Effects of physical exercise on the functional capacity and muscle strength of patients with gastric and esophageal cancer: a systematic review

Abstract

Esophageal and gastric cancers have a significant prevalence. These patients often face a decline in functional capacity (FC) and muscle strength (MS), as consequence of neoadjuvant treatments and surgical resection; however, this decline can be minimized through appropriate exercise protocols. To assess evidence of the effects of physical exercise on HR and MS in patients with esophageal and stomach cancer. Systematic review of Randomized clinical trials with intervention based on exercises for patients with esophagogastric cancer (EGC). FC and MS were the outcomes. Searches in Medline via Pubmed, PEDro, Cochrane Library, Embase and CINAHL databases were performed. Cochrane Collaboration tool and GRADE system for risk of bias assessment. From 117 articles identified, eight studies were included, involving a total of 673 patients. In general, the approach during neoadjuvant therapy had a positive effect on the 6-minute walk test (6MWT) and on FM. Exercise performed in the preoperative period showed divergent results for inspiratory muscle strength, but improved HR assessed by the 6-minute walk test (6MWT). The postoperative exercise protocol increased the FC in 6MWT, and maximal oxygen consumption (VO2max). However, it does not improve MS. Studies also showed a moderate-to-high risk of bias. Although some studies point to positive results in favor of physical exercise in improving FC and MS in patients being treated for esophagogastric cancer, the degree of clinical recommendation is low.