Dennett, A.M., Peiris, C.L., Shields, N., Prendergast, L.A., & Taylor, N.F. (2016). Moderate-intensity exercise reduces fatigue and improves mobility in cancer survivors: A systematic review and meta-regression. Journal of Physiotherapy, 62, 68–82. 

STUDY PURPOSE: To evaluate if a dose response effect of exercise on inflammation and fatigue in cancer survivors exists

TYPE OF STUDY: Meta-analysis and systematic review

• FINAL NUMBER STUDIES INCLUDED =  31 included in meta-regression 
• TOTAL PATIENTS INCLUDED IN REVIEW = 3,816
• SAMPLE RANGE ACROSS STUDIES: 16–500
• KEY SAMPLE CHARACTERISTICS: Participants had various tumor types, and the study included individuals in and post active treatment with chemotherapy and/or radiotherapy and/or surgery.

PHASE OF CARE: Multiple phases of care

Exercise interventions included aerobic, resistance, flexibility, and combinations of these. Interventions included supervised, unsupervised, home-based, hospital- or other setting–based, and group or individual exercise sessions. Moderate quality evidence that exercise had a positive effect on fatigue compared to usual care existed (standard mean deviation = 0.32, 95% confidence interval [0.13, 0.52]). A combination of aerobic and resistance provided the largest treatment effect. Aerobic intensity was negatively related to treatment effect. No relationships existed between resistance exercise and treatment effect.

Exercise has a beneficial effect on fatigue. Moderate intensity exercise appears to be most beneficial.

Varied study quality and sample sizes

This analysis adds to the body of evidence that exercise has a beneficial effect on fatigue among patients with cancer. This study suggests that moderate level aerobic exercise is more beneficial than more intense exercise. This information can be used to guide patient counseling and teaching to incorporate moderate exercise into daily routines.