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Meneses-Echavez, J.F., Gonzalez-Jimenez, E., & Ramirez-Velez, R. (2015). Effects of supervised exercise on cancer-related fatigue in breast cancer survivors: A systematic review and meta-analysis. BMC Cancer, 15, 77-015-1069-4.
KEYWORDS: Breast cancer, cancer-related fatigue, exercise
INCLUSION CRITERIA: Randomized, controlled trials, exercise intervention compared to usual care
EXCLUSION CRITERIA: Gray literature, nonsupervised interventions, tai chi, case reports, or series
Literature Evaluated
TOTAL REFERENCES RETRIEVED: 639
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Physiotherapy Evidence Database (PEDro) scale to evaluate risk of bias
Sample Characteristics
FINAL NUMBER STUDIES INCLUDED = 9
TOTAL PATIENTS INCLUDED IN REVIEW = 1,156
KEY SAMPLE CHARACTERISTICS: Of the trials, 67% were conducted during active treatment. The mean age was 55.2 years, and the studies were mainly of non-Hispanic Caucasians.
Phase of Care and Clinical Applications
PHASE OF CARE: Multiple phases of care
Results
All trials included aerobic training, and six included resistance training. The average duration of training was 21 weeks, and the average sessions per week was 2.5. Supervised aerobic exercise was more effective than usual care in improving fatigue (SMD = –0.51, 95% confidence interval [CI] [–0.81, –0.21]). SMD for resistance training was –0.41 (95% CI [–0.76, –0.05]). No dose response for training intensity was seen. Studies conducted during active treatment showed a significant benefit in reducing fatigue (SMD = –0.66, p < 0.05). In four studies conducted after cancer treatment, the effects of exercise on fatigue were not significant. Exercise improved physical well-being, but no significant effects were observed for social and emotional domains.
Conclusions
Supervised aerobic training during cancer treatment was associated with a significant improvement in fatigue.
Limitations
High heterogeneity among the studies
The analysis was limited to the use of supervised exercise compared to only usual care.
The number of studies reporting emotional and psychosocial outcomes was small.
Nursing Implications
Exercise during cancer treatment has been shown to reduce fatigue. This study suggests that the results may be best with aerobic exercise. The optimum intensity and “dosage” of exercise at various time points in cancer treatment remain unclear.