Aerobic and combined exercise may improve cancer related fatigue

1. Aerobic exercise alone or combined with resistance training improves cancer related fatigue better than other forms of activity.

2. Studies reporting the best improvements followed low to moderate intensity regimens. 

Evidence Rating Level: 1 (Excellent)

Cancer related fatigue (CRF) is the most common disease in cancer patients who receive cancer treatment affecting 70-100% of patients. This condition is very debilitating and can be more distressing to daily function than the pain associated with the cancer itself. As exercise is often recommended to improve CRF, the objective of the current systematic review was to evaluate the effects of aerobic, resistance, endurance and combined exercise modalities on CRF.

From 827 identified records, 15 randomized controlled trials were included in the present study from January 1^st 2001 to September 1^st 2019. A total of 1664 patients (23% men) were included. To be eligible, studies had to include adult patients living with a cancer diagnosis undergoing treatment. Studies had to evaluate various modalities of exercise and evaluate its influence on fatigue, as measured by a self-report questionnaire, to be included. Complex forms of exercise which required complex motor patterns (e.g. tai chi, pilates, etc) were excluded.

Results demonstrated that aerobic exercise improved CRF better than other forms of activity. However, good outcomes were also achieved when combined with resistance training. Low to moderate intensities worked equally well for both men and women and optimal results were found to occur when performed at least 2 days/week for 8 or more weeks. However, this study was limited in the inclusion of a small number of studies and lack of variety of cancer types, as there was a predominance of breast and prostate cancers. Despite this, the present study offered support for the inclusion of daily activities in life of a cancer patient suffering from CRF.

Click to read the study in Journal of Human Sport and Exercise

Image: PD

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