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Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment : a systematic review incorporating an indirect-comparisons meta-analysis
Authors: Hilfiker, Roger
Meichtry, Andre
Eicher, Manuela
Nilsson Balfe, Lina
Knols, Ruud H.
Verra, Martin L.
Taeymans, Jan
DOI: 10.21256/zhaw-4856
Published in: British Journal of Sports Medicine
Volume(Issue): 52
Issue: 10
Page(s): 651
Pages to: 658
Issue Date: May-2018
Publisher / Ed. Institution: BMJ Publishing Group
ISSN: 0306-3674
Language: English
Subjects: Cancer related fatigue; Exercise; Indirect comparison meta-analysis.; Network meta-analysis; Non-pharmaceutical interventions; Cognitive Therapy; Fatigue; Massage; Neoplasms; Randomized Controlled Trials as Topic; Relaxation Therapy; Resistance Training; Tai Ji; Yoga; Exercise Therapy
Subject (DDC): 615: Pharmacology and therapeutics
616: Internal medicine and diseases
Abstract: Aim: To assess the relative effects of different types of exercise and other non-pharmaceutical interventions on cancer-related fatigue (CRF) in patients during and after cancer treatment. Design: Systematic review and indirect-comparisons meta-analysis. Data sources: Articles were searched in PubMed, Cochrane CENTRAL and published meta-analyses. Eligibility criteria for selecting studies: Randomised studies published up to January 2017 evaluating different types of exercise or other non-pharmaceutical interventions to reduce CRF in any cancer type during or after treatment. Study appraisal and synthesis: Risk of bias assessment with PEDro criteria and random effects Bayesian network meta-analysis. Results: We included 245 studies. Comparing the treatments with usual care during cancer treatment, relaxation exercise was the highest ranked intervention with a standardised mean difference (SMD) of −0.77 (95% Credible Interval (CrI) −1.22 to −0.31), while massage (−0.78; −1.55 to −0.01), cognitive–behavioural therapy combined with physical activity (combined CBT, −0.72; −1.34 to −0.09), combined aerobic and resistance training (−0.67; −1.01 to −0.34), resistance training (−0.53; −1.02 to −0.03), aerobic (−0.53; −0.80 to −0.26) and yoga (−0.51; −1.01 to 0.00) all had moderate-to-large SMDs. After cancer treatment, yoga showed the highest effect (−0.68; −0.93 to −0.43). Combined aerobic and resistance training (−0.50; −0.66 to −0.34), combined CBT (−0.45; −0.70 to −0.21), Tai-Chi (−0.45; −0.84 to −0.06), CBT (−0.42; −0.58 to −0.25), resistance training (−0.35; −0.62 to −0.08) and aerobic (−0.33; −0.51 to −0.16) showed all small-to-moderate SMDs. Conclusions: Patients can choose among different effective types of exercise and non-pharmaceutical interventions to reduce CRF.
Fulltext version: Published version
License (according to publishing contract): CC BY-NC 4.0: Attribution - Non commercial 4.0 International
Departement: School of Health Sciences
Organisational Unit: Institute of Physiotherapy (IPT)
Appears in collections:Publikationen Gesundheit

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