlling for potential confounders are needed to confirm and expand preliminary findings.

Walking as an intervention during chemotherapy: integrative review

“…It should be noted that 10 studies included patients with breast cancer, only one study included patients with breast and colorectal cancer (Backman et al, 2014), and another study included patients with ovarian cancer (Newton et al, 2011). Similar results were found in review studies on physical activity in cancer patients (Zimmer et al, 2016;Meneses-Echávez al., 2015;Jacobsen, Donovan, Vadaparampil, & Small, 2007). With regard to the study objectives, they ranged from the assessment of the adherence to the physical activity intervention (S1, S5, S8, S12) to the assessment of the physical (S3, S4, S6, S11) and psychological impact (S2, S3, S4, S10, S11) of the intervention or more specific aspects, such as maximal oxygen uptake (S6, S9), hemoglobin (S6), inflammatory markers (S6), and immune system (S7).…”

“…Several interventions can be used to help the patient cope with the symptoms, including teaching sessions, psychotherapy, behavioral therapy, and physical exercise (Coolbrandt et al, 2014). Exercise interventions and increased physical activity are a promising way of counteracting the multiplicity of symptoms (Zimmer et al, 2016). Meneses-Echávez, González-Jiménez, Correa-Bautista, Río, and Ramírez-Vélez (2015) underline that exercise is a safe and effective intervention for fatigue management in cancer patients undergoing active treatment.…”

“…Meneses-Echávez, González-Jiménez, Correa-Bautista, Río, and Ramírez-Vélez (2015) underline that exercise is a safe and effective intervention for fatigue management in cancer patients undergoing active treatment. However, Zimmer et al (2016) highlight some methodological constraints, particularly the heterogeneity of assessments and interventions, as well as the lack of adequate control groups. Studies using physical activity interventions during chemotherapy adopt several strategies, namely regarding the type of exercises, duration, and implementation, self-managed or supervised interventions (Meneses-Echávez et al, 2015).…”

Cognitive decline in prostate cancer patients undergoing ADT: a potential role for exercise training

“…Although exercise has been shown to be important for the prevention and management of cognitive impairment in cancer patients generally (Zimmer et al 2016), various reviews have also associated exercise interventions with improved cognitive function in men treated with ADT (Trost et al 2013, Ahmadi & Daneshmand 2014, Gardner et al 2014, Nguyen et al 2015. However, as shown in Table 3, many of these exercise trials are limited by the use of a generalised quality of life (QoL) questionnaire containing subjective measures of cognitive function, such as the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC-QLQ C30) (Culos-Reed et al 2007, Livingston et al 2011, Oh et al 2012, Cormie et al 2014a, Buffart et al 2015.…”

“…Although there are currently no data on the effects of exercise training on cognitive function specific to ADT and non-ADT men with PCa, a review of trials in women with breast cancer and mixed cancer types show a positive effect of exercise training on cognitive function (Zimmer et al 2016). Thus, despite the lack of direct evidence, there is indirect evidence to support a role for exercise training in attenuating the negative effects of ADT on cognitive function.…”