Efficacy of Exercise Interventions in Modulating Cancer-Related Fatigue among Adult Cancer Survivors: A Meta-Analysis

• Published in: Cancer epidemiology, biomarkers & prevention Vol. 20; no. 1; pp. 123 - 133
• Main Authors: Brown, Justin C., Huedo-Medina, Tania B., Pescatello, Linda S., Pescatello, Shannon M., Ferrer, Rebecca A., Johnson, Blair T.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Association for Cancer Research 01.01.2011
• Subjects: Adult; Biological and medical sciences; Exercise - physiology; Exercise Therapy; Fatigue - etiology; Fatigue - prevention & control; Fatigue - therapy; Humans; Medical sciences; Neoplasms - complications; Neoplasms - therapy; Randomized Controlled Trials as Topic; Survival Analysis; Survivors; Treatment Outcome; Tumors; Human; Physical exercise; Evaluation; Cancerology; Survivor; Adult; Fatigue; Malignant tumor; Cancer; Metaanalysis
• ISSN: 1055-9965; 1538-7755; 1538-7755
• DOI: 10.1158/1055-9965.EPI-10-0988

Background: The purpose of this meta-analysis was to explore the efficacy of exercise as a nonpharmacologic intervention to reduce cancer-related fatigue (CRF) among adult cancer survivors. We also investigated how different components of the exercise prescription (Ex Rx), methodologic considerations, and subject characteristics modulate CRF. Methods: A systematic search for randomized controlled trials was conducted using words related to cancer, exercise, and fatigue. Results: In total, 44 studies with 48 interventions qualified, including 3,254 participants of varying cancer types, stages of diagnosis, treatments, and exercise interventions. Cancer survivors in exercise interventions reduced their CRF levels to a greater extent than usual care controls, d+ = 0.31 (95% CI = 0.22–0.40), an effect that appeared to generalize across several types of cancer. CRF levels improved in direct proportion to the intensity of resistance exercise (β = 0.60, P = 0.01), a pattern that was stronger in higher quality studies (β = 0.23, P < 0.05). CRF levels also reduced to a greater extent when interventions were theoretically driven (β = 0.48, P < 0.001) or cancer survivors were older (β = 0.24, P = 0.04). Conclusions: Exercise reduced CRF especially in programs that involved moderate-intensity, resistance exercise among older cancer survivors and that were guided by theory. Impact: Our results indicate exercise interventions for adult cancer survivors should be multi-dimensional and individualized according to health outcome and cancer type. Cancer Epidemiol Biomarkers Prev; 20(1); 123–33. ©2011 AACR.