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      Efficacy of Exercise Interventions in Patients with Acute Leukemia: A Meta-Analysis

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      1 , 2 , 3 , * , 4
      PLoS ONE
      Public Library of Science

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          Abstract

          Background

          Decreased physical performance and impaired physiological and psychological fitness have been reported in patients with acute leukemia (AL). We performed a meta-analysis to assess the efficacy of exercise in patients with AL.

          Methods

          In this meta-analysis, the electronic databases MEDLINE, Embase, Cochrane, Web of Science, SPORTDiscus, CINAHL and PEDro were searched through November 2015. Three authors participated in the study selection, data extraction and quality assessment. The instrument used for quality assessment was derived from the Cochrane Handbook for Systematic Reviews of Interventions. Analyses were performed according to the recommendations of The Cochrane Collaboration using Review Manager 5.3.

          Results

          Nine trials (8 randomized controlled trials and 1 quasi-experimental design trial) with 314 AL participants were included in this meta-analysis. The pooled standardized mean differences between the exercise and control groups were 0.45 (95% confidence interval (CI): 0.09 to 0.80, P value = 0.01, P for heterogeneity = 0.23, I 2 = 28%) for cardiorespiratory fitness and 0.67 (95% CI: 0.28 to 1.06, P value = 0.0007, P for heterogeneity = 0.14, I 2 = 43%) for muscle strength. Based on the data for fatigue, anxiety, and depression, there were no significant differences in these parameters between the exercise and control groups.

          Conclusions

          Exercise has beneficial effects on cardiorespiratory fitness, muscle strength and functional mobility; however, no significant improvements in fatigue, anxiety, depression or quality of life were observed. Further large-scale randomized trials are needed to assess the safety, feasibility and efficacy of exercise programs for AL patients.

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          Most cited references18

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          Cancer-Related Fatigue, Version 2.2015.

          Cancer-related fatigue is defined as a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning. It is one of the most common side effects in patients with cancer. Fatigue has been shown to be a consequence of active treatment, but it may also persist into posttreatment periods. Furthermore, difficulties in end-of-life care can be compounded by fatigue. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Cancer-Related Fatigue provide guidance on screening for fatigue and recommendations for interventions based on the stage of treatment. Interventions may include education and counseling, general strategies for the management of fatigue, and specific nonpharmacologic and pharmacologic interventions. Fatigue is a frequently underreported complication in patients with cancer and, when reported, is responsible for reduced quality of life. Therefore, routine screening to identify fatigue is an important component in improving the quality of life for patients living with cancer.
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            Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices.

            Cancer survivors are often highly motivated to seek information about food choices, physical activity, and dietary supplement use to improve their treatment outcomes, quality of life, and survival. To address these concerns, the American Cancer Society (ACS) convened a group of experts in nutrition, physical activity, and cancer to evaluate the scientific evidence and best clinical practices related to optimal nutrition and physical activity after the diagnosis of cancer. This report summarizes their findings and is intended to present health care providers with the best possible information from which to help cancer survivors and their families make informed choices related to nutrition and physical activity. The report discusses nutrition and physical activity issues during the phases of cancer treatment and recovery, living after recovery from treatment, and living with advanced cancer; select nutrition and physical activity issues such as body weight, food choices, and food safety; issues related to select cancer sites; and common questions about diet, physical activity, and cancer survivorship.
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              Modulation of blood flow, hypoxia, and vascular function in orthotopic prostate tumors during exercise.

              Previous studies have hypothesized that tumor blood flow may be elevated or reduced during exercise, which could impact the tumor microenvironment. However, to date technical limitations have precluded the measurement of tumor blood flow during exercise. Using an orthotopic preclinical model of prostate cancer, we tested the hypotheses that during exercise tumors would experience 1) diminished vascular resistance, 2) augmented blood flow, 3) increased numbers of perfused vessels, and 4) decreased tissue hypoxia and, furthermore, that the increased perfusion would be associated with diminished vasoconstriction in prostate tumor arterioles.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                27 July 2016
                2016
                : 11
                : 7
                : e0159966
                Affiliations
                [1 ]The First Hospital Affiliated with Nanjing Medical University, Nanjing, Jiangsu, PR China
                [2 ]College of Aerospace Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, PR China
                [3 ]Department of Nursing, The First Hospital Affiliated with Nanjing Medical University, Nanjing, Jiangsu, PR China
                [4 ]College of Nursing, Nanjing Medical University, Nanjing, Jiangsu, PR China
                Universidad Europea de Madrid, SPAIN
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: YZ ZG. Performed the experiments: YZ JZ ZG XY. Analyzed the data: YZ JZ. Contributed reagents/materials/analysis tools: YZ JZ. Wrote the paper: YZ ZG.

                Author information
                http://orcid.org/0000-0003-1973-3223
                Article
                PONE-D-16-03308
                10.1371/journal.pone.0159966
                4962985
                27463234
                be485b11-6f67-4e97-8d19-04a308a9b3eb
                © 2016 Zhou et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 27 February 2016
                : 9 July 2016
                Page count
                Figures: 7, Tables: 1, Pages: 16
                Funding
                Funded by: Jiangsu Province, "333 Project" Scientific Research Project
                Award ID: [2014] No.28
                Award Recipient :
                This work was supported by Jiangsu Province, "333 Project" Scientific Research Project [2014] No. 28, http://www.jsrcgz.gov.cn/333gc/gcindex.aspx.
                Categories
                Research Article
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Physical Fitness
                Exercise
                Medicine and Health Sciences
                Sports and Exercise Medicine
                Exercise
                Biology and Life Sciences
                Sports Science
                Sports and Exercise Medicine
                Exercise
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Physical Fitness
                Exercise
                Strength Training
                Medicine and Health Sciences
                Sports and Exercise Medicine
                Exercise
                Strength Training
                Biology and Life Sciences
                Sports Science
                Sports and Exercise Medicine
                Exercise
                Strength Training
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Physical Fitness
                Medicine and Health Sciences
                Complementary and Alternative Medicine
                Exercise Therapy
                Medicine and Health Sciences
                Diagnostic Medicine
                Signs and Symptoms
                Fatigue
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Signs and Symptoms
                Fatigue
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Meta-Analysis
                Physical Sciences
                Mathematics
                Statistics (Mathematics)
                Statistical Methods
                Meta-Analysis
                Biology and Life Sciences
                Psychology
                Emotions
                Anxiety
                Social Sciences
                Psychology
                Emotions
                Anxiety
                Medicine and Health Sciences
                Diagnostic Medicine
                Cancer Detection and Diagnosis
                Medicine and Health Sciences
                Oncology
                Cancer Detection and Diagnosis
                Custom metadata
                Data are from the literatures included in the paper.

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