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      A Systematic Review of Exercise Systematic Reviews in the Cancer Literature (2005-2017)

      , , , ,
      PM&R
      Elsevier BV

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          Abstract

          <div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d7237334e156">Background</h5> <p id="P2">Evidence supports the benefits of exercise for cancer patients, however, specific guidance for clinical decision making regarding exercise timing, frequency, duration and intensity is lacking. Efforts are needed to optimize clinical recommendations for exercise in the cancer population. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d7237334e161">Objectives</h5> <p id="P3">To aggregate information regarding the benefit of exercise through a systematic review of existing systematic reviews in the cancer exercise literature. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d7237334e166">Data Sources</h5> <p id="P4">PubMed, CINAHL Plus, Scopus, Web of Science, EMBASE.</p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d7237334e171">Study Eligibility Criteria</h5> <p id="P5">Systematic reviews and meta-analyses of the impact of movement-based exercise on the adult cancer population. </p> </div><div class="section"> <a class="named-anchor" id="S5"> <!-- named anchor --> </a> <h5 class="section-title" id="d7237334e176">Methods</h5> <p id="P6">Two author teams reviewed 302 abstracts for inclusion with 93 selected for full text review. 53 studies were analyzed. A Measurement Tool to Assess Systematic Reviews (AMSTAR©) was used as a quality measure of the reviews. Information was extracted using the PICO format ( <i>participants, intervention, comparison, outcomes).</i> Descriptive findings are reported. </p> </div><div class="section"> <a class="named-anchor" id="S6"> <!-- named anchor --> </a> <h5 class="section-title" id="d7237334e184">Results</h5> <p id="P7">Mean AMSTAR© score = 7.66 / 11 (±2.04) suggests moderate quality of the systematic reviews. Exercise is beneficial before, during, and after cancer treatment, across all cancer types, and for a variety of cancer-related impairments. Moderate to vigorous exercise is the best level of exercise intensity to improve physical function and mitigate cancer-related impairments. Therapeutic exercises are beneficial to manage treatment side effects, may enhance tolerance to cancer treatments, and improve functional outcomes. Supervised exercise yielded superior benefits versus unsupervised. Serious adverse events were not common. </p> </div><div class="section"> <a class="named-anchor" id="S7"> <!-- named anchor --> </a> <h5 class="section-title" id="d7237334e189">Limitations</h5> <p id="P8">Movement-based exercise intervention outcomes are reported. No analysis of pooled effects was calculated across reviews due to significant heterogeneity within the systematic reviews. Findings do not consider exercise in advanced cancers or pediatric populations. </p> </div><div class="section"> <a class="named-anchor" id="S8"> <!-- named anchor --> </a> <h5 class="section-title" id="d7237334e194">Conclusions</h5> <p id="P9">Exercise promotes significant improvements in clinical, functional, and in some populations, survival outcomes and can be recommended regardless of the type of cancer. Although generally safe, patients should be screened and appropriate precautions taken. Efforts to strengthen uniformity in clinical trial reporting, develop clinical practice guidelines, and integrate exercise and rehabilitation services into the cancer delivery system are needed. </p> </div>

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          Author and article information

          Journal
          PM&R
          PM&R
          Elsevier BV
          19341482
          September 2017
          September 2017
          : 9
          : 9
          : S347-S384
          Article
          10.1016/j.pmrj.2017.07.074
          5679711
          28942909
          1805d4e9-5f68-4356-9e27-cc2f5a74d562
          © 2017

          http://www.elsevier.com/tdm/userlicense/1.0/

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