Effect of Home- and Community-Based Physical Activity Interventions on Physical Function Among Cancer Survivors: A Systematic Review and Meta-Analysis

Abstract

Objective We reviewed randomized trials to examine the effect of home and community-based physical activity interventions on physical functioning among cancer survivors based on the most prevalent physical function measures. Data Sources Five electronic databases—Medline Ovid, Pubmed, CINAHL, Web of Science, and PsychINFO—were searched from inception to March 2016 for relevant articles. Study Selection Search terms included: community-based interventions, physical functioning, and cancer survivors. A reference librarian trained in systematic reviews conducted the final search. Detail protocol is registered on PROSPERO (www.crd.york.ac.uk/prospero/) CRD42016036730. Data Extraction Four reviewers evaluated eligibility and two reviewers evaluated methodological quality. Data were abstracted from studies that used the most prevalent physical function measurement tools—Medical Outcomes Study Short Form-36, Late Life Function and Disability Instrument, European Organisation for the Research and Treatment of Cancer Quality-of-Life Questionnaire, and six minute walk test. Random or fixed effects models were conducted to obtain overall effect size per physical function measure. Data Synthesis Fourteen studies met inclusion criteria and were used to compute standardized mean differences using inverse variance statistical method. The median sample size was 83 participants. The majority of the studies were conducted among breast cancer survivors (n = 7). The interventions produced short-term positive effects on physical functioning with overall effect sizes ranging from small (0.17, 95% CI: 0.07, 0.27) to medium (0.45, 95% CI: 0.23, 0.67). Community-based interventions that met in groups and used behavioral change strategies produced the largest effect sizes. Conclusions Home and community-based physical activity interventions may be a potential tool to combat functional deterioration among aging cancer survivors. More studies are needed among other cancer types using clinically relevant objective functional measures (e.g., gait speed) to accelerate translation into the community and clinical practice.

Cancer survivors’ experiences of a community-based cancer-specific exercise programme: results of an exploratory survey

“…Macmillan [42] have reported closed exercise classes in particular, provide an important opportunity for social contact and mutual support, as well as the possibility of a safe environment with an instructor who understands the condition specific to participants. This was confirmed in another recent review that suggested that community-based interventions that meet in groups and are using behavioural change strategies, were most effective in improving physical functioning and produced the largest effect sizes [43]. Other benefits reported by the current sample, such as having access to an exercise programme that is not limited to an end point and activities tailored to individual needs, provides direction for the exploration of factors that may optimise exercise interventions for people with cancer.…”

Physical Activity, Exercise and Breast Cancer - What Is the Evidence for Rehabilitation, Aftercare, and Survival A Review

“…Also, a systematic review with 14 randomized studies, and most of the included studies with breast cancer survivors, reports that group or community-based activities with approaches to behavioral change have the biggest effect. Home-and community-based physical activity programs could improve functional deterioration in aging cancer survivors [17].…”

Psychometric Properties of the 37-item Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) scale in Cancer Patients.

“…Recent guidelines have emphasized the importance of physical activity and social rehabilitation, both acquired in the workplace, to improve cognition in cancer patients [30][31][32]. The positive effect could be mediated by several biological mechanisms [33,34] but also by improved psychological factors such as anxiety and depression [32,35,36].…”