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Title
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Moderators of exercise effects on cancer-related fatigue : a meta-analysis of individual patient data
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Author
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Abstract
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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- and 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 (beta = -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 (beta (difference) = -0.18; 95% CI -0.28 to -0.08). Supervised interventions with a duration <= 12 wk showed larger effects on fatigue (beta = -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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Language
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English
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Source (journal)
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Medicine and science in sports and exercise. - Madison, Wis., 1980, currens
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Publication
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Madison, Wis.
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2020
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ISSN
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0195-9131
[print]
1530-0315
[online]
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DOI
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10.1249/MSS.0000000000002154
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Volume/pages
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52
:2
(2020)
, p. 303-314
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ISI
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000507878400005
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Pubmed ID
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31524827
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Full text (Publisher's DOI)
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Full text (open access)
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Full text (publisher's version - intranet only)
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