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Therapeutic effects of aerobic and resistance exercises for cancer survivors: a systematic review of meta-analyses of clinical trials
  1. Joel T Fuller1,2,
  2. Michael C Hartland2,
  3. Luke T Maloney2,
  4. Kade Davison2
  1. 1 Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
  2. 2 Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
  1. Correspondence to Joel T Fuller, Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW 2109, Australia; joel.fuller{at}


Objective To systematically appraise and summarise meta-analyses investigating the effect of exercise compared with a control condition on health outcomes in cancer survivors.

Design Umbrella review of intervention systematic reviews.

Data sources Web of Science, Scopus, Cochrane Library, CINAHL and MEDLINE databases were searched using a predefined search strategy.

Eligibility criteria Eligible meta-analyses compared health outcomes between cancer survivors participating in an exercise intervention and a control condition. Health outcomes were cardiovascular fitness, muscle strength, health-related quality of life, cancer-related fatigue and depression. Pooled effect estimates from each meta-analysis were quantified using standardised mean differences and considered trivial (<0.20), small (0.20–0.49), moderate (0.50–0.79) and large (≥0.80). Findings were summarised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.

Results There were 65 eligible articles that reported a total of 140 independent meta-analyses. 139/140 meta-analyses suggested a beneficial effect of exercise. The beneficial effect was statistically significant in 104 (75%) meta-analyses. Most effect sizes were moderate for cardiovascular fitness and muscle strength and small for cancer-related fatigue, health-related quality of life and depression. The quality of evidence was variable according to the GRADE scale, with most studies rated low or moderate quality. Median incidence of exercise-related adverse events was 3.5%.

Conclusion Exercise likely has an important role in helping to manage physical function, mental health, general well-being and quality of life in people undergoing and recovering from cancer and side effects of treatment.

PROSPERO registration number CRD42015020194.

  • cancer
  • fatigue
  • quality of life
  • aerobic fitness
  • physical activity

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  • Contributors All authors contributed to the conception and design of the review and completion of the search strategy. JTF drafted the manuscript. All authors edited and revised the manuscript and approved the final version of the manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests KD is an elected director for Exercise and Sports Science Australia.

  • Provenance and peer review Not commissioned; externally peer reviewed.