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Meta-Analysis
. 2023 Apr 11;31(5):254.
doi: 10.1007/s00520-023-07716-4.

The role of exercise for pain management in adults living with and beyond cancer: a systematic review and meta-analysis

Colleen Cuthbert  1   2 , Rosie Twomey  3 , Mannat Bansal  3 , Benny Rana  3 , Tana Dhruva  3 , Veronica Livingston  4 , Julia T Daun  3 , S Nicole Culos-Reed  5   3   6
Affiliations
Meta-Analysis

The role of exercise for pain management in adults living with and beyond cancer: a systematic review and meta-analysis

Colleen Cuthbert et al. Support Care Cancer. .

Abstract

Background: Pain is a common side effect of cancer or cancer treatment that negatively impacts biopsychosocial wellbeing and quality of life. Exercise is a potential intervention to manage pain that is safe and has multiple benefits. The objective was to determine the role of exercise in cancer pain management.

Methods: We completed a systematic review and meta-analysis of exercise interventions in adults with any type or stage of cancer by searching Ovid MEDLINE®, Embase, APA PsycInfo, the Cochrane Central Register of Controlled Trials, CINAHL, and SPORTDiscus. We included experimental and quasi-experimental designs where pain was measured as an outcome. Data synthesis included narrative and tabular summary. A meta-analysis was performed on studies powered to detect the effect of exercise on pain. Study quality was evaluated using the Cochrane risk of bias tool and certainty of evidence was evaluated using the GRADE tool.

Results: Seventy-six studies were included. Studies were predominantly conducted in breast cancer and exercise usually included a combination of aerobic and strength training. Ten studies were included in the meta-analysis demonstrating a significant effect for exercise in decreasing pain (estimated average standard mean difference (SMD) was g = - 0.73 (95% CI: - 1.16 to - 0.30)); however, the overall effect prediction interval was large. Overall risk of bias for most studies was rated as some concerns and the grading of evidence certainty was low.

Conclusion: There are limitations in the evidence for exercise to manage cancer-related pain. Further research is needed to understand the role of exercise in a multimodal pain management strategy.

Keywords: Cancer rehabilitation; Cancer-related pain; Exercise; Physical activity.

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Conflict of interest statement

The authors declare no competing interests.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Identification of studies via databases
Fig. 2
Fig. 2
Forest plot for standardized mean difference (SMD) effect size for post-intervention pain. The grey squares represent the SMD, and the left and right extremes of the squares represent the corresponding 95% CI. The grey diamond represents the overall effect, and the bold black line represents the prediction interval, derived from the SMD and 95% CI
Fig. 3
Fig. 3
Summary risk of bias using the RoB2
See this image and copyright information in PMC

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