The Relationship Between Muscle Strength and Body Composition Measures and Cancer-Related Fatigue: A Systematic Review and Meta-Analysis

Li, Chia-Chien; Chou, Yun; Shun, Shiow Ching

doi:10.1188/21.onf.558-576

Cited by 4 publications

(4 citation statements)

References 73 publications

(199 reference statements)

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“…Despite substantial heterogeneity in study designs and participant characteristics, the greatest and most consistent effect of exercise was seen in the improvement of muscular strength, exercise capacity, and agility, all of which are known to be reduced in response to cancer and its treatment among women [ 41 , 42 ]. These improvements in turn potentially reduce fatigue [ 43 , 44 ] and improve an individual’s ability to maintain activities of daily living for enhanced QoL [ 43 ]. Importantly, these outcomes are supported by mostly level II evidence, and both exercise capacity and lower limb strength were two of the most assessed physical outcomes, yielding a greater amount of pooled data than other objective outcomes.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of exercise interventions for women during and after gynaecological cancer treatment – a systematic scoping review

Rose

Stewart

Clifford

et al. 2023

Support Care Cancer

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Purpose To systematically synthesise evidence of exercise intervention efficacy for physical/psychosocial outcomes that matter to women during/following treatment for gynaecological cancer. Methods Five databases were searched (PubMed, EMBASE, CINAHL, PsychInfo, Scopus). Exercise-only intervention studies that included women during/ following treatment for any gynaecological cancer, with/ without control comparison, on any physical or psychosocial outcome(s), were included and qualitatively appraised using the Revised Cochrane Risk of Bias tool and a modified Newcastle-Ottawa Scale. Results Seven randomised controlled trials (RCTs), three single-arm pre-post studies, and one prospective cohort study satisfied were included (11 studies). Most studies were completed following treatment (91%), included combined (aerobic and resistance; 36%) and aerobic (36%) training, were fully/mostly (63%) unsupervised, and had a moderate-to-high risk of bias. Overall, 33 outcomes (64% objectively-measured) were assessed. Improvements were observed in aerobic capacity (V̇O2 Peak +1.6 mL/kg/min, 6-minute walk distance +20-27 m), lower- (30-second sit-to-stand +2-4 repetitions) and upper-limb strength (30-second arm curl +5 repetitions; 1RM grip strength/chest press +2.4-3.1 kg), and agility (timed up-and-go -0.6 seconds). However, changes in quality of life, anthropometry/body composition, balance and flexibility were inconsistent. There was no evidence to support worsening of outcomes. Conclusion Preliminary research into the role of exercise post-gynaecological cancer suggests an improvement in exercise capacity, muscular strength, and agility which, in the absence of exercise, typically decline following gynaecological cancer. Future exercise trials involving larger and more diverse gynaecological cancer samples will improve understanding of the potential and magnitude of effect of guideline-recommended exercise on outcomes that matter to patients.

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Section: Discussionmentioning

confidence: 99%

Efficacy of exercise interventions for women during and after gynaecological cancer treatment – a systematic scoping review

Rose

Stewart

Clifford

et al. 2023

Support Care Cancer

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“…Cancer-related fatigue (CRF) is a major problem among patients with cancer actively undergoing chemotherapy and/or cancer survivors. CRF is multifactorial, yet chemotherapy agents cause myotoxic effects thereby decreased muscle mass cannot generate efficient strength even for daily life activities [ 45 ]. Kilgour et al [ 46 ] stated that CRF is directly linked to muscle mass and strength in patients with advanced-stage cancer.…”

Section: Discussionmentioning

confidence: 99%

Assessment of sensorimotor and strength related function of breast cancer patients during systemic drug therapy: a prospective observational study

Tuğral,

Arıbaş,

Akyol

et al. 2023

BMC Cancer

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Background Chemotherapy is a well-known risk factor for sensorial and motor disturbances. Chemotherapy induced peripheral neuropathy (CIPN) which predominantly affects sensory nerves might cause a diminished fine motor function. This prospective observational study aimed to assess the sensorimotor functions of breast cancer patients before, during, and after chemotherapy. Methods A total of 56 breast cancer patients were evaluated at three different times as follows: T1 (before chemotherapy), T2 (middle chemotherapy), and T3 (completion of chemotherapy). Motor function was assessed with handgrip strength (HGS), peripheral muscle strength (PMS), and the Minnesota Manual Dexterity Test (MMDT). Semmes Weinstein Monofilament Test (SWMT) was performed to assess the sensory function. Fatigue was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Module Cancer Related Fatigue (EORTC-QLQ-FA12), respectively. Results HGS and MMDT were found significant (χ2: 11.279, p = 0.004 and χ2: 9.893, p = 0.007, respectively) whereas PMS was not found significant (F (2,110) = 1.914, p = 0.152). Pairwise comparisons with Bonferroni adjustments revealed that HGS was found significant between T1 and T3, while significant results were obtained between T1 and T2 as well as T2 and T3 in MMDT (p = 0.01 and p = 0.042). There were significant results in some reference points of SWMT, though they were not found after pairwise comparisons with Bonferroni adjustment (p > 0.05). Fatigue was found significantly increased from T1 through T3 (Median: 19.44 vs 27.77, z: -2.347, p = 0.019, Wilcoxon test). Conclusion Our study showed that decreased handgrip strength and fine motor function, as well as increased fatigue, are evident during the chemotherapy. SWMT can be an optional assessment in the context of tracking changes in cutaneous sensation during chemotherapy due to its non-invasive, cheap, and easily repeatable features among cancer patients. To preserve functional capacity as well as independence in daily living, precautions and follow up assessments during the systemic therapy process should be integrated as early as possible to prevent future deteriorations in daily life for patients who undergo chemotherapy. Trial registration NCT04799080.

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“…However, the association between fatigue and body composition is uncertain. The existing studies are mainly cross‐sectional studies, and the body composition indexes selected by each study are different 12 . A study on 104 colorectal cancer patients showed that visceral fat mass, intramuscular fat mass, and skeletal muscle index were not associated with fatigue 13 .…”

Section: Introductionmentioning

confidence: 99%

“…The existing studies are mainly cross‐sectional studies, and the body composition indexes selected by each study are different. 12 A study on 104 colorectal cancer patients showed that visceral fat mass, intramuscular fat mass, and skeletal muscle index were not associated with fatigue. 13 Other three cross‐sectional studies 14 , 15 , 16 concluded that the reduced trunk skeletal muscle mass 14 and skeletal muscle index 15 , 16 could predict the intensity of fatigue in only males.…”

Section: Introductionmentioning

confidence: 99%

Could nutrition status predict fatigue one week before in patients with nasopharynx cancer undergoing radiotherapy?

Song,

Yang,

et al. 2024

Cancer Medicine

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BackgroundPatients with nasopharyngeal carcinoma (NPC) undergoing radiotherapy experience significant fatigue, which is frequently underestimated due to the lack of objective indicators for its evaluation. This study aimed to explore the longitudinal association between fatigue and nutrition status 1 week in advance.MethodsFrom January 2021 to June 2022, a total of 105 NPC patients who received intensity‐modulated radiation therapy were enrolled in the observational longitudinal study. The significant outcomes, including the Piper Fatigue Scale‐12 (PFS‐12), the Scored Patient‐Generated Subjective Global Assessment (PG‐SGA), four body composition indices, and the Hospital Anxiety and Depression Scale (HADS), were assessed weekly from pre‐treatment until the completion of radiotherapy (T0–T7) to explore their relationship.ResultsThe trajectories of PFS‐12 and all dimensions for 105 participants reached a peak during the fifth week. Sensory fatigue consistently received the highest scores (T0 = 1.60 ± 2.20, T5 = 6.15 ± 1.57), whereas behavior fatigue exhibited the fastest increase over time (T0 = 1.11 ± 1.86, T5 = 5.47 ± 1.70). Higher PG‐SGA scores were found to be weakly explainable for aggravating fatigue (β = 0.02 ~ 0.04). Unlike generalized additive mixed models, marginal structural models (MSM) produced larger effect values (β = 0.12 ~ 0.21). Additionally, body composition indices showed weakly negative relationships with fatigue in MSMs one week in advance.ConclusionsThe PG‐SGA may be a more accurate predictor of future‐week fatigue than individual body composition indicators, particularly when HADS is controlled for as a time‐dependent confounder.

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The Relationship Between Muscle Strength and Body Composition Measures and Cancer-Related Fatigue: A Systematic Review and Meta-Analysis

Cited by 4 publications

References 73 publications

Efficacy of exercise interventions for women during and after gynaecological cancer treatment – a systematic scoping review

Efficacy of exercise interventions for women during and after gynaecological cancer treatment – a systematic scoping review

Assessment of sensorimotor and strength related function of breast cancer patients during systemic drug therapy: a prospective observational study

Could nutrition status predict fatigue one week before in patients with nasopharynx cancer undergoing radiotherapy?

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