Abstract
Background: To evaluate and synthesize the existing evidence of the effects of practicing martial arts by cancer patients and cancer survivors in relation to overall quality of life (QoL) and cancer-related fatigue (CRF). Methods: Randomized controlled trials (RCTs) from 1 January 2000 to 5 November 2020 investigating the impact of martial arts were compared with any control intervention for overall QoL and CRF among cancer patients and survivors. Publication quality and risk of bias were assessed using the Cochrane handbook of systematic reviews. Results: According to the electronic search, 17 RCTs were retrieved including 1103 cancer patients. Martial arts significantly improved social function, compared to that in the control group (SMD = −0.88, 95% CI: −1.36, −0.39; p = 0.0004). Moreover, martial arts significantly improved functioning, compared to the control group (SMD = 0.68, 95% CI: 0.39–0.96; p < 0.00001). Martial arts significantly reduced CRF, compared to that in the control group (SMD = −0.51, 95% CI: −0.80, −0.22; p = 0.0005, I2 > 95%). Conclusions: The results of our systematic review and meta-analysis reveal that the effects of practicing martial arts on CRF and QoL in cancer patients and survivors are inconclusive. Some potential effects were seen for social function and CRF, although the results were inconsistent across different measurement methods. There is a need for larger and more homogeneous clinical trials encompassing different cancer types and specific martial arts disciplines to make more extensive and definitive cancer- and symptom-specific recommendations.
Highlights
In 2020, 19.3 million new cancer cases were diagnosed globally, where breast, lung, and prostate were the most frequent type of malignancies [1]
The results show martial arts significantly improved fatigue, compared to the control group (SMD = 0.68, 95% confidence interval (CI): 0.39–0.96; p < 0.00001)
The results reveal that the standardized mean difference (SMD) between martial art and control groups was non-significant (SMD = −0.31, 95% CI: −0.71–0.10; p = 0.14), and the data are heterogeneous (p = 0.06, I2 = 64%) (Figure 7)
Summary
In 2020, 19.3 million new cancer cases were diagnosed globally, where breast, lung, and prostate were the most frequent type of malignancies [1]. Cancer is the second cause of mortality worldwide after ischemic heart disease, with 8.97 million deaths, and it is predicted to become the leading cause of death by 2060 with approximately 18.63 million deaths [2]. Improvements in diagnostics and treatments have increased the survival rate of the most prevalent cancers in developed countries [3]. As of January 2019, there were an estimated 16.9 million cancer survivors in the United States. The number of cancer survivors is projected to increase to 22.2 million by 2030 [4]. The burden of cancer incidence and survivors continues to increase in low- and middle-income countries as well [5]
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