Efficacy of Exercise Interventions in Modulating Cancer-Related Fatigue among Adult Cancer Survivors: A Meta-Analysis

Abstract

Background: The purpose of this meta-analysis was to explore the efficacy of exercise as a nonpharmacologic intervention to reduce cancer-related fatigue (CRF) among adult cancer survivors. We also investigated how different components of the exercise prescription (Ex R x ), methodologic considerations, and subject characteristics modulate CRF.Methods: A systematic search for randomized controlled trials was conducted using words related to cancer, exercise, and fatigue.Results: In total, 44 studies with 48 interventions qualified, including 3,254 participants of varying cancer types, stages of diagnosis, treatments, and exercise interventions. Cancer survivors in exercise interventions reduced their CRF levels to a greater extent than usual care controls, d þ ¼ 0.31 (95% CI ¼ 0.22-0.40), an effect that appeared to generalize across several types of cancer. CRF levels improved in direct proportion to the intensity of resistance exercise (b ¼ 0.60, P ¼ 0.01), a pattern that was stronger in higher quality studies (b ¼ 0.23, P < 0.05). CRF levels also reduced to a greater extent when interventions were theoretically driven (b ¼ 0.48, P < 0.001) or cancer survivors were older (b ¼ 0.24, P ¼ 0.04).Conclusions: Exercise reduced CRF especially in programs that involved moderate-intensity, resistance exercise among older cancer survivors and that were guided by theory.Impact: Our results indicate exercise interventions for adult cancer survivors should be multi-dimensional and individualized according to health outcome and cancer type. Cancer Epidemiol Biomarkers Prev; 20(1); 123-33.

Impact of an exercise programme on sustaining physical activity for recovering cancer patients: A qualitative study.

“…The low levels of physical activity in cancer patients are of concern given the benefits that have been demonstrated pertaining to: patients' health and wellbeing; quality of life [13] immune function [48]; fitness [14]; fatigue levels and enhanced survival rates [11]. However, opportunities for cancer patients to engage in physical activity are sparse given the lack of availability of community physical activity programmes [49].…”

“…Evidence has shown exercise to be safe and effective with various cancer types that enable wide reaching benefits for the recovery of patients both before, during and after treatment [9,10]. Specifically, exercise interventions have been shown to reduce the debilitating effects of cancer-related fatigue [11], re-occurrence rates and co-morbidities [12], while increasing quality of life [13], functional capacity and wellbeing [14]. Despite this only 22 to 50% of cancer patients are deemed physically active following diagnosis and treatment [15].…”

Efectividad del ejercicio físico en la fatiga de pacientes con cáncer durante el tratamiento activo: revisión sistemática y metaanálisis

“…El ejercicio físico es considerado una intervención no farmacológica eficaz en la promoción del bienestar físico, mental y funcional de pacientes con cáncer 10,11,12 . Cramp & Byron 13 en una revisión sistemática encontraron que el ejercicio físico produjo mejoras significativas en la fatiga de pacientes con cáncer durante y después del tratamiento activo; aunque los autores no realizaron estimaciones del efecto de las modalidades de ejercicio estudiadas.…”

Physical Therapy Interventions are Beyond Adjunct Care in Improving Quality of Life and Alleviating Pain Related to Cancer and its Treatment: Perspectives and Confronts

“…Improved exercise capacity means decreased progressive in turn better pain control, because progressive fatigue is associated with severe pain (51). A meta-analysis found out that exercise interventions of moderate-intensity (3-6 METs, 60%-80% 1-RM) resistance exercise were successful in reducing cancer related fatigue (CRF), regardless of the use of theory in the exercise intervention, age of the cancer survivor, and methodologic intervention quality [56]. Some time exercises were effective when applied in combination with passive techniques like massage in reducing pain and improving mood in even terminal cancer patients.…”