Effects of high-intensity training on the quality of life of cancer patients and survivors: a systematic review with meta-analysis

Abstract

Cancer and associated medical treatments affect patients' health-related quality of life (HRQoL) by decreasing functional dimensions of physical, social, cognitive, and emotional well-being, while increasing short and late-term symptoms. Exercise, however, is demonstrated to be a useful therapy to improve cancer patients' and survivors’ HRQoL, yet the effectiveness of high-intensity training (HIT) exercise is uncertain. This systematic review and meta-analysis aimed to analyse the effects of HIT on HRQoL dimensions in cancer patients and survivors as well as evaluate the optimal prescription of HIT. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) and examined Web of Science and PubMed (Medline) databases. Data were analysed utilizing Review Manager Software. Twenty-two articles were included in the systematic review and 17 in the meta-analysis. Results showed HIT improved global quality of life, physical functioning, role functioning, social functioning, cognitive functioning, fatigue, pain, dyspnea, and insomnia, compared to an inactive control group, yet no differences were found between HIT and low to moderate-intensity exercise interventions. Particular improvements in HRQoL were observed during cancer treatment and with a training duration of more than eight weeks, a frequency of 2 days/week, and a volume of at least 120 min/week, including 15 min or more of HIT. Our findings whilst encouraging, highlight the infancy of the extant evidence base for the role of HIT in the HRQoL of cancer patients and survivors.

Updated systematic review of the effects of exercise on understudied health outcomes in cancer survivors

“…Overall, findings suggest the benefits of exercise on self‐reported cognitive function; however, more research is needed to confirm this, as data remain preliminary. Available evidence also indicates that, while HIIT may improve self‐reported cognition, it may not confer additional benefit above and beyond that of moderate‐intensity aerobic exercise 72,77 …”

“…Available evidence also indicates that, while HIIT may improve self-reported cognition, it may not confer additional benefit above and beyond that of moderate-intensity aerobic exercise. 72,77 Fewer studies have measured cognition objectively and, among those that have, risk of bias is high, and demonstration of effect is equivocal. Specifically, these studies have provided low-quality evidence that exercise generally may benefit executive function and attention, 74 and aerobic exercise may benefit processing speed in breast cancer survivors.…”

Exercícios para um envelhecimento saudável

“…Nesse sentido, Lavín-Pérez et al, (2021) em sua revisão sistemática e metanálise sobre o efeito do treinamento de alta intensidade (HIT) nas dimensões da qualidade de vida relacionada com a saúde (QVRS) em pacientes com câncer e sobreviventes, sugere o HIT como parte da terapia por exercícios para pessoas com diagnóstico de câncer pode melhorar a saúde global e fornecer benefícios físicos, cognitivos e de funcionamento social em comparação com os controles. Além disso, diminuições de fadiga, dor corporal, dispneia e insônia podem ser alcançadas com HIT, todos com resultados semelhantes observados usando exercícios de intensidade baixa a moderada (LAVÍN-PÉREZ et al, 2021).…”

Lifestyle and Pain following Cancer: State-of-the-Art and Future Directions

“…Inappropriate beliefs regarding the expected outcome of physical activity represent a major barrier for CSs to engage in physical activity programs. For example, some breast CSs fear that resistance exercises can aggravate cancer-related lymphedema, which is proven to be wrong as resistance exercises are perfectly safe in this group and do not increase lymphedema [ 125 ], others might fear that exercise can exacerbate their pain, which was refuted by systematic reviews with meta-analyses in CSs and a Cochrane review in chronic non-cancer pain populations, demonstrating that physical activity has a small positive effect on pain ( Table 1 , Figure 2 ) [ 123 , 126 , 127 ]. Despite all this evidence, patients’ adherence to physical activity remains low and remains a bottleneck in current care [ 128 ].…”