Exercise for the management of cancer-related fatigue in adults

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 strategy 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 analaysis 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.