Effects of Supervised Multimodal Exercise Interventions on Cancer-Related Fatigue: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Table 2

Characteristics of the included studies in systematic review ( = 9).

Study	Design	Type of cancer	Participants	Intervention	Outcome measures
Adamsen et al. 2009 [24]	RCT	Mixed types of cancer	Characteristics of cancer treatment = chemotherapy; = 235; Female = 171; Male = 64; Exp ( = 118); Age (yr) = 47.2 (10.7); Con ( = 117); Age (yr) = 47.2 (10.6)	Exp = aerobic exercise, resistance training, and stretching; Length = 6 weeks; Duration = 120 min/session; Frequency = 5 sessions/week; Intensity = 85%–95%; Con = conventional care	EORTC QLQ-C30,; MOS SF-36, Leisure Time Physical Activity Questionnaire, muscular strength (1RM)
Campbell et al. 2005 [25]	RCT	Early stage (I-II) breast cancer	Characteristics of cancer treatment = chemotherapy, radiotherapy, and combination; = 22; Female = 22; Exp ( = 12); Age (yr) = 48 (10); Con ( = 10); Age (yr) = 47 (5)	Exp = aerobic exercise and resistance training; Length = 12 weeks; Duration = 20 min/session; Frequency = 2 sessions/week; Intensity = 60%–75%; Con = conventional care	FACT-G, FACT-B, SWLS, PFS, SPAQ, 12-minute walk test
Cantarero-Villanueva et al. 2013 [26]	RCT	Breast cancer (stages I–IIIA)	Characteristics of cancer treatment = chemotherapy, radiotherapy, and combination; = 61; Female = 61; Exp ( = 32); Age (yr) = 49 (7); Con ( = 29); Age (yr) = 47 (8)	Exp = aerobic exercise and resistance training; Length = 8 weeks; Duration = 60 min/session; Frequency = 3 sessions/week; Intensity = 60%–75%; Con = conventional care	PFS, the Spanish version of the Profile of Mood States, the “multiple sit-to-stand test,” the trunk curl static endurance test
Ergun et al. 2013 [27]	RCT	Breast cancer (stages I–IIIA)	Characteristics of cancer treatment = chemotherapy, radiotherapy, mastectomy, axillary dissection, and sentinel lymph node biopsy; = 60; Female = 60; Exp ( = 20); Age (yr) = 49.65 (8.25); Home-based exercise ( = 20); Age (yr) = 55.05 (6.85); Education group ( = 20); Age (yr) = 55.30 (10.37)	Exp = aerobic exercise and resistance training; Length = 12 weeks; Duration = 45 min/session; Frequency = 3 sessions/week; Intensity = 60%–80%; Con = home-based exercise (brisk walking for 30 min/day for 3 days/week) + education programme; Education group = patient information booklet that also included lymphedema-specific exercises	EORTC QLQ-C30, BFI, BDI, ELISA kit, RayBio Human Cytokine Antibody Array 3
Galvão et al. 2010 [28]	RCT	Prostate; localized (93.1%); Nodal metastases; (6.9%)	Characteristics of cancer treatment = chemotherapy—radiotherapy; = 57; Male = 57; Exp ( = 29); Age (yr) = 53.5 (8.7); Con ( = 28); Age (yr) = 52.1 (11.8)	Exp = aerobic exercise, resistance training, and stretching; Length = 12 weeks; Duration = 20 min/session; Frequency = 2 sessions/week; Intensity = 65%–80%; Con = conventional care	EORTC QLQ-C30, MOS SF-36, DXA, 1 RM
Milne et al. 2008 [29]	RCT	Early stage breast cancer	Characteristics of cancer treatment = chemotherapy—radiotherapy; = 58; Female = 58; Exp ( = 29); Age (yr) = 55.2 (8.4); Con ( = 29); Age (yr) = 55.1 (8.0)	Exp = aerobic exercise, resistance training, and stretching; Length = 12 weeks; Duration = 30 min/session; Frequency = 3 sessions/week; Intensity = about 75%; Con = delayed exercise group (DEG) completed the exercise program from 13 to 24 weeks	FACT-B, SCFS, rPARQ, Aerobic Power Index
Mutrie et al. 2007 [30]	RCT	Early stage breast cancer	Characteristics of cancer treatment = chemotherapy—radiotherapy and combination; = 174; Female = 174; Exp ( = 82); Age (yr) = 51.3 (10.3); Con ( = 92); Age (yr) = 51.8 (8.7)	Exp = aerobic exercise and resistance training; Length = 12 weeks; Duration = 45 min/session; Frequency = 2 sessions/week; Intensity = 50%–75%; Con = conventional care	FACT-G, FACT-B, FACT-F, BDI, PANAS, SPAQ leisure time, BMI, 12-minute walk test
Segal et al. 2009 [31]	RCT	Stages I–IV prostate cancer	Characteristics of cancer treatment = radiotherapy; = 121; Male = 121; Exp ( = 40); Age (yr) = 66.2 (6.8); Resistance ( = 40); Age (yr) = 66.4 (7.6); Con ( = 41); Age (yr) = 65.3 (7.6)	Exp = aerobic exercise, resistance training, and stretching; Length = 24 weeks; Duration = 45 min/session; Frequency = 3 sessions/week; Intensity = 70%–75%; Resistance = supervised resistance training of 3 times/week for 24 weeks and 2 times 8 to 12 reps of 10 exercises at 60% to 70% estimated 1 RM; Con = conventional care	FACT-G, FACT-P, FACT-F, VO(2)max, 1RM, DEXA scan (percent body fat)
Winters-Stone et al. 2012 [32]	RCT	Breast cancer (stages I–IIIA)	Characteristics of cancer treatment = chemotherapy—radiotherapy; = 106; Female = 106; Exp ( = 52); Age (yr) = 62.3 (6.7); Con ( = 54); Age (yr) = 62.6 (6.7)	Exp = resistance training; Length = 1 year; Duration = 60 min/session; Frequency = 2 sessions/week; Intensity = 60%–80%; Con = stretching placebo program	SCFS, 1-RM, PPB, hand-grip dynamometry

BDI, Beck Depression Inventory; DXA, dual-energy X-ray absorptiometry; EORTC QLQ-C30, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; RBDI, Finnish modified version of Beck’s 13-item depression scale; FACT-B, FACT-F, FACT-G, and FACT-P, Functional Assessment of Cancer Therapy- (FACT-) Breast, Fatigue, General, and Prostate; FACIT-F, Functional Assessment of Chronic Illness Therapy (FACIT) questionnaire for fatigue; MOS SF-36, Medical Outcomes Study Short Form; MFSI-SF, Multidimensional Fatigue Inventory; PARQ, Physical Activity Readiness Questionnaire; PFS, Piper Fatigue Scale; PANAS, Positive and Negative Affect Scale; SPAQ, Scottish Physical Activity Questionnaire; SCFS, Schwartz Cancer Fatigue Scale; SWLS, Satisfaction with Life Scale; WHQ, Women’s Health Questionnaire.
^*Age presented with mean and SD or range where reported.
^**Supervised multimodal exercise interventions involved a warm-up period, aerobic training (walking, cycling ergometers, and circuits), muscle strength training, and stretching exercises followed by cooldown and relaxation periods.