Effects and moderators of exercise on muscle strength, muscle function and aerobic fitness in patients with cancer: a meta-analysis of individual patient data

TY - JOUR

T1 - Effects and moderators of exercise on muscle strength, muscle function and aerobic fitness in patients with cancer: a meta-analysis of individual patient data

AU - Sweegers, Maike G

AU - Altenburg, Teatske M

AU - Brug, Johannes

AU - May, Anne M

AU - van Vulpen, Jonna K

AU - Aaronson, Neil K

AU - Arbane, Gill

AU - Bohus, Martin

AU - Courneya, Kerry S

AU - Daley, Amanda J

AU - Galvao, Daniel A

AU - Garrod, Rachel

AU - Griffith, Kathleen A

AU - Van Harten, Wim H

AU - Hayes, Sandra C

AU - Herrero-Román, Fernando

AU - Kersten, Marie J

AU - Lucia, Alejandro

AU - McConnachie, Alex

AU - van Mechelen, Willem

AU - Mutrie, Nanette

AU - Newton, Robert U

AU - Nollet, Frans

AU - Potthoff, Karin

AU - Schmidt, Martina E

AU - Schmitz, Kathryn H

AU - Schulz, Karl Heinz

AU - Sonke, Gabe

AU - Steindorf, Karen

AU - Stuiver, Martijn M

AU - Taaffe, Dennis R

AU - Thorsen, Lene

AU - Twisk, Jos W

AU - Velthuis, Miranda J

AU - Wenzel, Jennifer

AU - Winters-Stone, Kerri M

AU - Wiskemann, Joachim

AU - Chin A Paw, Mai J

AU - Buffart, Laurien M

N1 - © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2019/7

Y1 - 2019/7

N2 - OBJECTIVE: To optimally target exercise interventions for patients with cancer, it is important to identify which patients benefit from which interventions.DESIGN: We conducted an individual patient data meta-analysis to investigate demographic, clinical, intervention-related and exercise-related moderators of exercise intervention effects on physical fitness in patients with cancer.DATA SOURCES: We identified relevant studies via systematic searches in electronic databases (PubMed, Embase, PsycINFO and CINAHL).ELIGIBILITY CRITERIA: We analysed data from 28 randomised controlled trials investigating the effects of exercise on upper body muscle strength (UBMS) and lower body muscle strength (LBMS), lower body muscle function (LBMF) and aerobic fitness in adult patients with cancer.RESULTS: Exercise significantly improved UBMS (β=0.20, 95% Confidence Interval (CI) 0.14 to 0.26), LBMS (β=0.29, 95% CI 0.23 to 0.35), LBMF (β=0.16, 95% CI 0.08 to 0.24) and aerobic fitness (β=0.28, 95% CI 0.23 to 0.34), with larger effects for supervised interventions. Exercise effects on UBMS were larger during treatment, when supervised interventions included ≥3 sessions per week, when resistance exercises were included and when session duration was >60 min. Exercise effects on LBMS were larger for patients who were living alone, for supervised interventions including resistance exercise and when session duration was >60 min. Exercise effects on aerobic fitness were larger for younger patients and when supervised interventions included aerobic exercise.CONCLUSION: Exercise interventions during and following cancer treatment had small effects on UBMS, LBMS, LBMF and aerobic fitness. Demographic, intervention-related and exercise-related characteristics including age, marital status, intervention timing, delivery mode and frequency and type and time of exercise sessions moderated the exercise effect on UBMS, LBMS and aerobic fitness.

AB - OBJECTIVE: To optimally target exercise interventions for patients with cancer, it is important to identify which patients benefit from which interventions.DESIGN: We conducted an individual patient data meta-analysis to investigate demographic, clinical, intervention-related and exercise-related moderators of exercise intervention effects on physical fitness in patients with cancer.DATA SOURCES: We identified relevant studies via systematic searches in electronic databases (PubMed, Embase, PsycINFO and CINAHL).ELIGIBILITY CRITERIA: We analysed data from 28 randomised controlled trials investigating the effects of exercise on upper body muscle strength (UBMS) and lower body muscle strength (LBMS), lower body muscle function (LBMF) and aerobic fitness in adult patients with cancer.RESULTS: Exercise significantly improved UBMS (β=0.20, 95% Confidence Interval (CI) 0.14 to 0.26), LBMS (β=0.29, 95% CI 0.23 to 0.35), LBMF (β=0.16, 95% CI 0.08 to 0.24) and aerobic fitness (β=0.28, 95% CI 0.23 to 0.34), with larger effects for supervised interventions. Exercise effects on UBMS were larger during treatment, when supervised interventions included ≥3 sessions per week, when resistance exercises were included and when session duration was >60 min. Exercise effects on LBMS were larger for patients who were living alone, for supervised interventions including resistance exercise and when session duration was >60 min. Exercise effects on aerobic fitness were larger for younger patients and when supervised interventions included aerobic exercise.CONCLUSION: Exercise interventions during and following cancer treatment had small effects on UBMS, LBMS, LBMF and aerobic fitness. Demographic, intervention-related and exercise-related characteristics including age, marital status, intervention timing, delivery mode and frequency and type and time of exercise sessions moderated the exercise effect on UBMS, LBMS and aerobic fitness.

KW - Journal Article

KW - Review

KW - Neoplasms/physiopathology

KW - Physical Fitness/physiology

KW - Humans

KW - Muscle Strength/physiology

KW - Muscular Diseases/physiopathology

KW - Quality of Life

KW - Exercise Therapy/methods

U2 - 10.1136/bjsports-2018-099191

DO - 10.1136/bjsports-2018-099191

M3 - SCORING: Journal article

C2 - 30181323

VL - 53

SP - 812

JO - BRIT J SPORT MED

JF - BRIT J SPORT MED

SN - 0306-3674

IS - 13

ER -