Efficacy of aerobic and resistance exercises on cancer pain: A meta-analysis of randomised controlled trials

Philip D Austin; Wei Lee; Daniel Sj Costa; Alison Ritchie; Melanie R Lovell

doi:10.1016/j.heliyon.2024.e29193

Efficacy of aerobic and resistance exercises on cancer pain: A meta-analysis of randomised controlled trials

Heliyon. 2024 Apr 6;10(7):e29193. doi: 10.1016/j.heliyon.2024.e29193. eCollection 2024 Apr 15.

Authors

Philip D Austin¹, Wei Lee^{1

2

3}, Daniel Sj Costa^{4

5

6

7}, Alison Ritchie¹, Melanie R Lovell^{1

4}

Affiliations

¹ Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, New South Wales, Australia.
² Improving Care for Palliative Aged, and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
³ St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
⁴ Sydney Medical School-Northern, University of Sydney, Sydney, New South Wales, Australia.
⁵ Kolling Institute, Northern Sydney Local Health District, Sydney, NSW, Australia.
⁶ School of Psychology, University of Sydney, Sydney, NSW, Australia.
⁷ The University of Sydney, Sydney, NSW, Australia.

Abstract

Purpose: To evaluate effects of aerobic and resistance exercises for cancer-related pain in adults with and surviving cancer. Secondary objectives were to a) evaluate the effect of exercise on fatigue, psychological function, physical function, b) assess fidelity to exercise.

Design: A systematic search of MEDLINE, EMBASE, AMED, CINAHL and Cochrane Central Register of Controlled Trials was conducted to identify randomised controlled trials (RCTs) comparing aerobic and/or resistance exercise to control groups. The primary endpoint were changes in cancer-related pain intensity from baseline to post intervention. Meta-regression analysis evaluated predictors for heterogeneity between study findings. Tolerability was defined as reporting of exercise-induced adverse events while fidelity evaluated by reported intervention dropout.

Results: Twenty-three RCTs including 1954 patients (age 58 ± 8.5 years; 78 % women); 1087 (56 %) and 867 (44 %) allocated to aerobic/resistance exercise therapy and control group, respectively. Exercise therapy was associated with small to moderate decreases in cancer-related pain compared to controls (SMD = 0.38, 95 % CI: 0.17, 0.58). Although there was significant heterogeneity between individual and pooled study effects (Q = 205.25, p < 0.0001), there was no publication bias. Meta-regression including supervision, age, duration and exercise type as moderators showed no significant differences in reported outcomes. Analysis of secondary outcomes revealed a moderate effect for improvements in physical function, fatigue and psychological symptoms.

Conclusions: Aerobic and resistance exercises are tolerable and effective adjunct therapies to reduce cancer-related pain while also improving physical function, fatigue and mood. Future RCTs of dose, frequency, compliance and exercise type in specific cancer settings are required.

Publication types

Review