TY - JOUR
T1 - The effects of physical exercise in the palliative care phase for people with advanced cancer
T2 - a systematic review with meta-analysis
AU - Toohey, Kellie
AU - Chapman, Michael
AU - Rushby, Anne Marie
AU - Urban, Kat
AU - Ingham, Gemma
AU - Singh, Benjamin
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2023/4
Y1 - 2023/4
N2 - Purpose: The purpose of this systematic review with meta-analysis was to evaluate the safety, feasibility and effectiveness of exercise in the palliative care phase for people with advanced cancer. Methods: Electronic databases were searched for exercise randomised controlled trials involving individuals with incurable cancer that were published prior to April 14, 2021. Meta-analyses were performed to evaluate the effects of exercise on health outcomes. Subgroup effects for exercise mode, supervision, intervention duration and cancer diagnosis were assessed. Results: Twenty-two trials involving interventions ranging between 2 weeks and 6 months were included. Interventions comprised of aerobic (n = 3), resistance (n = 4), mixed-mode (n = 14) and other exercise (n = 1) modalities. Cancer types consisted of lung (n = 6), breast (n = 3), prostate (n = 2), multiple myeloma (n = 1) and mixed cancer types (n = 10). Meta-analysis of 20 RCTs involving 1840 participants showed no difference in the risk of a grade 2–4 adverse event between exercise and usual care (n = 110 adverse events (exercise: n = 66 events; usual care: n = 44 events), RD = − 0.01 (91% CI = − 0.01, 0.02); p = 0.24). Overall median recruitment, retention and adherence rates were 56%, 80% and 69%, respectively. Meta-analysis of health outcomes showed effects in favour of exercise for quality of life, fatigue, aerobic fitness and lower-body strength (SMD range = 0.27–0.48, all p < 0.05). Conclusions: Participants who engaged in exercise experienced an increase in quality of life, fitness and strength and a decrease in fatigue. Implications for Cancer Survivors: Physical activity programs were found to be safe and feasible for people with advanced cancer in the palliative care phase.
AB - Purpose: The purpose of this systematic review with meta-analysis was to evaluate the safety, feasibility and effectiveness of exercise in the palliative care phase for people with advanced cancer. Methods: Electronic databases were searched for exercise randomised controlled trials involving individuals with incurable cancer that were published prior to April 14, 2021. Meta-analyses were performed to evaluate the effects of exercise on health outcomes. Subgroup effects for exercise mode, supervision, intervention duration and cancer diagnosis were assessed. Results: Twenty-two trials involving interventions ranging between 2 weeks and 6 months were included. Interventions comprised of aerobic (n = 3), resistance (n = 4), mixed-mode (n = 14) and other exercise (n = 1) modalities. Cancer types consisted of lung (n = 6), breast (n = 3), prostate (n = 2), multiple myeloma (n = 1) and mixed cancer types (n = 10). Meta-analysis of 20 RCTs involving 1840 participants showed no difference in the risk of a grade 2–4 adverse event between exercise and usual care (n = 110 adverse events (exercise: n = 66 events; usual care: n = 44 events), RD = − 0.01 (91% CI = − 0.01, 0.02); p = 0.24). Overall median recruitment, retention and adherence rates were 56%, 80% and 69%, respectively. Meta-analysis of health outcomes showed effects in favour of exercise for quality of life, fatigue, aerobic fitness and lower-body strength (SMD range = 0.27–0.48, all p < 0.05). Conclusions: Participants who engaged in exercise experienced an increase in quality of life, fitness and strength and a decrease in fatigue. Implications for Cancer Survivors: Physical activity programs were found to be safe and feasible for people with advanced cancer in the palliative care phase.
KW - Advanced
KW - Aerobic exercise
KW - Cancer
KW - Exercise oncology
KW - Neoplasm
KW - Palliative
KW - Resistance exercise
UR - http://www.scopus.com/inward/record.url?scp=85123060927&partnerID=8YFLogxK
U2 - 10.1007/s11764-021-01153-0
DO - 10.1007/s11764-021-01153-0
M3 - Review article
SN - 1932-2259
VL - 17
SP - 399
EP - 415
JO - Journal of Cancer Survivorship
JF - Journal of Cancer Survivorship
ER -