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Effects and moderators of exercise on quality of life and physical function in patients with cancer: An individual patient data metaanalysis of 34 RCTs

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  • Laurien M Buffart
  • Joeri Kalter
  • Maike G Sweegers
  • Kerry S Courneya
  • Robert U Newton
  • Neil K Aaronson
  • Paul B Jacobsen
  • Anne M May
  • Daniel A Galvao
  • Mai J Chinapaw
  • Karen Steindorf
  • Melinda L Irwin
  • Martijn M Stuiver
  • Sandi Hayes
  • Kathleen A Griffith
  • Alejandro Lucia
  • Ilse Mesters
  • Ellen van Weert
  • Hans Knoop
  • Martine M Goedendorp
  • Amanda J Daley
  • Alex McConnachie
  • Martin Bohus
  • Lene Thorsen
  • Karl-Heinz Schulz
  • Camille E Short
  • Erica L James
  • Ron C Plotnikoff
  • Gill Arbane
  • Martina E Schmidt
  • Karin Poffhoff
  • Marc van Beurden
  • Hester S Oldenburg
  • Gabe S Sonke
  • Wim H van Harten
  • Rachel Garrod
  • Kathryn H Schmitz
  • Kerri M Winters-Stone
  • Miranda J Velthuis
  • Dennis R Taaffe
  • Willem van Mechelen
  • Marie-Jose Kersten
  • Frans Nollet
  • Jennifer Wenzel
  • Joachim Wiskemann
  • IM Verdonck-de Leeuw
  • J Brug

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Original languageEnglish
Pages (from-to)91-104
Number of pages14
JournalCancer treatment reviews
Volume52
Early online date25 Nov 2016
DOIs
Publication statusPublished - 1 Jan 2017

Abstract

This individual patient data meta-analysis aimed to evaluate the effects of exercise on quality of life (QoL) and physical function (PF) in patients with cancer, and to identify moderator effects of demographic (age, sex, marital status, education), clinical (body mass index, cancer type, presence of metastasis), intervention-related (intervention timing, delivery mode and duration, and type of control group), and exercise-related (exercise frequency, intensity, type, time) characteristics.
Relevant published and unpublished studies were identified in September 2012 via PubMed, EMBASE, PsycINFO, and CINAHL, reference checking and
personal communications. Principle investigators of all 69 eligible trials were requested to share IPD from their study. IPD from 34 randomised controlled trials (n=4,519 patients) that evaluated the effects of exercise compared to a usual care, wait-list or attention control group on QoL and PF in adult patients with cancer were retrieved and pooled. Linear mixed-effect models were used to evaluate the effects of the exercise on post-intervention outcome values (z-score) adjusting for baseline values. Moderator effects were studies by testing interactions. Exercise significantly improved QoL (β=0.15, 95%CI=0.10;0.20) and PF
(β=0.18,95%CI=0.13;0.23). The effects were not moderated by demographic, clinical or exercise characteristics. Effects on QoL (βdifference_in_effect=0.13, 95%CI=0.03;0.22) and PF (βdifference_in_effect=0.10, 95%CI=0.01;0.20) were significantly larger for supervised than unsupervised interventions.
In conclusion, exercise, and particularly supervised exercise, effectively improves QoL and PF in patients with cancer with different demographic and clinical characteristics during and following treatment. Although effect sizes are small, there is consistent empirical evidence
to support implementation of exercise as part of cancer care.

    Research areas

  • exercise, quality of life, physical function , neoplasm , individual patient data meta-analysis

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