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Meta-Analysis
. 2015:2015:328636.
doi: 10.1155/2015/328636. Epub 2015 Jun 17.

Effects of Supervised Multimodal Exercise Interventions on Cancer-Related Fatigue: Systematic Review and Meta-Analysis of Randomized Controlled Trials

José Francisco Meneses-Echávez  1 , Emilio González-Jiménez  2 , Robinson Ramírez-Vélez  1
Affiliations
Meta-Analysis

Effects of Supervised Multimodal Exercise Interventions on Cancer-Related Fatigue: Systematic Review and Meta-Analysis of Randomized Controlled Trials

José Francisco Meneses-Echávez et al. Biomed Res Int. 2015.

Abstract

Objective: Cancer-related fatigue (CRF) is the most common and devastating problem in cancer patients even after successful treatment. This study aimed to determine the effects of supervised multimodal exercise interventions on cancer-related fatigue through a systematic review and meta-analysis.

Design: A systematic review was conducted to determine the effectiveness of multimodal exercise interventions on CRF. Databases of PubMed, CENTRAL, EMBASE, and OVID were searched between January and March 2014 to retrieve randomized controlled trials. Risk of bias was evaluated using the PEDro scale.

Results: Nine studies (n = 772) were included in both systematic review and meta-analysis. Multimodal interventions including aerobic exercise, resistance training, and stretching improved CRF symptoms (SMD = -0.23; 95% CI: -0.37 to -0.09; P = 0.001). These effects were also significant in patients undergoing chemotherapy (P < 0.0001). Nonsignificant differences were found for resistance training interventions (P = 0.30). Slight evidence of publication bias was observed (P = 0.04). The studies had a low risk of bias (PEDro scale mean score of 6.4 (standard deviation (SD) ± 1.0)).

Conclusion: Supervised multimodal exercise interventions including aerobic, resistance, and stretching exercises are effective in controlling CRF. These findings suggest that these exercise protocols should be included as a crucial part of the rehabilitation programs for cancer survivors and patients during anticancer treatments.

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Figures

Figure 1
Figure 1
Figure 2
Figure 2
Effect estimate of supervised multimodal exercise on CRF. Standardized mean difference (SMD) was calculated for the random effects model of meta-analysis. IV, inverse of variance; CI, confidence interval.
Figure 3
Figure 3
Funnel plot for the assessment of publication bias.
Figure 4
Figure 4
Effect estimate of supervised multimodal exercise on CRF according to anticancer treatment stage. Standardized mean difference (SMD) was calculated for the random effects model of meta-analysis. IV, inverse of variance; CI, confidence interval.
Figure 5
Figure 5
Effect estimate of supervised multimodal exercise on CRF according to the mode of exercise. A + RT + ST, aerobic exercise + resistance training + stretching; RT, resistance training. Standardized mean difference (SMD) was calculated for the random effects model of meta-analysis. IV, inverse of variance; CI, confidence interval.
Figure 6
Figure 6
Bubble plot for the dose-response relationship between the intervention duration (minutes/session) and effect estimates changes for CRF from the nine randomized controlled trials included in the metaregression analysis (P = 0.04).
See this image and copyright information in PMC

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