Focht, B.C., Clinton, S.K., Devor, S.T., Garver, M.J., Lucas, A.R., Thomas-Ahner, J.M., & Grainger, E. (2013). Resistance exercise interventions during and following cancer treatment: A systematic review. Journal of Supportive Oncology, 11, 45–60. 

DOI Link

Purpose

STUDY PURPOSE: To review the effects of resistance exercise (RE) interventions on clinically relevant physiologic and quality of life (QOL) outcomes during and following cancer treatment and to calculate the magnitude of the change in these outcomes following
 
TYPE OF STUDY: Systematic review

Search Strategy

DATABASES USED: PubMed and MEDLINE databases
 
KEYWORDS: Resistance exercise with related terms and cancer with related terms
 
INCLUSION CRITERIA: Those that included an RE intervention in isolation among patients with cancer or survivors were included. RE was defined as regular participation in a structured, repetitive strength training program over an extended period of time with the goal of improving health or fitness outcomes. Studies targeting individuals diagnosed with cancer who were actively undergoing cancer treatment or had successful cancer treatment with a curative intent were included. All study designs were included. 
 
EXCLUSION CRITERIA: RE in combination with other exercise, lifestyle, or behavioral interventions

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 417 
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: During data extraction by two reviewers, any instances of disagreement were resolved by a consensus of all authors. Quality was assessed by two independent reviewers using seven quality indicators from he Delphi List, a consensus criteria list for quality assessment in randomized, controlled trials. Quality indicators were listed.

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 15
  • TOTAL PATIENTS INCLUDED IN REVIEW = 1,077
  • KEY SAMPLE CHARACTERISTICS: Six studies addressed RE during treatment, and four were conducted during androgen deprivation therapy, one during chemotherapy, and two during radiation therapy. The remaining nine studies focused on RE in participants following the completion of active cancer treatment with a curative intent. This included participants with BRCA (n = 6), prostate cancer (n = 4), head and neck cancer (n = 3), lung cancer (n = 1), and a mixed group (n = 1).

Results

Pertaining to fatigue outcomes, two randomized, controlled design studies showed insignificant changes in fatigue with BRCA survivors. One nonrandomized trial showed insignificant change in patients with prostate cancer. Two randomized, controlled studies showed moderate to large effect sizes in patients with BRCA and prostate cancer patients over time after three and six months. Large effects were seen in the Schmidt study with BRCA survivors. A moderate effect was seen in the Segal study of patients with prostate cancer receiving androgen deprivation therapy. Small effect sizes were seen in BRCA patients undergoing chemotherapy at a midpoint and post-treatment.

Conclusions

The results of this study suggested that RE may improve fatigue in patients with BRCA undergoing chemotherapy, patients with prostate cancer undergoing androgen deprivation therapy, and in BRCA survivors.

Limitations

Although methodologic quality was good overall, an increase of intent-to-treat analyses of future randomized, controlled trials is needed.

Nursing Implications

Few studies examined this type of exercise, and additional study is indicated.

Legacy ID

5304