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.
- physical activity
- physical fitness
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Contributors MGS, TMA, LMB, JB, MJCAP and AMM contributed to the concept and design of the study. LMB and JB are members of the steering committee of POLARIS. KSC, RUN, AMM and NKA are members of the (inter)national advisory board of POLARIS. MGS and LMB, gathered, pooled and analszed the data. JKvV was involved in analysing the data. MGS, TMA and LMB drafted the manuscript. LMB, KSC, RUN, NKA, AMM, DAG, MJCAP, KS, MMS, KAG, AL, NM, AJD, AM, MB, LT, FH-R, KatHS, GA, MES, KP, GS, WHVH, RG, KarHS, KMW-S, MJV, WvM, MJK, FN, JeW, JoW and JB are principal investigators of the randomised controlled trials of which the data are pooled for the current study and have consequently contributed to the study concept, design and conduct of the trial that they were responsible for. All authors have critically revised the manuscript and approved the final version.
Funding Via ’Bas Mulder Award' granted to LMB by the Alpe d’HuZes foundation/Dutch Cancer Society (VU 2011-5045).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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