INTRODUCTION & AIMS Physical capacity, functional performance, and fatigue status have prognostic value and protective benefits against all-cause mortality and future adverse health events in prostate, breast, and colon cancer survivors. However, the effects of exercise on these parameters in cancers with disproportionately high rates of mortality and morbidity remain unclear. Therefore, this systematic review aims to evaluate the effects of exercise on aerobic fitness, muscle strength, balance, gait, and fatigue symptoms among adult brain cancer survivors. METHODS Following PRIMSA guidelines, databases were searched using subject MESH headings for papers published before June 2023. Studies involving adults with a primary brain cancer diagnosis where exercise interventions were applied with the intent to treat and where pre- and post-intervention outcome measures were available. The risk of bias tool for non-randomised trials was used and the overall strength of evidence was assessed using the GRADE approach. RESULTS Ten studies from 367 retrieved papers were eligible for inclusion. A total of 293 participants aged 18-82 years, all diagnosed with gliomas, who were on-treatment or <62 months post-treatment were involved. Interventions varied substantially across studies regarding duration (4-26 weeks), assessments, prescriptions (frequencies, intensities, modalities, and durations), and delivery. Findings were consistent, reporting significant positive effects of exercise on submaximal aerobic capacity, upper and lower limb strength, balance, fatigue scores, 30s sit-to-stand, and gait speed. However, all studies had a serious risk of bias with numerous methodological problems. Overall certainty of the evidence was rated as very low for each outcome. CONCLUSION Results from these preliminary studies are encouraging and suggest that exercise may improve health and functional outcomes and potentially reduce the risk of all-cause mortality in adult brain cancer survivors. However, these findings should be interpreted with caution due to the small body of literature, high risk of bias, and weak evidence available.
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