Abstract
Cancer and associated medical treatments affect patients' health-related quality of life (HRQoL) by decreasing functional dimensions of physical, social, cognitive, and emotional well-being, while increasing short and late-term symptoms. Exercise, however, is demonstrated to be a useful therapy to improve cancer patients' and survivors’ HRQoL, yet the effectiveness of high-intensity training (HIT) exercise is uncertain. This systematic review and meta-analysis aimed to analyse the effects of HIT on HRQoL dimensions in cancer patients and survivors as well as evaluate the optimal prescription of HIT. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) and examined Web of Science and PubMed (Medline) databases. Data were analysed utilizing Review Manager Software. Twenty-two articles were included in the systematic review and 17 in the meta-analysis. Results showed HIT improved global quality of life, physical functioning, role functioning, social functioning, cognitive functioning, fatigue, pain, dyspnea, and insomnia, compared to an inactive control group, yet no differences were found between HIT and low to moderate-intensity exercise interventions. Particular improvements in HRQoL were observed during cancer treatment and with a training duration of more than eight weeks, a frequency of 2 days/week, and a volume of at least 120 min/week, including 15 min or more of HIT. Our findings whilst encouraging, highlight the infancy of the extant evidence base for the role of HIT in the HRQoL of cancer patients and survivors.
Highlights
Cancer and associated medical treatments affect patients’ health-related quality of life (HRQoL) by decreasing functional dimensions of physical, social, cognitive, and emotional well-being, while increasing short and late-term symptoms
Results showed significant improvements in High-intensity exercise group (HIEG) compared to control group (CG) in global health (p = 0.03, with standardized mean differences (SMDs) of 0.18 and a 95% CI from 0.02, to 0.42) and physical functioning (p = 0.006, with SMD of 0.24 and a 95% CI from 0.07 to 0.40) only when patients exercised at least 120 min/week
Interventions that combined resistance training and high-intensity training (HIT) showed better improvements compared to the CG in global health (p = 0.0008, with an SMD of 0.25 and a 95% CI from 0.10 to 0.39) and physical functioning (p = 0.0006, with an SMD of 0.34 and a 95% CI from 0. 15 to 0.53)
Summary
Cancer and associated medical treatments affect patients’ health-related quality of life (HRQoL) by decreasing functional dimensions of physical, social, cognitive, and emotional well-being, while increasing short and late-term symptoms. Results showed HIT improved global quality of life, physical functioning, role functioning, social functioning, cognitive functioning, fatigue, pain, dyspnea, and insomnia, compared to an inactive control group, yet no differences were found between HIT and low to moderate-intensity exercise interventions. Short-term and late effects vary depending on a patients’ medical history and treatment exposures[11], and can directly impact a survivors physical and mental health, which can worsen with the increased comorbidities that likely occur with aging[26]. Cancer patients’ HRQoL functional capacities, which include physical, emotional, cognitive, social, Wellbeing Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Scientific Reports | (2021) 11:15089. Physical cancer symptoms of fatigue, pain, insomnia, and dyspnoea showed a decrease with exercise p rogrammes[35]
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