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  • Moderators of Exercise Effects on Cancer-related Fatigue: A Meta-analysis of Individual Patient Data

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    Hayes448340-Accepted.pdf (2.337Mb)
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    Accepted Manuscript (AM)
    Author(s)
    Van Vulpen, JK
    Sweegers, MG
    Peeters, PHM
    Courneya, KS
    Newton, RU
    Aaronson, NK
    Jacobsen, PB
    Galvaõ, DA
    Chinapaw, MJ
    Steindorf, K
    Irwin, ML
    Stuiver, MM
    Hayes, S
    Griffith, KA
    et al.
    Griffith University Author(s)
    Hayes, Sandi C.
    Year published
    2020
    Metadata
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    Abstract
    Purpose Fatigue is a common and potentially disabling symptom in patients with cancer. It can often be effectively reduced by exercise. Yet, effects of exercise interventions might differ across subgroups. We conducted a meta-analysis using individual patient data of randomized controlled trials (RCT) to investigate moderators of exercise intervention effects on cancer-related fatigue. Methods We used individual patient data from 31 exercise RCT worldwide, representing 4366 patients, of whom 3846 had complete fatigue data. We performed a one-step individual patient data meta-analysis, using linear mixed-effect models to ...
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    Purpose Fatigue is a common and potentially disabling symptom in patients with cancer. It can often be effectively reduced by exercise. Yet, effects of exercise interventions might differ across subgroups. We conducted a meta-analysis using individual patient data of randomized controlled trials (RCT) to investigate moderators of exercise intervention effects on cancer-related fatigue. Methods We used individual patient data from 31 exercise RCT worldwide, representing 4366 patients, of whom 3846 had complete fatigue data. We performed a one-step individual patient data meta-analysis, using linear mixed-effect models to analyze the effects of exercise interventions on fatigue (z score) and to identify demographic, clinical, intervention- A nd exercise-related moderators. Models were adjusted for baseline fatigue and included a random intercept on study level to account for clustering of patients within studies. We identified potential moderators by testing their interaction with group allocation, using a likelihood ratio test. Results Exercise interventions had statistically significant beneficial effects on fatigue (β =-0.17; 95% confidence interval [CI],-0.22 to-0.12). There was no evidence of moderation by demographic or clinical characteristics. Supervised exercise interventions had significantly larger effects on fatigue than unsupervised exercise interventions (βdifference =-0.18; 95% CI-0.28 to-0.08). Supervised interventions with a duration ≤12 wk showed larger effects on fatigue (β =-0.29; 95% CI,-0.39 to-0.20) than supervised interventions with a longer duration. Conclusions In this individual patient data meta-analysis, we found statistically significant beneficial effects of exercise interventions on fatigue, irrespective of demographic and clinical characteristics. These findings support a role for exercise, preferably supervised exercise interventions, in clinical practice. Reasons for differential effects in duration require further exploration.
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    Journal Title
    Medicine and Science in Sports and Exercise
    Volume
    52
    Issue
    2
    DOI
    https://doi.org/10.1249/MSS.0000000000002154
    Copyright Statement
    © 2020 LWW. This is a non-final version of an article published in final form in Medicine and Science in Sports and Exercise, 2020, 52 (2), pp. 303-314. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal link for access to the definitive, published version.
    Subject
    Sports science and exercise
    Oncology and carcinogenesis
    Medical physiology
    Health services and systems
    Public health
    Publication URI
    http://hdl.handle.net/10072/398894
    Collection
    • Journal articles

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