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Effects and moderators of exercise on muscle strength, muscle function and aerobic fitness in patients with cancer: a meta-analysis of individual patient data
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Objective: To optimally target exercise interventions for patients with cancer, it is important to identify which patients benefit from which interventions. Design: We conducted an individual patient data meta-analysis to investigate demographic, clinical, intervention-related and exercise-related moderators of exercise intervention effects on physical fitness in patients with cancer. Data sources: We identified relevant studies via systematic searches in electronic databases (PubMed, Embase, PsycINFO and CINAHL). Eligibility criteria: We analysed data from 28 randomised controlled trials investigating the effects of exercise on upper body muscle strength (UBMS) and lower body muscle strength (LBMS), lower body muscle function (LBMF) and aerobic fitness in adult patients with cancer. Results: Exercise significantly improved UBMS (β=0.20, 95% Confidence Interval (CI) 0.14 to 0.26), LBMS (β=0.29, 95% CI 0.23 to 0.35), LBMF (β=0.16, 95% CI 0.08 to 0.24) and aerobic fitness (β=0.28, 95% CI 0.23 to 0.34), with larger effects for supervised interventions. Exercise effects on UBMS were larger during treatment, when supervised interventions included ≥3 sessions per week, when resistance exercises were included and when session duration was >60 min. Exercise effects on LBMS were larger for patients who were living alone, for supervised interventions including resistance exercise and when session duration was >60 min. Exercise effects on aerobic fitness were larger for younger patients and when supervised interventions included aerobic exercise. Conclusion: Exercise interventions during and following cancer treatment had small effects on UBMS, LBMS, LBMF and aerobic fitness. Demographic, intervention-related and exercise-related characteristics including age, marital status, intervention timing, delivery mode and frequency and type and time of exercise sessions moderated the exercise effect on UBMS, LBMS and aerobic fitness.
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“an individual’s response to a given exercise stimulus may vary due to the direct effects of cancer treatments on physiological systems (i.e., anemia), side effects of cancer treatment (i.e., cancer-related fatigue may lower exercise tolerance), or demographics factors (i.e., age)(90).”
From Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable (2019) · cites this paper as [90]
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Metadata
- Authors
- Sweegers, M. G., Altenburg, T. M., Brug, J., May, A. M., van Vulpen, J. K., Aaronson, N. K., Arbane, G., Bohus, M., Courneya, K. S., Daley, A. J., Galvao, D. A., Garrod, R., Griffith, K. A., Van Harten, W. H., Hayes, S. C., Herrero-Román, F., Kersten, M. J., Lucia, A., McConnachie, A., van Mechelen, W., Mutrie, N., Newton, R. U., Nollet, F., Potthoff, K., Schmidt, M. E., Schmitz, K. H., Schulz, K. H., Sonke, G., Steindorf, K., Stuiver, M. M., Taaffe, D. R., Thorsen, L., Twisk, J. W., Velthuis, M. J., Wenzel, J., Winters-Stone, K. M., Wiskemann, J., Chin A Paw, M. J., & Buffart, L. M.
- Affiliations
- Amsterdam Public Health (NL)
- University of Amsterdam (NL)
- Utrecht University (NL)
- The Netherlands Cancer Institute (NL)
- Guy's and St Thomas' NHS Foundation Trust (GB)
- University of Antwerp (BE)
- University of Alberta (CA)
- Loughborough University (GB)
- Edith Cowan University (AU)
- King's College London (GB)
- George Washington University (US)
- Queensland University of Technology (AU)
- Amsterdam UMC Location University of Amsterdam (NL)
- University of Glasgow (GB)
- University of Edinburgh (GB)
- Amsterdam University Medical Centers (NL)
- Heidelberg University (DE)
- German Cancer Research Center (DE)
- Pennsylvania State University (US)
- University Medical Center Hamburg-Eppendorf (DE)
- Oslo University Hospital (NO)
- Netherlands Comprehensive Cancer Organisation (NL)
- Johns Hopkins University (US)
- Corresponding author
- Buffart, Laurien M
- ORCID
- Sweegers, Maike G
- Altenburg, Teatske M
- Brug, Johannes
- May, Anne M
- Aaronson, Neil K
- Bohus, Martin
- Courneya, Kerry S
- Daley, Amanda J
- Galvao, Daniel A
- Griffith, Kathleen A
- Hayes, Sandra C
- Kersten, Marie J
- McConnachie, Alex
- Mutrie, Nanette
- Newton, Robert U
- Nollet, Frans
- Potthoff, Karin
- Schmidt, Martina E
- Schmitz, Kathryn H
- Schulz, Karl Heinz
- Sonke, Gabe
- Steindorf, Karen
- Stuiver, Martijn M
- Taaffe, Dennis R
- Thorsen, Lene
- Twisk, Jos W
- Velthuis, Miranda J
- Wenzel, Jennifer
- Wiskemann, Joachim
- Buffart, Laurien M
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2018-09-04
- Volume
- 53
- Issue
- 13
- Pages
- 812-812
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- OpenAlex
- W2891196398
- Cited by
- 109
- References
- 80
- Citations by year
- 2026: 4 · 2025: 18 · 2024: 16 · 2023: 16 · 2022: 20 · 2021: 16 · 2020: 10 · 2019: 8 · 2018: 1
- FWCI
- 0.91
- 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)
- Edinburgh Research Explorer (University of Edinburgh) (publishedVersion, other-oa)
- University of Twente Research Information (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Australasian Journal of Paramedicine (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- ABACUS. Repositorio de Producción Científica (Universidad Europea) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- Griffith Research Online (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- University of Twente Research Information (submittedVersion)
- Funders
- Bas Mulder Award by Alpe d’HuZes foundation/Dutch Cancer Society
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Keywords
- exercise intervention, cancer patients, muscle strength, muscle function, cardiorespiratory fitness, physical fitness, resistance training, aerobic exercise, supervised exercise, cancer therapy, individual patient data
- MeSH terms
- Exercise Therapy, Humans, Muscular Diseases, Neoplasms, Physical Fitness, Quality of Life, Muscle Strength
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