Description of studies of exercise in patients with cancer
| Study | Design | Sample | Exercise intervention | Outcome variable | Results | p Value |
|---|---|---|---|---|---|---|
| Adamsen et al25 | RCT with usual care controls | Patients with cancer (mixed) (randomised, n=269; completed programme, n=235) during chemotherapy, aged 18–65 years, WHO-PS 0–1 | Supervised exercise compromising high intensity cardiovascular and resistance training, relaxation, massage, 9 h/week for 6 weeks | EORTC-QLQ MOS SF-36 Leisure Time Physical Activity Questionnaire, 1RM, VO2 maximum | Significant reduce in fatigue* in intervention. No significant improvement in QoL** | 0.02* 0.4** |
| Courneya et al26 | RCT with usual care controls | Postmenopausal breast cancer survivors (randomised, n=53; completed programme, n=52) aged 50–69 | Upright cycling 3 times a week, intensity of 70–75%, for 15 min at beginning, increased by 5 min/week | Overall QoL (FACT-B) FACT-G TOI HM Peak oxygen consumption | Significant increase in QoL* and peak oxygen consumption** in exercise group in comparison with control group | 0.001* <0.01** |
| Courneya et al27 | RCT with usual care controls | Colorectal cancer survivors (mixed)(randomised, n=102; completed programme, n=93 (QoL)/88 (fitness) | Home-based, personalised exercise programme, 20–30 min, 3–5 times/week, intensity of 65–75% | QoL (FACT-C) FACT-G TOI | No difference between exercise and control group in QoL* | 0.68* |
| Courneya et al28 | RCT with usual care controls | Patients with breast cancer (randomised, n=242; completed programme, n=194) during chemotherapy, aged ≥18 years, stage I-IIIA cancer | AET: aerobic exercising 3 times/week, increasing from 60–80% of VO2 maximum from week 1–18, 15 min, increasing 5 min/week starting from week 3. RET: resistance exercising 3 times/week, for 18 weeks, intensity 60–70%. | QoL Peak oxygen consumption | Significant increase in peak oxygen consumption in AET* and RET** group in comparison with control group, as well as self- esteem in the AET† and RET†† group. No difference in QoL. | 0.006* 0.014** 0.015† 0.018†† |
| Courneya et al29 | RCT with usual care controls | Lymphoma patients (randomised; n=122, completed programme, n=117), aged ≥18 years, during chemotherapy | Aerobic exercise 3 times/week for 12 weeks, 15 min increasing 5 min/week, intensity 60% with 5% increase every week | TOI-An FACT-An HM VO2 maximum | Significant increase in physical functioning*, overall QoL** and fatigue*** in AET group in comparison with control group | 0.012* 0.021** 0.013*** |
| Dimeo et al30 | RCT with aerobic exercise vs relaxation training | Patients with cancer (mixed)(randomised, n=72; completed programme, n=69), after surgery, aged 30–75 years, ECOG score 0–2 | Exercise: stationary bike 30 min 5 times/week intervals, intensity 80% for 3 weeks. Relaxation: 45 min 3 times/week for 3 weeks | EORTC-QLQ Physical performance Fatigue Global health | Significant increase in physical performance in exercise group, unchanged in relaxation group*. No difference for fatigue and global health between groups** | 0.01* 0.67** |
| Goedendorp et al31 | RCT with BNI and CBT vs usual care controls | Patients with cancer (mixed)(randomised, n=240; completed programme, n=218) during therapy, aged 18–75 years | BNI: walking/cycling 5 days/week for 3 months, 5 min and 5 min increasing/week CBT: therapy for up to 10 1 h sessions for 6 months | Fatigue SF-36 SCL-90 EORTC-QLQ DOA | Significant decrease in fatigue in CBT group in comparison with control*, no difference in BNI group in comparison with control** | 0.019* 1.000** |
| Milne et al32 | RCT with IEG vs DEG | Breast cancer survivors (randomised, n=58; completed programme, n=57), aged ≥18 years, with stage I-II cancer | Supervised aerobic and resistance training, 3 times/week for 12 weeks | QoL (FACT-B) Fatigue (SCFS) SPAS-7 | Significant increase in QoL in exercise groups in comparison with control group* | <0.001* |
| Mutrie et al33 | RCT with usual care controls | Patients with breast cancer (randomised, n=203; completed programme, n=177) during therapy, stage 0-III cancer | Supervised group exercise, 45 min for 12 weeks | FACT-G BMI 12 min-WT Length of hospital stay GP visits | Significant decrease in hospital nights* and GP visits** in exercise group in comparison with control group. No difference in FACT-G*** | 0.044* 0.011** 0.053*** |
| Andersen et al34 | RCT with usual care controls | Patients with cancer (mixed)(randomised, n=269; completed programme, n=213) during chemotherapy, aged 18–65 years, WHO-PS 0–1 | Four high and low intensity physical training sessions, 9 h/week for 6 weeks | CRF FACT-An FACT-G Well-being | Significant reduce in fatigue in intervention group in comparison with control group*. No difference in FACT-G** | 0.002* 0.21** |
| Cadmus et al35 | RCT with usual care controls | Patients with breast cancer (randomised, n=50, n=75; completed programme, n=45, n=67) during (IMPACT, aged 35–75 years) and after treatment (YES, aged 34–79 years), with stage 0-IIIA cancer | Exercise 30 min of moderate physical activity 5 days a week for 6 months | HM RSES CES-D STAI FACT-B MOS SF-36 PAL | Exercise was not associated with improvement in QoL, but did improve social functioning* | <0.05* |
| Streckmann et al36 | RCT with usual care controls | Lymphoma patients (randomised, n=61; completed programme, n=56) during therapy, aged ≥18 years and KPS score ≥60 | Supervised exercise 2 times/week for 36 weeks, 1 h; aerobic, stability and strength | EORTC-QLQ PNP Activity level Balance | Significant increase in QoL* in exercise group | 0.03* |
| Oldervoll et al37 | RCT with usual care controls | Patients with cancer (mixed) (randomised, n=231; completed programme, n=163) with metastases, KPS score ≥60 | Exercise 2 times/week for 8 weeks, 60 min | FQ | Significant improvement in physical performance tests in exercise group*, no difference in fatigue** between groups | 0.008* 0.62** |
| Samuel et al38 | RCT with usual care controls | Patients with cancer (mixed)(randomised, n=48; completed programme, n=44) during chemoradiotherapy, aged ≥18 years | Exercise 5 days/week for 6 weeks, 20 min | 6MWD QoL (MCS/PCS) | Significant improvement in MCS of QoL in exercise group | 0.014 |
| Henke et al39 | RCT with usual care controls | Stage IIIA/IIIb/IV patients with lung cancer (randomised, n=46; completed programme, n=29, aged ≥18 years during chemotherapy | Endurance training (6 min walk) and breathing techniques 5 days/week, strength training every other day | Barthel Index EORTC-QLQ 6WT | Significant increase in Barthel Index* and physical functioning in exercise group in comparison with control group** | 0.003* 0.025** |
| Monga et al40 | RCT with usual care controls | Patients with prostate cancer (randomised, n=21; completed programme, n=16), first cancer diagnosis, during radiotherapy | Aerobic exercise 3 times/week for 8 weeks, 50 min | QoL (FACT-P) Fatigue (PFS) Strength Fitness Flexibility | Significant increase in QoL* and fatigue in exercise group in comparison with control group** | 0.006* <0.001** |
The symbols (*, **, †, etc) connect the p values with the corresponding statements in the Results column.
12 min-WT, 12 min walk test; 1RM, 1-repetition maximum; 6MWD, 6 min walk distance; BMI, body mass index; CES-D, Centers for Epidemiological Studies-Depression Scale; CRF, cancer-related fatigue; DOA, daily observed activity; EORTC-QLQ, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; FACT-An, Functional Assessment of Cancer Therapy-Anemia; FACT-B, Functional Assessment of Cancer Therapy-Breast; FACT-C, Functional Assessment of Cancer Therapy-Colorectal; FACT-G, Functional Assessment of Cancer Therapy-General; FACT-P, Functional Assessment of Cancer Therapy-Prostate; FQ, Fatigue Questionnaire; HM, happiness measure; MCS, Mental Component Score; MOS SF-36, Medical Outcomes Study Short Form; PAL, Physical Activity Log; PCS, Physical Component Score; PFS, Piper Fatigue Scale; PNP, peripheral neuropathy; QoL, quality of life; RCT, randomised controlled trial; RSES, Rosenberg Self-Esteem Scale; SCL-90, Symptom Checklist-90; SF-36, Health Survey Short Form-36; SPAS-7, Social Physique Anxiety Scale; STAI, State-Trait Anxiety Scale; TOI, Trial Outcome Index.