Efficacy of exercise interventions for women during and after gynaecological cancer treatment - a systematic scoping review

Grace Laura Rose; Elizabeth Mary Stewart; Briana Kristine Clifford; Tom George Bailey; Alexandra Jane Rush; Claudia Rose Abbott; Sandra Christine Hayes; Andreas Obermair; Alexandra Leigh McCarthy

doi:10.1007/s00520-023-07790-8

Efficacy of exercise interventions for women during and after gynaecological cancer treatment - a systematic scoping review

Support Care Cancer. 2023 May 17;31(6):342. doi: 10.1007/s00520-023-07790-8.

Authors

Grace Laura Rose^{1

2}, Elizabeth Mary Stewart³, Briana Kristine Clifford^{3

4

5}, Tom George Bailey^{3

4}, Alexandra Jane Rush⁴, Claudia Rose Abbott⁴, Sandra Christine Hayes^{6

7}, Andreas Obermair^{8

9}, Alexandra Leigh McCarthy^{4

10}

Affiliations

¹ School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia. grose1@usc.edu.au.
² School of Health, University of the Sunshine Coast, Sippy Downs, Australia. grose1@usc.edu.au.
³ School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
⁴ School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.
⁵ School of Health Sciences, University of New South Wales, Sydney, Australia.
⁶ School of Health Sciences and Social Work, Griffith University, Brisbane, Australia.
⁷ Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
⁸ School of Medicine, The University of Queensland, Brisbane, Australia.
⁹ Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women's Hospital, Brisbane, Australia.
¹⁰ Mater Research Institute, Brisbane, Australia.

Abstract

Purpose: To systematically synthesise evidence of exercise intervention efficacy for physical/psychosocial outcomes that matter to women during/following treatment for gynaecological cancer.

Methods: Five databases were searched (PubMed, EMBASE, CINAHL, PsychInfo, Scopus). Exercise-only intervention studies that included women during/ following treatment for any gynaecological cancer, with/ without control comparison, on any physical or psychosocial outcome(s), were included and qualitatively appraised using the Revised Cochrane Risk of Bias tool and a modified Newcastle-Ottawa Scale.

Results: Seven randomised controlled trials (RCTs), three single-arm pre-post studies, and one prospective cohort study satisfied were included (11 studies). Most studies were completed following treatment (91%), included combined (aerobic and resistance; 36%) and aerobic (36%) training, were fully/mostly (63%) unsupervised, and had a moderate-to-high risk of bias. Overall, 33 outcomes (64% objectively-measured) were assessed. Improvements were observed in aerobic capacity (V̇O₂ Peak +1.6 mL/kg/min, 6-minute walk distance +20-27 m), lower- (30-second sit-to-stand +2-4 repetitions) and upper-limb strength (30-second arm curl +5 repetitions; 1RM grip strength/chest press +2.4-3.1 kg), and agility (timed up-and-go -0.6 seconds). However, changes in quality of life, anthropometry/body composition, balance and flexibility were inconsistent. There was no evidence to support worsening of outcomes.

Conclusion: Preliminary research into the role of exercise post-gynaecological cancer suggests an improvement in exercise capacity, muscular strength, and agility which, in the absence of exercise, typically decline following gynaecological cancer. Future exercise trials involving larger and more diverse gynaecological cancer samples will improve understanding of the potential and magnitude of effect of guideline-recommended exercise on outcomes that matter to patients.

Keywords: agility; body composition; fitness; oncology; strength.

Publication types

Systematic Review
Review

MeSH terms

Exercise Therapy
Exercise Tolerance
Exercise*
Female
Humans
Muscle Strength
Neoplasms* / therapy
Quality of Life