Which exercise prescriptions improve quality of life and physical function in patients with cancer during and following treatment? A systematic review and meta-analysis of randomised controlled trials

Sweegers, Maike G; Altenburg, Teatske M; Chinapaw, Mai J; Kalter, Joeri; Verdonck-de Leeuw, Irma M; Courneya, Kerry S; Newton, Robert U; Aaronson, Neil K; Jacobsen, Paul B; Brug, Johannes; Buffart, Laurien M

doi:10.1136/bjsports-2017-097891

Cited by 288Cancer survivorship and carePhysical Activity and HealthCancer-related cognitive impairment studies

Which exercise prescriptions improve quality of life and physical function in patients with cancer during and following treatment? A systematic review and meta-analysis of randomised controlled trials

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Sweegers, Maike G, Altenburg, Teatske M, Chinapaw, Mai J, Kalter, Joeri, Verdonck-de Leeuw, Irma M, Courneya, Kerry S, Newton, Robert U, Aaronson, Neil K +3 more·2018·British Journal of Sports Medicine

DOI 10.1136/bjsports-2017-097891

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Abstract

Objective: Certain exercise prescriptions for patients with cancer may improve self-reported quality of life (QoL) and self-reported physical function (PF). We investigated the effects of exercise on QoL and PF in patients with cancer and studied differences in effects between different intervention-related and exercise-related characteristics. Design: We searched four electronic databases to identify randomised controlled trials investigating exercise effects on QoL and PF in patients with cancer. Pooled effects (Hedges’ g) were calculated using Comprehensive Meta-Analysis software. Subgroup analyses were conducted based on intervention dimensions, including timing, duration and delivery mode, and exercise dimensions, including frequency, intensity, type and time (FITT factors). Results: We included 74 exercise arms. Patients who were randomised to exercise interventions had significantly improved QoL (g=0.15, 95% CI (0.10 to 0.20), n=67 exercise arms) and PF (g=0.21, 95% CI (0.15 to 0.27), n=59 exercise arms) compared with patients in control groups. We found a significant between-group difference for exercise delivery mode, with significant beneficial effects for supervised exercise interventions (g=0.20, 95% CI (0.14 to 0.26) for QoL and g=0.27, 95% CI (0.20 to 0.33) for PF), but not for unsupervised interventions (g=0.04, 95% CI (−0.06 to 0.13) for QoL and g=0.09, 95% CI (−0.01 to 0.19) for PF). No statistically significant differences in intervention effects were found for variations in intervention timing, duration or exercise FITT factors. Unsupervised exercise with higher weekly energy expenditure was more effective than unsupervised exercise with lower energy expenditure (z=2.34, p=0.02). Conclusions: Exercise interventions, especially when supervised, have statistically significant and small clinical benefit on self-reported QoL and PF in patients with cancer. Unsupervised exercise intervention effects on PF were larger when prescribed at a higher weekly energy expenditure.

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The efficacy of exercise for cancer-related fatigue appears independent of the level of supervision and/or setting for training.
“The efficacy of exercise for this outcome appears to be independent of the level of supervision and/or setting for training(21, 27, 30).”
From Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable (2019) · cites this paper as [30]
Only supervised exercise training with planned duration and intensity has demonstrated benefit.
“It seems only supervised ExTr, accounting for planned interventions considering both duration and intensity, has been proven beneficial (3,53-55).”
From Exercise Training Improves Tumor Control by Increasing CD8+ T-cell Infiltration via CXCR3 Signaling and Sensitizes Breast Cancer to Immune Checkpoint Blockade (2021) · cites this paper as [55]

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Authors: Sweegers, M. G., Altenburg, T. M., Chinapaw, M. J., Kalter, J., Verdonck-de Leeuw, I. M., Courneya, K. S., Newton, R. U., Aaronson, N. K., Jacobsen, P. B., Brug, J., & Buffart, L. M.
Affiliations: Amsterdam Public Health (NL)
University of Alberta (CA)
Edith Cowan University (AU)
The Netherlands Cancer Institute (NL)
Moffitt Cancer Center (US)
Corresponding author: Buffart, Laurien M
ORCID: Sweegers, Maike G
Altenburg, Teatske M
Chinapaw, Mai J
Kalter, Joeri
Courneya, Kerry S
Newton, Robert U
Aaronson, Neil K
Jacobsen, Paul B
Brug, Johannes
Buffart, Laurien M
Venue: British Journal of Sports Medicine
Publisher: BMJ
Published: 2017-09-27
Volume: 52
Issue: 8
Pages: 505-513
ISSN: 0306-3674 (ISSN-L)
1473-0480
DOI: 10.1136/bjsports-2017-097891
OpenAlex: W2756598459
Cited by: 288
References: 121
Citations by year: 2026: 26 · 2025: 21 · 2024: 46 · 2023: 41 · 2022: 28 · 2021: 35 · 2020: 41 · 2019: 34 · 2018: 12 · 2017: 2
FWCI: 2.55
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: British Journal of Sports Medicine (publishedVersion)
PubMed (publishedVersion)
UvA-DARE (University of Amsterdam) (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
VU Research Portal (publishedVersion, other-oa)
Australasian Journal of Paramedicine (submittedVersion)
HighWire Press Open Archive (submittedVersion)
Pure Amsterdam UMC (submittedVersion, cc-by)
Data Archiving and Networked Services (DANS) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders: Bas Mulder Award, Alpe d’HuZes foundation/Dutch Cancer Society
Topics: Health Sciences › Medicine › Oncology › Cancer survivorship and care
Health Sciences › Medicine › Physiology › Physical Activity and Health
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
Keywords: exercise prescription, cancer patients, quality of life, physical function, supervised exercise, unsupervised exercise, energy expenditure, cancer treatment side effects
MeSH terms: Energy Metabolism, Exercise Therapy, Humans, Neoplasms, Quality of Life, Randomized Controlled Trials as Topic, Prescriptions

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Which exercise prescriptions improve quality of life and physical function in patients with cancer during and following treatment? A systematic review and meta-analysis of randomised controlled trials

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