Effects and moderators of exercise on quality of life and physical function in patients with cancer: an individual patient data meta-analysis of 34 RCTs

Buffart, L. M. et al. (2017) Effects and moderators of exercise on quality of life and physical function in patients with cancer: an individual patient data meta-analysis of 34 RCTs. Cancer Treatment Reviews, 52, pp. 91-107. (doi: 10.1016/j.ctrv.2016.11.010) (PMID:28006694)

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 Relevant published and unpublished studies were identified in September 2012 via PubMed, EMBASE, PsycINFO, and CINAHL, reference checking and personal communications.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.

• Item Type: Articles
• Additional Information: Open Access funded by VSNU.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McConnachie, Professor Alex
• Authors: Buffart, L. M., Kalter, J., Sweegers, M. G., Courneya, K. S., Newton, R. U., Aaronson, N. K., Jacobsen, P. B., May, A. M., Galvão, D. A., Chinpaw, M. J., Steindorf, K., Irwin, M. L., Stuiver, M. M., Haynes, S., Griffith, K. A., Lucia, A., Mesters, I., van Weert, E., Knoop, H., Goedendorp, M. M., Mutrie, N., Daley, A. J., McConnachie, A., Bohus, M., Thorsen, L., Schulz, K.-H., Short, C. E., James, E. L., Poltnikoff, R. C., Arbane, G., Schmidt, M. E., Potthoff, K., van Beurden, M., Oldenburg, H. S., Sonke, G. S., van Harten, W. H., Garrod, R., Schmitz, K. H., Winters-Stone, K. M., Velthuis, M. J., Taaffe, D. R., van Mechelen, W., Kersten, M.-J., Nollet, F., Wenzel, J., Wiskemann, J., Verdonck-de Leeuw, I.M., and Brug, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Cancer Treatment Reviews
• Publisher: Elsevier
• ISSN: 0305-7372
• ISSN (Online): 1532-1967
• Published Online: 05 December 2016
• Copyright Holders: Copyright © 2016 The Authors
• First Published: First published in Cancer Treatment Reviews 52:91-104
• Publisher Policy: Reproduced under a creative commons license