The effect of training during treatment with chemotherapy on muscle strength and endurance capacity: A systematic review

Abstract

Background Treatment of cancer with chemotherapy decreases endurance capacity and muscle strength. Training during chemotherapy might prevent this. There are no clear guidelines concerning which type of training and which training dose are effective. This review aims to gain insight into the different training modalities during chemotherapy and the effects of such training to improve endurance capacity and muscle strength in order to obtain the knowledge to compose a future training program which trains cancer patients in the most effective way. Material and methods A systematic search of PubMed was carried out. In total, 809 studies of randomized controlled trials studying the effects of training during chemotherapy on endurance capacity and muscle strength were considered. Only 14 studies met all the inclusion criteria. The studies were assessed on methodological quality by using Cochrane criteria for randomized controlled trials. Results The quality of the studies was generally poor and the study populations varied considerably as the training programs were very heterogeneous. Variables of endurance capacity reported beneficial effects in 10 groups (59%). Increases due to training ranged from 8% to 31%. Endurance capacity decreased in nine of 13 control groups (69%), which ranged from 1% to 32%. Muscle strength improved significantly in 17 of 18 intervention groups (94%), ranging from 2% to 38%. Muscle strength also improved in 11 of 14 control groups (79%), but this increase was only minimal, ranging from 1.3% to 6.5%. Conclusions This review indicates that training during chemotherapy may help in preventing the decrease in muscle strength and endurance capacity. It is important to know which training intensity and duration is the most effective in training cancer patients, to provide a training program suitable for every cancer patient. Training should be based on good research and should be implemented into international guidelines and daily practice. More research is needed.

The association of resistance training with mortality: A systematic review and meta-analysis

“…Regardless of its association with mortality, resistance training is likely to be particularly important for cancer patients, as it helps to improve their muscle strength and specifically retains lean body mass. 35,36 This may help to protect patients from the adverse musculoskeletal effects of cancer treatments such as chemotherapy, as well as increasing quality of life and functional capacity compared with patients that do not participate in resistance training. 21,37,38…”

Preventive Cardio-Oncology: The Time Has Come

“…and habilitation (while undergoing cancer therapies; adjuvant) programs. Studies show that cardiovascular fitness is preserved or improved if exercise training is initiated prior to completion of cancer therapy, rather than waiting to recover cardiopulmonary function after completion of cancer therapy (105,106). This provides support for the benefit of habilitation even over rehabilitation.…”

Effect of different types of exercise on health-related quality of life during and after cancer treatment: a protocol for a systematic review and network meta-analysis

“…The health benefits of an active lifestyle during and after cancer treatment in the adult population have been described in the scientific literature. During cancer treatment, a systematic review of 14 RCTs in patients undergoing chemotherapy reported a positive effect of resistance and aerobic training in cardiorespiratory and muscular fitness 8. Likewise, a systematic review of 16 RCTs concluded that the practice of aerobic and/or resistance exercise during therapy (chemotherapy or radiotherapy) improved muscular strength 31.…”

“…Physical activity and exercise interventions are powerful tools associated with numerous benefits in terms of the HRQOL of cancer patients8–13 and survivors,9 10 14 15 including improvement in cardiorespiratory and muscular fitness, reduction in fatigue and improvement in body composition and well-being (ie, depression, anxiety, sleep quality and quality of life). As such, cancer patients and survivors have been encouraged to undertake regular exercise 16 17.…”