Exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment : a systematic review incorporating an indirect-comparisons meta-analysis

Hilfiker, Roger (School of Health Sciences, HES-SO Valais-Wallis, Leukerbad, Switzerland) ; Eicher, Manuela (School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland ; Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland) ; Meichtry, Andre (Zurich University of Applied Sciences, Winterthur, Switzerland) ; Nilsson Balfe, Lina (School of Health Sciences, HES-SO Valais-Wallis, Leukerbad, Switzerland) ; Knols, Ruud H (Directory of Research and Education, Physiotherapy Occupational Therapy Research, Center University Hospital Zurich, Zurich, Switzerland) ; Verra, Martin L. (Department of Physiotherapy, Inselspital, Bern University Hospital, Berne, Switzerland) ; Taeymans, Jan (Bern University of Applied Sciences Health, Berne, Switzerland ; Faculty of Sports Sciences and Exercise Rehabilitation, Vrije Universiteit Brussel, Brussels, Belgium)

Aim To assess the relative effects of different types of exercise and other non-pharmaceutical interventions on cancer-related fatigue (CRF) in patients during and after cancer treatment. Design Systematic review and indirect-comparisons meta-analysis. Data sources Articles were searched in PubMed, Cochrane CENTRAL and published meta-analyses. Eligibility criteria for selecting studies Randomised studies published up to January 2017 evaluating different types of exercise or other non-pharmaceutical interventions to reduce CRF in any cancer type during or after treatment. Study appraisal and synthesis Risk of bias assessment with PEDro criteria and random effects Bayesian network meta-analysis. Results We included 245 studies. Comparing the treatments with usual care during cancer treatment, relaxation exercise was the highest ranked intervention with a standardisedmean difference (SMD) of −0.77 (95% Credible Interval (CrI) −1.22 to −0.31), while massage (−0.78; −1.55 to −0.01), cognitive–behavioural therapy combined with physical activity (combined CBT, −0.72; −1.34 to −0.09), combined aerobic and resistance training (−0.67; −1.01 to −0.34), resistance training (−0.53; −1.02 to −0.03), aerobic (−0.53; −0.80 to −0.26) and yoga (−0.51; −1.01 to 0.00) all had moderate-to-large SMDs. After cancer treatment, yoga showed the highest effect (−0.68; −0.93 to −0.43). Combined aerobic and resistance training (−0.50; −0.66 to −0.34), combined CBT (−0.45; −0.70 to −0.21), Tai-Chi (−0.45; −0.84 to −0.06), CBT (−0.42; −0.58 to −0.25), resistance training (−0.35; −0.62 to −0.08) and aerobic (−0.33; −0.51 to −0.16) showed all small-to-moderate SMDs. Conclusions Patients can choose among different effective types of exercise and non-pharmaceutical interventions to reduce CRF.

Type d'article:
Institut Santé
7 p.
Veröffentlicht in:
British journal of sports medicine
Numérotation (vol. no.):
2018, vol. 52, no. 10, pp. 651-658
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 Datensatz erzeugt am 2019-03-04, letzte Änderung am 2020-10-27

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