Abstract
BackgroundCancer patients may benefit from physical exercise programs. It is unclear, however, how sustained levels of physical activity are best achieved in this population. A systematic review was performed to summarize the current evidence of the effect of physical activity interventions on daily walking activity enhancement in cancer survivors, and to review the literature for its methodological quality.MethodsA search in Medline, PEDro and the Cochrane databases was performed for English literature citations (randomized controlled trials; 'RCTs'). In a first step, one reviewer abstracted data from the included studies on patients, physical activity interventions and outcomes. Two independent reviewers reviewed the methodological quality of these studies. Data were pooled using random-effects calculations.ResultsOur search identified 201 citations. Five RCTs that reported changes in daily step activity over time were identified, and were reviewed for methodological quality and substantive results. The median score across studies for methodological quality based on the PEDro criteria was 8. These 5 RCTs evaluated 660 participants with a mean age of 53.6 (SD 4.2) years. The mean change in daily step activity for patients with a physical exercise intervention was 526 daily steps (SD 537), with a range from -92 to 1299 daily steps. The data of three studies reporting the effect of combined physical activity and counseling on daily walking activity in breast cancer survivors were pooled, however; the I2 was 79%, indicating statistical heterogeneity between the three trials.ConclusionThe 5 RCTs reviewed were of good methodological quality. Together they suggest that combined physical activity and counseling improves daily step activity in (breast) cancer survivors. Studies that define a step goal appear to be more effective in improving daily walking activity than studies that do not do so. However, the current results should be interpreted with caution because of the observed clinical and statistical heterogeneity. Future studies are warranted to evaluate the effects of goal targeted physical activity, with or without counseling, on daily walking in various cancer populations.
Highlights
Cancer patients may benefit from physical exercise programs
Aaronson NK: Effects of an outpatient physical exercise program in hematopoietic stem-cell transplantation recipients: a randomized clinical trial, unpublished] that was submitted for publication at the time of inquiry, met the eligibility criteria and were included in the final analysis
The report of Irwin et al [24] was used in this systematic review, as this paper provided means and standard deviations of pedometer steps/day for baseline and posttreatment, that were needed for the meta-analysis
Summary
Cancer patients may benefit from physical exercise programs. It is unclear, how sustained levels of physical activity are best achieved in this population. A systematic review was performed to summarize the current evidence of the effect of physical activity interventions on daily walking activity enhancement in cancer survivors, and to review the literature for its methodological quality. Physical exercise programs have been developed with the aim of improving a range of outcomes, including physical performance, body composition, hemoglobin concentration, immune function, fatigue, psychological well-being and health-related quality-of-life (HRQOL) [2,3,4]. It is unclear whether an increase in walking activity results in enhanced functional health
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