Exercise interventions on health-related quality of life for people with cancer during active treatment

• Published in: Cochrane database of systematic reviews 2012-08, Vol.2012 (8), p.CD008465-CD008465
• Main Authors: Mishra, Shiraz I, Scherer, Roberta W, Snyder, Claire, Geigle, Paula M, Berlanstein, Debra R, Topaloglu, Ozlem
• Format: Article
• Language: English
• Subjects: 'ORPHAN' TOPICS CURRENTLY BEING ADDRESSED; Adult; Anxiety - therapy; Bicycling - psychology; Breathing Exercises; Cancer; Depression - therapy; Exercise Therapy - methods; Exercise Therapy - psychology; Fatigue - therapy; Female; Health Status; Humans; Male; Neoplasms - psychology; Neoplasms - therapy; Quality of Life; Randomized Controlled Trials as Topic; Resistance Training - methods; Survivors - psychology; Walking - psychology; Yoga - psychology
• ISSN: 1469-493X
• DOI: 10.1002/14651858.CD008465.pub2

People with cancer undergoing active treatment experience numerous disease- and treatment-related adverse outcomes and poorer health-related quality of life (HRQoL). Exercise interventions are hypothesized to alleviate these adverse outcomes. HRQoL and its domains are important measures of cancer survivorship, both during and after the end of active treatment for cancer. To evaluate the effectiveness of exercise on overall HRQoL outcomes and specific HRQoL domains among adults with cancer during active treatment. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed MEDLINE, EMBASE, CINAHL, PsycINFO, PEDRO, LILACS, SIGLE, SportDiscus, OTSeeker, Sociological Abstracts from inception to November 2011 with no language or date restrictions. We also searched citations through Web of Science and Scopus, PubMed's related article feature, and several websites. We reviewed reference lists of included trials and other reviews in the field. We included all randomized controlled trials (RCTs) and quasi-randomized controlled clinical trials (CCTs) comparing exercise interventions with usual care or other type of non-exercise comparison intervention to maintain or enhance, or both, overall HRQoL or at least one distinct domain of HRQoL. Included trials tested exercise interventions that were initiated when adults with cancer were undergoing active cancer treatment or were scheduled to initiate treatment. Five paired review authors independently extracted information on characteristics of included trials, data on effects of the intervention, and assessed risk of bias based on predefined criteria. Where possible, we performed meta-analyses for HRQoL and HRQoL domains for the reported difference between baseline values and follow-up values using standardized mean differences (SMDs) and a random-effects model by length of follow-up. We also reported the SMD at follow-up between the exercise and control groups. Because investigators used many different HRQoL and HRQoL domain instruments and often more than one for the same domain, we selected the more commonly used instrument to include in the SMD meta-analyses. We also report the mean difference for each type of instrument separately. We included 56 trials with 4826 participants randomized to an exercise (n = 2286) or comparison (n = 1985) group. Cancer diagnoses in trial participants included breast, prostate, gynecologic, hematologic, and other. Thirty-six trials were conducted among participant