Effects of home-based exercise programs on physical fitness in cancer patients undergoing active treatment

Abstract

Objectives: This systematic review and meta-analysis aimed to investigate the effects of home-based exercise on physical fitness (cardiorespiratory fitness, muscle strength, and body composition) in cancer patients undergoing active treatment. Design: Systematic review with meta-analysis and Grading Recommendations Assessment, Development, and Evaluation of the evidence. Methods: A comprehensive search of existing literature was carried out in four electronic databases: PubMed, Web of Science, Scopus, and PEDro. All databases were searched for randomized controlled trials assessing the effects of home-based exercise on physical fitness outcomes in cancer patients during active treatment. Multicomponent interventions (i.e., exercise plus diet/behavioral therapy) were excluded. The methodological quality of each study was assessed using the Revised Cochrane risk-of-bias tool for randomized trials. Meta-analytical procedures were performed when appropriate and standardized mean differences (SMD) were calculated. Results: Twenty-eight randomized controlled trials (n = 2424 cancer patients) were included. Most of the interventions were conducted in breast cancer patients (n = 13) during the adjuvant treatment period (n = 17); 18 studies included a walking component in their home-based protocol. Home-based exercise was effective at improving the distance of the 6-minute walk test (k = 6; SMD = 0.321, p = 0.010). However, the results were no longer significant when performing sensitivity analysis based on exclusively walking (k = 1) and non-exclusively walking interventions (k = 5; SMD = 0.258; p = 0.072). No effects were found for muscle strength and body composition outcomes (p > 0.05). Conclusions: Regular home-based exercise programs are an effective strategy to improve 6-minutes walk test in cancer patients undergoing active treatment. Conversely, no alterations were found in muscle strength and body composition.