Positive Health Online

Abstract

HILFIKER and COLLEAGUES, 1 School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland Valais, Leukerbad, Switzerland; 2 Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland.;3 School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland; 4 Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland;             5 Directory of Research and Education, Physiotherapy Occupational Therapy Research, Center University Hospital Zurich, Zurich, Switzerland; 6 Department of Physiotherapy, Inselspital, Bern University Hospital, Berne, Switzerland; 7 Bern University of Applied Sciences Health, Berne, Switzerland;8 Faculty of Sports Sciences and Exercise Rehabilitation, Vrije Universiteit Brussel, Brussels, Belgium  assessed the relative effects of different types of exercise and other non-pharmaceutical interventions on cancer-related fatigue (CRF) in patients during and after cancer treatment.

Background

Methodology

Aim: To assess the relative effects of different types of exercise and other non-pharmaceutical interventions on cancer-related fatigue (CRF) in patients during and after cancer treatment. Design: Systematic review and indirect-comparisons meta-analysis. Data sources: Articles were searched in PubMed, Cochrane CENTRAL and published meta-analyses. Eligibility criteria for selecting studies: Randomised studies published up to January 2017 evaluating different types of exercise or other non-pharmaceutical interventions to reduce CRF in any cancer type during or after treatment.; Study appraisal and synthesis: Risk of bias assessment with PEDro criteria and random effects Bayesian network meta-analysis.

Results

The authors included 245 studies. Comparing the treatments with usual care during cancer treatment, relaxation exercise was the highest ranked intervention with a standardised mean difference (SMD) of -0.77 (95% Credible Interval (CrI) -1.22 to -0.31), while massage (-0.78; -1.55 to -0.01), cognitive-behavioural therapy combined with physical activity (combined CBT, -0.72; -1.34 to -0.09), combined aerobic and resistance training (-0.67; -1.01 to -0.34), resistance training (-0.53; -1.02 to -0.03), aerobic (-0.53; -0.80 to -0.26) and yoga (-0.51; -1.01 to 0.00) all had moderate-to-large SMDs. After cancer treatment, yoga showed the highest effect (-0.68; -0.93 to -0.43). Combined aerobic and resistance training (-0.50; -0.66 to -0.34), combined CBT (-0.45; -0.70 to -0.21), Tai-Chi (-0.45; -0.84 to -0.06), CBT (-0.42; -0.58 to -0.25), resistance training (-0.35; -0.62 to -0.08) and aerobic (-0.33; -0.51 to -0.16) showed all small-to-moderate SMDs.

Conclusion

Patients can choose among different effective types of exercise and non-pharmaceutical interventions to reduce CRF.

References

Roger Hilfiker  1 , Andre Meichtry  2 , Manuela Eicher  3   4 , Lina Nilsson Balfe  1 , Ruud H Knols  5 , Martin L Verra  6 , Jan Taeymans  7   8. Exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment: a systematic review incorporating an indirect-comparisons meta-analysis. Br J Sports Med.;52(10):651-658. doi: 10.1136/bjsports-2016-096422  Epub May 13 2017 . May 2018.

 

Comment

Comparing the treatments from 245 studies with usual care during cancer treatment, relaxation exercise was the highest ranked intervention.