The effect of psychologically informed practice with behavioural graded activity in cancer survivors: systematic review and meta-analysis

Astrid Lahousse; Iris Reynebeau; Jo Nijs; David Beckwée; Paul van Wilgen; César Fernández-de-Las-Peñas; Kenza Mostaqim; Eva Roose; Laurence Leysen

doi:10.1007/s11764-022-01270-4

The effect of psychologically informed practice with behavioural graded activity in cancer survivors: systematic review and meta-analysis

J Cancer Surviv. 2023 Jan 26:1-46. doi: 10.1007/s11764-022-01270-4. Online ahead of print.

Authors

Astrid Lahousse^{1

2

3

4}, Iris Reynebeau^{5

6}, Jo Nijs^{5

6

7

8}, David Beckwée^{9

6

10}, Paul van Wilgen^{5

6

11}, César Fernández-de-Las-Peñas¹², Kenza Mostaqim^{5

6}, Eva Roose^{5

9

6}, Laurence Leysen^{5

9

6}

Affiliations

¹ Research Foundation - Flanders (FWO), Brussels, Belgium. Astrid.Lucie.Lahousse@vub.be.
² Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium. Astrid.Lucie.Lahousse@vub.be.
³ Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium. Astrid.Lucie.Lahousse@vub.be.
⁴ Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium. Astrid.Lucie.Lahousse@vub.be.
⁵ Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
⁶ Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
⁷ Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.
⁸ Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
⁹ Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
¹⁰ Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
¹¹ Transcare Transdisciplinary Pain Management Centre, Groningen, the Netherlands.
¹² Department of Physical Therapy Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcon, Madrid, Spain.

Abstract

Purpose: This systematic review and meta-analysis aimed to determine the effectiveness of psychologically informed practice (PIP) with behavioural graded activity (BGA) compared to (1) waitlist controls (WLC), (2) other interventions (OI), (3) PIP alone or (4) BGA alone in cancer patients and survivors (CPaS).

Methods: PubMed, Web of Science and Embase were screened for randomised controlled trials encompassing BGA + PIP in CPaS. Effect sizes were inventoried for outcomes regarding physical activity (PA), quality of life (QoL) and debilitating symptoms (DS), which were assessed at four time points: post-intervention (PI), follow-up F1 (1 to 3 months), F2 (4 to 6 months) and F3 (> 6 months). The quality of the evidence was classified by the GRADE approach.

Results: Thirty-three studies were found eligible, comprising 4330 participants. Significant effects with low heterogeneity of PIP + BGA comparing to WLC were found for anxiety (SMD - 1.29 [-1.71; - 0.86]), depression (SMD - 0.79 [- 1.10; - 0.48]), functional impairment (SMD - 0.72 [- 0.95; - 0.50]), PA (self-reported: (SMD - 0.58 [- 0.84; - 0.32]) and objectively measured: (SMD - 0.51 [- 0.90; - 0.13])) and social impairment (SMD - 0.33 [- 0.58; - 0.08]). When comparing PIP + BGA to OI, fatigue (SMD - 0.35 [- 0.51; - 0.20]) and PA (SMD - 0.26 [- 0.41; - 0.11]) at PI, and fatigue (SMD - 0.34 [- 0.58; - 0.10]) at F1 were found significant with low heterogeneity. No significant effects were observed in the meta-analyses of studies comparing PIP + BGA to BGA or PIP alone.

Conclusions: PIP with BGA has a favourable effect on DS, PA and QoL in CPaS when compared to non-behavioural interventions such as WLC, usual care and education. However, further research is needed on 'how' and 'when' PIP + BGA should be provided in cancer rehabilitation.

Implications for cancer survivors: PIP + BGA has the potential to facilitate CPaS to reach the recommended amount of PA and reduce DS.

Keywords: Adverse effects; Behaviour therapy; Exercise; Meta-analysis; Neoplasms; Quality of life.

Abstract

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