Tian, L., Lu, H.J., Lin, L., & Hu, Y. (2016). Effects of aerobic exercise on cancer-related fatigue: A meta-analysis of randomized controlled trials. Supportive Care in Cancer, 24, 969–983. 

DOI Link

Purpose

STUDY PURPOSE: To systematically assess and determine the effects of aerobic exercise interventions in the management of cancer-related fatigue (CRF)
 
TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: The Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Web of Science, China Biology Medicine, China National Knowledge Infrastructure
 
KEYWORDS: exercise, physical activity, exercise therapy, exercise training, aerobic exercise, physical training, cancer, oncology, neoplasm, cancer treatment, chemotherapy, radiotherapy, hormonal therapy, fatigue, cancer-related fatigue, CRF
 
INCLUSION CRITERIA: Adults diagnosed with any type of cancer, trials using aerobic exercise interventions with usual care (UC) or no exercise, fatigue as a primary or secondary outcome, containing fatigue scores
 
EXCLUSION CRITERIA: Focused only on range of motion

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 1,428
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Two independent reviewers used 12 criteria; studies meeting at least 6 of the 12 criteria were rated as low risk of bias. Meta-analysis was performed using Review Manager Software.

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 26
  • TOTAL PATIENTS INCLUDED IN REVIEW = 2,830
  • SAMPLE RANGE ACROSS STUDIES: 10 of 26 had a sample size less than 30
  • KEY SAMPLE CHARACTERISTICS: 13 studies of breast, 3 of prostate, 2 of colorectal, 2 of nasopharyngeal, 2 of hematological, 1 of gynecologic, and 3 of various types of cancer. The mean age ranged from 40–70.6 years. Twelve studies reported cancer stage from mostly I to III. Eight studies included patients who had completed active treatment.

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment

Results

Exercise was supervised or home-based, 15–50 minutes in length, two to five times per week for 6–24 weeks. Overall aerobic exercise had a small but significant effect (p = 0.01). Studies with patients past active treatment had a moderate effect on fatigue compared to usual care (p < 0.01). Professionally led exercise led to significant improvements in fatigue (p = 0.02). Professionally led exercises lasted 20–30 (p < 0.01) or 50 minutes (p < 0.02), two to three (p < 0.01, p = 0.01) times per week for eight weeks (p < 0.01). No significant difference by exercise type existed.

Conclusions

Structured exercise can have a positive effect on CRF. The effect may be greater when activity is professionally led and after active treatment.

Limitations

  • The majority of patients had breast cancer, limiting generalizability.
  • Other potential contributing factors to CRF were not reported in these studies.

Nursing Implications

Consistent physical activity should be discussed with patients with cancer to lessen the effects of CRF.

Legacy ID

6105