Effects of exercise on cancer related fatigue in adults: A literature review and meta-analysis of randomized controlled trials

Abstract

Cancer related fatigue (CRF) is one among the common distressing symptoms experienced by cancer patients. Evidence showed that exercise interventions are effective in decreasing CRF. This review is to evaluate the evidence of the effectiveness of exercise interventions on CRF among adults with varied types of cancer in all phases of the cancer trajectory. A literature review with meta-analysis of randomized controlled trials (RCTs) was conducted. The results of RCTs (n = 20) that examined the effects of exercise on CRF were combined using two approaches: meta-analysis (n = 18) and summative analysis (n = 2). A summary effects size of the standardized mean difference (SMD) with 95% confidence intervals was calculated using random effects model and heterogeneity was assessed with the I² statistic. The results showed overall, a small but significant decrease in the level of CRF (SMD, -0.32; 95% CI, -0.51 to -0.12; p = .002) was observed following exercise intervention. Subgroup analyses showed that both mixed modes (combination of resistance and aerobic exercises) and aerobic exercises were effective in significantly reducing CRF (p = .033; p = .046 respectively). The results indicated substantial heterogeneity between studies (I² = 79%; p ≤ .0001). Summative analysis also suggested that exercise may be effective in reducing CRF. In conclusion, both resistance and aerobic exercises may be effective in decreasing CRF in adult patients. The result needs to be interpreted with caution due to considerable between-study heterogeneity.