A review of studies spanning 45 years shows that exercise, particularly aerobic rather than strength- or flexibility-based training, improves fatigue in cancer patients.
The review, published in the Cochrane Database of Systematic Reviews, includes data for over 1400 individuals with solid tumors - predominantly breast cancer - who received or underwent an exercise intervention, and for more than 1100 of their peers who did not (controls).
The findings indicate that aerobic exercise "should therefore be considered as one component of a management strategy for fatigue," suggest Fiona Cramp (University of the West of England, Bristol, UK) and colleagues, who explain that the improving survival of cancer patients calls for a greater focus on approaches to enhancing their quality of life.
The analysis included data from 38 studies of 1461 individuals who undertook an exercise intervention and 1187 controls who did not.
Aerobic activities included walking and stationary cycling; other studies involved weight training and yoga, all completed for a range of 10-120 minutes per session, from daily to twice per week.
By the end of the intervention period, exercise was statistically more effective than control at reducing fatigue in the 38 studies, with a standardized mean difference (SMD) in fatigue scores (those used included the Functional Assessment of Cancer Therapy, Profile of Mood States, and Brief Fatigue Inventory) of -0.27.
The same trend emerged for those patients who exercised during cancer treatment and those who exercised after it, with both associations significant, report Cramp and co-authors.
Exercise interventions were also statistically more effective for breast and prostate cancer patients compared with usual care or no intervention, with SMD scores of -0.35 and -0.45, respectively. However, fatigue scores did not differ significantly between the exercise and control arms of studies involving patients with hematologic cancers, with an SMD of -0.15.
With regards to the type of exercise, aerobic training was more effective than control at alleviating fatigue symptoms overall, whereas resistance exercise and "mind-body" exercise (ie, yoga) was no different from control interventions.
The research team concludes that further work is needed to determine the most effective parameters of exercise for fatigue management, including type, frequency, and duration, and that "consensus is also needed on the most appropriate multi-dimensional outcome measure to use."
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