Exercise for the management of cancer-related fatigue in adults

  • Review
  • Intervention

Authors


Abstract

Background

Cancer-related fatigue is now recognised as an important symptom associated with cancer and its treatment. A number of studies have investigated the effects of physical activity in reducing cancer-related fatigue with no definitive conclusions regarding its effectiveness.

Objectives

To evaluate the effect of exercise on cancer-related fatigue both during and after cancer treatment.

Search methods

The Cochrane Controlled Trials Register (CENTRAL/CCTR), MEDLINE (1966 to July 2007), EMBASE (1980 to July 2007), CINAHL (1982 to July 2007), British Nursing Index (January 1984 to July 2007), AMED (1985 to July 2007), SIGLE (1980 to July 2007), and Dissertation Abstracts International (1861 to July 2007) were all searched using key words. Reference lists off all studies identified for inclusion and relevant reviews were also searched. In addition, relevant journals were hand searched and experts in the field of cancer-related fatigue were contacted.

Selection criteria

Randomised controlled trials (RCTs) that investigated the effect of exercise on cancer-related fatigue in adults were included.

Data collection and analysis

Two review authors independently assessed the methodological quality of studies and extracted data based upon predefined criteria. Where data were available meta-analyses were performed for fatigue using a random-effects model.

Main results

Twenty-eight studies were identified for inclusion (n = 2083 participants), with the majority carried out on participants with breast cancer (n = 16 studies; n = 1172 participants). A meta-analysis of all fatigue data, incorporating 22 comparisons provided data for 920 participants who received an exercise intervention and 742 control participants. At the end of the intervention period exercise was statistically more effective than the control intervention (SMD -0.23, 95% Confidence Interval (CIs) -0.33 to -0.13).

Authors' conclusions

Exercise can be regarded as beneficial for individuals with cancer-related fatigue during and post cancer therapy. Further research is required to determine the optimal type, intensity and timing of an exercise intervention.

摘要

背景

探討以運動來處理成年人之癌症相關之疲憊

疲憊現在認為是一種與癌症和其治療有關聯的重要症狀。已有許多研究探討運動對於減緩癌症相關疲憊之效果,但相關其效力卻缺乏可靠的結論。

目標

評估運動對癌症治療前後相關疲憊症狀的療效。

搜尋策略

我們使用關鍵字搜尋了The Cochrane Controlled Trials Register (CENTRAL/CCTR), MEDLINE (1966 to July 2007), EMBASE(1980 to July 2007), CINAHL (1982 to July 2007), British Nursing Index (January1984 to July 2007), AMED (1985 to July 2007), SIGLE (1980 to July 2007), and Dissertation Abstracts International (1861 to July 2007) 。進一步搜尋已被挑選出來的研究之參考文獻與相關的文獻回顧。此外也人工搜尋看相關的期刊及諮詢癌症相關疲憊領域的專家們。

選擇標準

研究運動對癌症相關疲憊的成年人之影響的隨機對照試驗

資料收集與分析

2位評估者各自根據預先定義的標準調查各研究使用方法的品質和抽取數據。在資料可取得的情形下以隨機效用模型(randomeffects model)對疲憊進分析統合分析(metaanalyses)。

主要結論

共有28個研究(包括2083名受試者)納入本研究,絕大多數受試者是乳癌患者(16個研究;包括1172名受試者) 。 多項研究統合分析所有的數據,共有22個研究,包括920受試者有介入性運動治療,另外742人為對照組。評估結果是運動優於對照組,可以有效的改善疲憊(SMD −0.23 , 95 %的CI為 −0.33至−0.13) 。

作者結論

運動可被視為有利於改善癌症治療期間及其治療後所產生的相關疲憊。未來,需要進一步的研究確定最佳的運動類型,運動量和時間長短。

翻譯人

本摘要由三軍總醫院吳宜穎翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

疲憊是現在公認與癌症或其治療相關的副作用。在過去我們常鼓勵癌症患者在他們覺得疲倦時多休息,現階段癌症患者應得到適當的支助和諮詢,來幫助他們應付這些副作用。目前已有多個研究從事運動對於癌症治療期間及之治療的功效。而此文獻回顧即在評估體能活動對癌症相關疲憊之效益。共有28個研究納入本文獻回顧結果指出,運動可以幫助減少癌症治療期間治療之後的疲憊。然而,目前尚未有足夠證據顯示何種運動類型與運動量最能有效減少疲憊的症狀。

Plain language summary

The effect of exercise on fatigue associated with cancer

Fatigue is now recognised as a side-effect of cancer and its treatment. In the past people with cancer were encouraged to rest if they felt fatigued. It is important that individuals with cancer receive appropriate support and advice to help them cope with any adverse-effects. Physical exercise has been suggested as helpful in reducing the fatigue that is associated with cancer. A number of studies have been carried out to investigate the effects of exercise both during and after treatment. The current review was carried out to evaluate the effect of physical exercise on fatigue related to cancer. Twenty-eight studies were included in the review. Results suggest that physical exercise can help to reduce fatigue both during and after treatment for cancer. However, the evidence is not sufficient to demonstrate the best type or intensity of exercise for reducing the symptom of fatigue.

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