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BMC Cancer
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Research article

Exercise and cancer-related fatigue in adults: a systematic review of previous systematic reviews with meta-analyses

Authors: George A. Kelley, Kristi S. Kelley

Published in: BMC Cancer | Issue 1/2017

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Abstract

Background

Conduct a systematic review of previous systematic reviews with meta-analysis to determine the effects of exercise (aerobic, strength or both) on cancer-related-fatigue (CRF) in adults with any type of cancer.

Methods

Systematic reviews with meta-analyses of previous randomized controlled trials published through July of 2016 were included by searching six electronic databases and cross-referencing. Dual-selection and data abstraction were conducted. Methodological quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) instrument. Standardized mean differences (SMD) that were pooled using random-effects models were included as the effect size. In addition, 95% prediction intervals (PI), number needed-to-treat (NNT) and percentile improvements were calculated.

Results

Sixteen studies representing 2 to 48 SMD effect sizes per analysis (mean ± SD, 7 ± 8, median = 5) and 37 to 3254 participants (mean ± SD, 633 ± 690, median = 400) were included. Length of training lasted from 3 to 52 weeks (mean ± SD, 14.6 ± 3.1, median = 14), frequency from 1 to 10 times per week (mean ± SD, 3.4 ± 0.8, median = 3), and duration from 10 to 120 min per session (mean ± SD, 44.3 ± 5.5, median = 45). Adjusted AMSTAR scores ranged from 44.4% to 80.0% (mean ± SD, 68.8% ± 12.0%, median = 72.5%). Overall, mean SMD improvements in CRF ranged from −1.05 to −0.01, with 22 of 55 meta-analytic results (52.7%) statistically significant (non-overlapping 95% CI). When PI were calculated for results with non-overlapping 95% CI, only 3 of 25 (12%) yielded non-overlapping 95% PI favoring reductions in CRF. Number needed-to-treat and percentile improvements ranged from 3 to 16 and 4.4 to 26.4, respectively.

Conclusions

A lack of certainty exists regarding the benefits of exercise on CRF in adults. However, exercise does not appear to increase CRF in adults.

Trial registration

PROSPERO Registration # CRD42016045405.
Appendix
Available only for authorised users
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Metadata
Title
Exercise and cancer-related fatigue in adults: a systematic review of previous systematic reviews with meta-analyses
Authors
George A. Kelley
Kristi S. Kelley
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3687-5

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