Arnold, M., & Taylor, N. F. (2010). Does exercise reduce cancer-related fatigue in hospitalised oncology patients? A systematic review. Onkologie, 33, 625–630.

Databases searched were AMED, EMBASE, MEDLINE, and PubMed via the Ovid platform and CINAHL via EBSCO.

Search keywords were oncology, chemotherapy, radiotherapy, strength training, aerobic exercise, walking program, physical activity, and fatigue.

Studies were included if they reported 

• An acute or rehab hospital setting
• A controlled trial
• An outcome measure of fatigue
• Sufficient exercise intensity to have a physiologic effect.

Studies were excluded if they reported additional diversional interventions.

Initially, 2,954 studies were retrieved. After exclusions, there was a final set of five studies. The PEDro scale was applied for evaluation of study quality.

• The final five trials included 269 patients with various cancer types.
• Sample sizes ranged from 22 to 104 patients.

• Overall study quality was low, with scores being an average of 4.6 out of 10 possible points.
• Four trials were included in the meta-analysis. Findings for fatigue showed a standardized mean difference of -0.22 (95% confidence interval [-0.62, 0.08]; p = 0.13).
• The most common fatigue measures were the Brief Fatigue Inventory (BFI) and visual analog scale (VAS).
• All interventions involved aerobic exercise.
• There were no between-group effects seen for other symptoms analyzed.

This review showed no significant effect of aerobic exercise interventions for fatigue outcomes in hospitalized patients with cancer. As this study only included hospitalized patients, the findings may not be applicable in other patient groups.

The study was limited by the small number of included trials, with most having small sample sizes.

Effectiveness of exercise for fatigue may vary greatly depending on the phase of care and time in the cancer disease trajectory at which the intervention is provided. Lack of significant positive findings here may be related to the timing of the intervention with all patients in acute or rehabilitation hospitals.