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Cited by 396Cancer survivorship and careCancer-related cognitive impairment studiesChildhood Cancer Survivors' Quality of Life

The DOI matches its Crossref record; 75 of the 77 references it cites were found in a registry or an index.

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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Hilfiker, Roger, Meichtry, Andre, Eicher, Manuela, Nilsson Balfe, Lina, Knols, Ruud H, Verra, Martin L, Taeymans, Jan·2018·British Journal of Sports Medicine
DOI 10.1136/bjsports-2016-096422PMC PMC5931245
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Abstract

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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Crossref · 10.1136/bjsports-2016-096422

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Figure 1 Flow chart of the study selection process.
Figure 1 Flow chart of the study selection process.CC BY-NC · PubMed Central
Figure 2 Plots of the two networks (during and after cancer treatment). The size of the circles corresponds to the number of patients within the groups, the width of the lines between the treatment circles indicates the statistical precision of the comparison (ie, inverse of the variance). The numbers on or besides the lines between the treatments indicate the number of trials comparing the two treatments and the numbers in parentheses indicate the number of patients in the given comparison. Red coloured lines indicate that more than 50% of the trials had no allocation concealment or more than 15% drop-outs; green dashed lines indicate that 50% or more of the trials had correct allocation concealment and less than 15% drop-outs. CBT, cognitive–behavioural therapy.
Figure 2 Plots of the two networks (during and after cancer treatment). The size of the circles corresponds to the number of patients within the groups, the width of the lines between the treatment circles indicates the statistical precision of the comparison (ie, inverse of the variance). The numbers on or besides the lines between the treatments indicate the number of trials comparing the two treatments and the numbers in parentheses indicate the number of patients in the given comparison. Red coloured lines indicate that more than 50% of the trials had no allocation concealment or more than 15% drop-outs; green dashed lines indicate that 50% or more of the trials had correct allocation concealment and less than 15% drop-outs. CBT, cognitive–behavioural therapy.CC BY-NC · PubMed Central
Figure 3 Forest plots for the comparisons between the active interventions and the control intervention (usual care) for the studies performed during cancer treatment. The left side of the panel shows all studies. The right side shows only the studies with more than 25 patients per arm (on average). CBT, cognitive–behavioural therapy; SMD, standardised mean difference; SUCRA, surface under the cumulative ranking curve; 95% Crl, 95% Crl.
Figure 3 Forest plots for the comparisons between the active interventions and the control intervention (usual care) for the studies performed during cancer treatment. The left side of the panel shows all studies. The right side shows only the studies with more than 25 patients per arm (on average). CBT, cognitive–behavioural therapy; SMD, standardised mean difference; SUCRA, surface under the cumulative ranking curve; 95% Crl, 95% Crl.CC BY-NC · PubMed Central
Figure 4 Forest plots for the comparisons between the active interventions and the control intervention (usual care) for the studies performed after cancer treatment. The left side of the panel shows all studies. The right side shows only the studies with more than 25 patients per arm (on average). CBT, cognitive–behavioural therapy; SMD, standardised mean difference; SUCRA, surface under the cumulative ranking curve; 95%Crl, 95% Crl.
Figure 4 Forest plots for the comparisons between the active interventions and the control intervention (usual care) for the studies performed after cancer treatment. The left side of the panel shows all studies. The right side shows only the studies with more than 25 patients per arm (on average). CBT, cognitive–behavioural therapy; SMD, standardised mean difference; SUCRA, surface under the cumulative ranking curve; 95%Crl, 95% Crl.CC BY-NC · PubMed Central

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  1. 10.1037/0033-2909.112.1.155 · DOI · Paper page

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Metadata

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
ORCID
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
DOI
10.1136/bjsports-2016-096422
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
FWCI
2.41
Type
journal article
Language
en
Open access
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 › Oncology › 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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