Abstract
Background: Cancer-related fatigue (CRF) is the most common and distressing symptom in breast cancer survivors. Approximately 40% to 80% of cancer patients undergoing active treatment suffer from CRF. Exercise improves overall quality of life and CRF; however, the specific effects of the training modalities are not well understood. Purpose: This study aimed to determine the effects of health professional supervised multimodal exercise interventions on cancer-related fatigue through a systematic review and meta-analysis. Methods: A systematic review was conducted to determine the effectiveness of multimodal exercise interventions on CRF. Databases of PubMed, CENTRAL, EMBASE and OVID were searched until March 2014 to retrieve randomized controlled trials. Risk of bias was evaluated using the PEDro scale. Results:Nine studies (n= 772) were included in both systematic review and meta-analysis. The studies had a low risk of bias (PEDro scale mean score of 6.45 (Standard deviation (SD)± 1.0). Supervised multimodal interventions including aerobic exercise, resistance training and stretching improved CRF symptoms (SMD=−0.23; 95% CI: −0.37 to −0.09; p= 0.001). These effects were also significant in patients receiving chemotherapy (p 6 weeks) and duration (>40minutes/session) were positively associated with improvements on CRF (p< 0.05). Conclusion(s): Health professional supervised multimodal exercise interventions including aerobic, resistance and stretching exercises are effective in controlling CRF. These findings suggest that these exercise protocols should be included as a crucial part of the rehabilitation programs for cancer survivors and patients during anti-cancer treatments. Implications: On the basis of our results, we recommend that supervised and structured exercise programs be prescribed to cancer survivors, regardless of treatment stage as a means to improve CRF symptoms. Further research is required to strengthen this evidence.
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