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
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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.
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Patients are recommended various forms of psychotherapy such as relaxation, guided imagery, mindfulness meditation, music therapy, occupational therapy, and breathing exercises.
“Patients are also recommended various forms of psychotherapy [10,11,12], such as relaxation and guided imagery [13,14], mindfulness meditation (mindfulness-based stress reduction) [14], music therapy [15,16], occupational therapy [17,18,19], and breathing exercises [20,21,22].”
From The Effect of Vinyasa Yoga Practice on the Well-Being of Breast-Cancer Patients during COVID-19 Pandemic (2023) · cites this paper as [13]
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- Authors
- Hilfiker, R., Meichtry, A., Eicher, M., Nilsson Balfe, L., Knols, R. H., Verra, M. L., & Taeymans, J.
- Affiliations
- HES-SO Valais-Wallis (CH)
- Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland
- HES-SO University of Applied Sciences and Arts Western Switzerland (CH)
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland Valais, Leukerbad, Switzerland
- University Hospital Zurich (CH)
- University Hospital of Bern (CH)
- Bern University of Applied Sciences (CH)
- Corresponding author
- Hilfiker, Roger
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2017-05-13
- Volume
- 52
- Issue
- 10
- Pages
- 651-658
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- PMC
- PMC5931245
- OpenAlex
- W2612715342
- Cited by
- 396
- References
- 77
- Citations by year
- 2026: 26 · 2025: 46 · 2024: 50 · 2023: 69 · 2022: 63 · 2021: 56 · 2020: 41 · 2019: 28 · 2018: 11 · 2017: 4 · 2016: 1
- FWCI
- 2.41
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- British Journal of Sports Medicine (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- SERVAL (Université de Lausanne) (publishedVersion, other-oa)
- ARBOR - Bern University of Applied Sciences Repository (submittedVersion, other-oa)
- Zürcher Hochschule für Angewandte Wissenschaften digital collection (Zurich University of Applied Sciences) (submittedVersion, cc-by-nc-nd)
- ArODES (HES-SO (https://www.hes-so.ch/)) (submittedVersion)
- IRIS (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- ZHAW Digital Collection (cc-by-nc)
- BFH: ARBOR
- Funders
- physioswiss
- HES-SO
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- cancer-related fatigue, exercise intervention, non-pharmaceutical interventions, relaxation techniques, massage, cognitive behavioral therapy, aerobic exercise, resistance training, yoga, Tai Chi, post-treatment fatigue, cancer survivors, indirect comparison, credible intervals, heterogeneous effects, treatment effect heterogeneity
- MeSH terms
- Exercise Therapy, Fatigue, Massage, Neoplasms, Relaxation Therapy, Yoga, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Tai Ji, Resistance Training
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