Skip to main content

Advertisement

Log in

Exercise interventions for cancer patients: systematic review of controlled trials

  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Objective: To systematically review controlled trials investigating the effects of exercise interventions in cancer patients.

Methods: Studies were located through searching seven electronic databases (Medline, Embase, Cochrane Library, CancerLit, PsycInfo, Cinahl, SportDiscus), scanning reference lists of relevant articles, contacting experts (n = 20), and checking the contents lists of journals available through ZETOC (Electronic Table of Contents). To be included, trials had to be prospective, controlled, involve participants diagnosed with cancer and test an exercise intervention. Types of outcome were not restricted. Two reviewers independently applied the selection criteria.

ResultsThirty-three controlled trials (including 25 randomized trials) were included in the review. There was some evidence that physical function was increased among those who exercised. Furthermore, symptoms of fatigue did not appear to be increased and there were few adverse effects reported. There was insufficient evidence to determine effects on other outcomes, such as quality of life, with results hampered by the heterogeneity between studies as well as poor methodological quality. Data were also lacking on the long term effects of exercise relating to cancer recurrence or survival.

Conclusions There is preliminary evidence that exercise interventions for cancer patients can lead to moderate increases in physical function and are not associated with increased symptoms of fatigue. However, it is impossible from current evidence to determine whether exercise has long term beneficial effects on survival or quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Jolliffe J, Rees K, Taylor RS, Thompson D, Oldridge N, Abrahim S (2004) Exercise-based rehabilitation for coronary heart disease [Cochrane Review ]. The Cochrane Library Issue 2. Oxford: Update Software.

  2. Pescatello L, Franklin, BA, Fagard R, Farquhar WB, Kelley GA, Ray CA, American College of Sports Medicine (2004) American College of Sports Medicine position stand. Exercise and hyper-tension. Med Sci Sports Exerc 36: 533–553.

    Google Scholar 

  3. Gordon N, Gulanick M, Costa F, et al., American Heart Association Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention; the Council on Cardiovascular Nursing; the Council on Nutrition, Physical Activity, and Metabolism; and the Stroke Council (2004) Physical activity and exercise recommendations for stroke survivors. Stroke 35: 1230–1240.

    Google Scholar 

  4. Jakicic J, Clark K, Coleman E, et al., American College of Sports Medicine (2001) American College of Sports Medicine position stand. Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 33: 2145–2156.

    Google Scholar 

  5. Albright A, Franz M, Hornsby G, et al. (2000) American College of Sports Medicine position stand. Exercise and type 2 diabetes. Med Sci Sports Exerc 32: 1345–1360.

    Google Scholar 

  6. Vuori I (2001) Dose-response of physical activity and low back pain, osteoarthritis, and osteoporosis. Med Sci Sports Exerc 33: S551–S586.

    Google Scholar 

  7. Schneider C, Dennehy C, Carter S (2003) Exercise and Cancer Recovery. Champaign, IL: Human Kinetics.

    Google Scholar 

  8. Jones L, Courneya KS (2002) Exercise discussions during cancer treatment consultations. Cancer Pract 10: 66–74.

    Google Scholar 

  9. Stevinson C, Fox K (2004) Role of exercise for cancer rehabil-itation in UK hospitals: a survey of oncology nurses. Eur J Cancer Care (in press).

  10. Curt G (2001) Fatigue in cancer. BMJ 322: 1560.

    Google Scholar 

  11. Smith S (1996) Physical exercise as an oncology nursing inter-vention to enhance quality of life. Oncol Nurs Forum 23: 771–778.

    Google Scholar 

  12. Thune I, Smeland S (2000) Is physical activity important in treatment and rehabilitation of cancer patients? [Norwegian ]. Tidsskr Nor Laegeforen 120: 3302–3304.

    Google Scholar 

  13. Pinto B, Maruyama NC (1999) Exercise in the rehabilitation of breast cancer survivors. Psychooncology 8: 191–206.

    Google Scholar 

  14. Courneya K, Friedenreich CM (1999) Physical exercise and quality of life following cancer diagnosis: a literature review. Ann Behav Med 21: 171–179.

    Google Scholar 

  15. Courneya K, Mackey JR, Jones LW (2000) Coping with cancer: can exercise help? Phys Sportsmed 28: 49–73.

    Google Scholar 

  16. Courneya K (2001) Exercise interventions during cancer treat-ment: biopsychosocial outcomes. Exerc Sport Sci Rev 29: 60–64.

    Google Scholar 

  17. Courneya K, Mackey JR, McKenzie DC (2002) Exercise for breast cancer survivors: research evidence and clinical guidelines. Phys Sportsmed 30: 33–42.

    Google Scholar 

  18. Sibbald B, Roland M(1998) Why are randomised controlled trials important? BMJ 316: 201.

    Google Scholar 

  19. Oldervoll L, Kaasa S, Hjermstad MJ, Lund JA, Loge JH (2004) Physical exercise results in the improved subjective well-being of a few or is effective rehabilitation for all cancer patients? Eur J Cancer 40: 951–962.

    Google Scholar 

  20. McManus R, Wilson S, Delaney BC, et al. (1998) Review of the usefulness of contacting other experts when conducting a litera-ture search for systematic reviews. BMJ 317: 1562–1563.

    Google Scholar 

  21. Blanchard C, Courneya KS, Laing D (2001) Effects of acute exercise on state anxiety in breast cancer survivors. Oncol Nurs Forum 28: 1617–1621.

    Google Scholar 

  22. Schultz I, Barholm M, Grondal S (1997) Delayed shoulder exercises in reducing seroma frequency after modi ed radical mastectomy: a prospective randomized study. Ann Surg Oncol 4: 293–297.

    Google Scholar 

  23. Ju ¨ni P, Altman G, Egger M (2001) Assessing the quality of controlled clinical trials. BMJ 323: 42–46.

    Google Scholar 

  24. Rosenthal R (1994) Parametric measures of effect size. In: Cooper H, Hedges LV, eds. The Handbook of Research Synthesis. New York: Russell Sage Foundation, pp. 231–244.

    Google Scholar 

  25. DerSimonian R, Laird N (1986) Meta-regression analysis in clinical trials. Control Clin Trials 7: 177–188.

    Google Scholar 

  26. Sterne J, Bradburn MJ, Egger M(2001) Meta-analysis in StataTM. In: Egger M, Davey Smith G, Altman DG, eds. Systematic Reviews in Health Care: Meta-analysis in Context. London: BMA Books, pp. 347–369.

    Google Scholar 

  27. Turchetta A, Calzolari A, Donfrancesco A, Drago F, Miano C (1990) Physical activity and competitive sport in youngs with leukemia' off therapy' [abstract ]. Proceedings of the World Congress on Sport for All: Tampere, Finland.

    Google Scholar 

  28. Whittaker J, Baracos VE, Haennel RG, Brown BE, Humen DP (1991) Exercise training in the posttreatment remission period of patients with limited small cell lung cancer [abstract]. Proceedings of the 24th Annual Meeting of the Canadian Association of Sport Sciences: Kingston, Ontario.

    Google Scholar 

  29. Adamsen L, Rasmussen JM, Pedersen LS (2001) 'Brothers in arms': how men with cancer experience a sense of comradeship through group intervention which combines physical activity with information relay. J Clin Nurs 10: 528–537.

    Google Scholar 

  30. Decker W, Turner-McGlade JT, Fehir KM (1989) Psychosocial aspects and the physiological effects of a cardiopulmonary exercise program in patients undergoing bone marrow transplan-tation for acute leukemia. Transplant Proc 21: 3068–3069.

    Google Scholar 

  31. Derman W, Coleman KL, Noakes TD (1999) Effects of exercise training in patients with cancer who have undergone chemother-apy [abstract ]. 46th Annual Meeting of the American College of Sports Medicine: Seattle. Med Sci Sports Exerc 31: S368.

    Google Scholar 

  32. Dimeo F, Bertz H, Finke J, Fetscher S, Mertelsmann R, Keul J (1996) An aerobic exercise program for patients with haemato-logical malignancies after bone marrow transplantation. Bone Marrow Transplant 18: 1157–1160.

    Google Scholar 

  33. Dimeo F, Rumberger G, Keul J (1998) Aerobic exercise as therapy for cancer fatigue. Med Sci Sports Exerc 30: 475–478.

    Google Scholar 

  34. Durak E, Lilly PC (1998) The application of an exercise and wellness program for cancer patients: a preliminary outcomes report. J Strength Cond Res 6: 3–6.

    Google Scholar 

  35. Durak E, Lilly PC (1999) A 5 year follow-up survey on health and exercise habits in women breast cancer survivors [abstract]. 2nd Annual Meeting of the American Society of Exercise Physiolo-gists: Albuquerque. Breast Cancer Res Treat 57: 92.

    Google Scholar 

  36. Durak E, Lilly PC, Hackworth JL (1999) Physical and psychosocial responses to exercise in cancer patients: a two year follow-up survey with postate, leukemia and general carcinoma. J Exerc Physiol Online (http: //www.css. edu/users/tboone2/asep/jan12b. htm. Accessed Oct 30, 2002).

  37. Gaskin T, LoBuglio A, Kelly P, Doss M, Pizitz N (1989) STRETCH: a rehabilitative program for patients with breast cancer. South Med J 82: 467–469.

    Google Scholar 

  38. Kolden G, Strauman TJ, Ward A, et al. (2002) A pilot study of group exercise training (GET)for women with primary breast cancer: feasibility and health bene ts. Psychooncology 11: 447–456.

    Google Scholar 

  39. Kramer MM (1996) The effects of exercise on psychological well-being in women recovering from breast cancer [abstract ]. Diss Abstr Int 57: 2157.

    Google Scholar 

  40. Loetzerich H, Peters C, Niemeier B, Schule K, Hoff HG, Uhlenbruck G (1994) Influence of endurance training on natural cytotoxicity and behaviour in cancer patients. Psychologische-Beitraege 36: 47–52.

    Google Scholar 

  41. Peters C, Lotzerich H, Niemeier B, Schule K, Uhlenbruck G (1995) Exercise, cancer and the immune response of monocytes. Anticancer Res 15: 175–180.

    Google Scholar 

  42. Peters C, Lotzerich H, Niemeier B, Schule K, Uhlenbruck G (1994) In. Influence of a moderate exercise training on natural killer cytotoxicity and personality traits in cancer patients. Anticancer Res 14: 1033–1036.

    Google Scholar 

  43. Peters C (1992) Ausdauersport als Rehabilitationsmassnahme in der Krebsnachsorge: Immunologishce und Psychologische As-pekte [dissertation]. Köln: Deutschen Sporthochschule.

  44. Porock D, Kristjanson L, Tinnelly K, Duke T, Blight J (2000) An exercise intervention for advanced cancer patients experiencing fatigue: a pilot study. J Palliat Care 16: 30–36.

    Google Scholar 

  45. Schulz K, Szlovak C, Schulz H, et al. (1998) Implementation and evaluation of an exercise rehabilitation training for breast cancer patients [German ]. Psychother Psychosom Med Psychol 48: 398–407.

    Google Scholar 

  46. Schwartz A (1998) The relationship of exercise to fatigue and quality of life in women with breast cancer [dissertation ]. Salt Lake City: University of Utah.

    Google Scholar 

  47. Schwartz AL (2000) Exercise and weight gain in breast cancer patients receiving chemotherapy. Cancer Pract 8: 231–237.

    Google Scholar 

  48. Schwartz AL, Mori M, Gao R, Nail LM, King ME (2001) Exercise reduces daily fatigue in women with breast cancer receiving chemotherapy. Med Sci Sports Exerc 33: 718–723.

    Google Scholar 

  49. Schwartz AL (1999) Fatigue mediates the effects of exercise on quality of life. Qual Life Res 8: 529–538.

    Google Scholar 

  50. Schwartz AL (2000) Daily fatigue patterns and effect of exercise in women with breast cancer. Cancer Pract 8: 16–24.

    Google Scholar 

  51. Sharkey A, Carey AB, Heise CT, Barber G (1993) Cardiac rehabilitation after cancer therapy in children and young adults. Am J Cardiol 71: 1488–1490.

    Google Scholar 

  52. Segal R, Reid R, Johnson D, et al. (1996) Pilot study of physical tness and quality of life in patients with breast cancer [abstract ]. 32nd Annual Meeting of the American Society of Clinical Oncology: Philadelphia, Pennsylvania.

  53. Yoshioka H (1994) Rehabilitation for the terminal cancer patient. Am J Phys Med Rehabil 73: 199–206.

    Google Scholar 

  54. Shore S, Shepard RJ (1999) Immune responses to exercise in children treated for cancer. J Sports Med Phys Fitness 39: 240–243.

    Google Scholar 

  55. Earle C, Reid B, Johnson D (1996) Exercise may ameliate the effects of adjuvant breast cancer treatment on physical tness and quality of life [abstract ]. Clin Invest Med 19: 417.

    Google Scholar 

  56. Segal R, Reid B, Johnson D (1996) Effects of exercise on body composition in breast cancer patients receiving adjuvant therapy [abstract ]. Clin Invest Med 19: 426.

    Google Scholar 

  57. Segal R, Reid B, Johnson D (1997) Progressive resistance exercise training in men with advanced prostate cancer [abstract ]. Clin Invest Med 20: S58.

    Google Scholar 

  58. Segal R, Evans WK, Gayton J, Woodard S, Wells G, Reid, R (2000) Structured exercise improves physical functioning in women with breast cancer (BC): results of a randomized con-trolled trial [abstract ]. Breast Cancer Res Treat 64: 128.

    Google Scholar 

  59. Segar M, Katch VL, Roth RS, et al. (1995) Aerobic exercise reduces depression and anxiety, and increases self-esteem among breast cancer survivors [abstract ]. Med Sci Sports Exer 27: S212.

    Google Scholar 

  60. Seifert E, Ewert S, Werle J (1992) Physical training in the aftercare of patients with cancer of the head and neck [German ]. Rehabil-itation (Stuttg) 31: 33–37.

    Google Scholar 

  61. Durak E, Lilly PC (1999) Preliminary results of exercise in breast cancer: a two year follow up survey. J Rehabil Outcomes Meas 3: 53–60.

    Google Scholar 

  62. Lazowski DA, Ecclestone NA, Myers AM, et al. (1999) A randomized outcome evaluation of group exercise programs in long-term care institutions. J Gerontol 54: M621–M628.

    Google Scholar 

  63. Pfalzer L (1990) The responses of bone marrow transplant patients to graded exercise testing prior to transplant and after transplant with and without exercise training [dissertation ]. Columbus: Ohio State University.

    Google Scholar 

  64. Schwartz AL, Thompson JA, Masood N (2002) Interferon-induced fatigue in patients with melanoma: a pilot study of exercise and methylphenidate. Oncol Nurs Forum 29: E85–E90.

    Google Scholar 

  65. Petersson LM, Berglund G, Brodin O, Glimelius B, Sjoden PO (2000) Group rehabilitation for cancer patients: satisfaction and perceived bene ts. Patient Educ Couns 40: 219–229.

    Google Scholar 

  66. Mock V, Pickett M, Ropka ME, et al. (2001) Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer Pract 9: 119–127.

    Google Scholar 

  67. Campbell A, Mutrie N, White F, McGuire F, Kearney N (2004) A pilot study of a supervised group exercise program as a rehabil-itation treatment for women with breat cancer receiving adjuvant treatment. Eur J Oncol Nurs (in press).

  68. Courneya K, Mackey JR, Bell GJ, Jones LW, Field CJ, Fairey AS (2003) Randomized controlled trial of exercise training in post-menopausal breast cancer survivors: cardiopulmonary and quality of life outcomes. J Clin Oncol 21: 1660–1668.

    Google Scholar 

  69. Fairey AS, Courneya KS, Field CJ, Bell GJ, Jones LW, Mackey JR (2003) Effects of exercise training on fasting insulin, insulin resistance, insulin-like growth factors, and insulin-like growth factor binding proteins in postmenopausal breast cancer survivors: a randomized controlled trial. Cancer Epidemiol Biomarkers Prev 12: 721–727.

    Google Scholar 

  70. Drouin J (2002) Aerobic exercise training effects on physical function, fatigue and mood, immune status, and oxidative stress in subjects undergoing radiation treatment for breast cancer [dissertation]. Detroit: Wayne State University.

    Google Scholar 

  71. Galantino ML, Capito L, Kane RJ, Ottey N, Switzer S, Packel L (2003) The effects of Tai Chi and walking on fatigue and body mass index in women living with breast cancer: a pilot study. Rehabil Oncol 21: 17–22.

    Google Scholar 

  72. Segal R, Evans W, Johnson D, et al. (2001) Structured exercise improves physical functioning in women with stages I and II breast cancer: results of a randomized controlled trial. J Clin Oncol 19: 657–665.

    Google Scholar 

  73. Segar ML, Katch VL, Roth RS, et al. (1998) The e. ect of aerobic exercise on self-esteem and depressive and anxiety symptoms among breast cancer survivors. Oncol Nurs Forum 25: 107–113.

    Google Scholar 

  74. Mock V, Dow KH, Meares CJ, et al. (1997) Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncol Nurs Forum 24: 991–1000.

    Google Scholar 

  75. Nieman DC, Cook VD, Henson DA, et al. (1995) Moderate exercise training and natural killer cell cytotoxic activity in breast cancer patients. Int J Sports Med 16: 334–337.

    Google Scholar 

  76. Mock V, Burke MB, Sheehan P, et al. (1994) A nursing rehabilitation program for women with breast cancer receiving adjuvant chemotherapy. Oncol Nurs Forum 21: 899–907.

    Google Scholar 

  77. MacVicar MG, Winningham ML, Nickel JL (1989) Effects of aerobic interval training on cancer patients' functional capacity. Nurs Res 38: 348–351.

    Google Scholar 

  78. Winningham ML, MacVicar MG, Bondoc M, Anderson JI, Minton JP (1989) Effect of aerobic exercise on body weight and composition in patients with breast cancer on adjuvant chemo-therapy. Oncol Nurs Forum 16: 683–689.

    Google Scholar 

  79. Winningham ML, MacVicar MG (1988) The effect of aerobic exercise on patient reports of nausea. Oncol Nurs Forum 15: 447–450.

    Google Scholar 

  80. MacVicar M, Winningham, ML (1986) Promoting the functional capacity of cancer patients. Cancer Bull 38: 235–239.

    Google Scholar 

  81. Winningham M (1983) Effects of a bicycle ergometry program on functional capacity and feelings of control in women with breast cancer [dissertation]. Columbus: Ohio State University.

    Google Scholar 

  82. Oliver S (2003) Physiological and psychological effects of pro-gressive resistance training in elderly prostate cancer patients undergoing androgen deprivation therapy: a pilot study [disser-tation]. Bangor: University of Wales-Bangor.

    Google Scholar 

  83. Segal R, Reid RD, Courneya KS, et al. (2003) Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol 21: 1653–1659.

    Google Scholar 

  84. Berglund G, Petersson L-M, Eriksson KRN, Häggman M (2003) 'Between men': patient perceptions and priorities in a rehabilita-tion program for men with prostate cancer. Patient Educ Couns 49: 285–292.

    Google Scholar 

  85. Courneya K, Friedenreich CM, Sela RA, Quinney A, Rhodes RE, Handman M (2003) The group psychotherapy and home-based physical exercise (GROUP-HOPE)trial in cancer survivors: physical tness and quality of life outcomes. Psychooncology 12: 357–374.

    Google Scholar 

  86. Hayes S, Davies PSW, Parker TW, Bashford J (2003) Total energy expenditure and body composition changes following peripheral blood stem cell transplantation and participation in an exercise programme. Bone Marrow Transplant 31: 331–338.

    Google Scholar 

  87. Hayes SC, Rowbottom D, Davies PSW, Parker TW, Bashford J (2003) Immunological changes after cancer treatment and participation in an exercise program. Med Sci Sports Exerc 35: 2–9.

    Google Scholar 

  88. Hayes S, Davies PSW, Parker TW, Bashford J, Green A (2004) The role of a mixed type, moderate intensity exercise program following peripheral blood stem cell transplantation. Br J Sports Med 38: 304–309.

    Google Scholar 

  89. Hayes S, Davies PSW, Parker TW, Bashford J, Newman B (2004) Quality of life changes following peripheral blood stem cell transplantation and participation in a mixed-type, moderate intensity exercise program. Bone Marrow Transplant 33: 553–558.

    Google Scholar 

  90. Burnham TR, Wilcox A (2002) Effects of exercise on physiolog-ical and psychological variables in cancer survivors. Med Sci Sports Exerc 34: 1863–1867.

    Google Scholar 

  91. Mello M, Tanaka C, Dulley FL (2003) Effects of an exercise program on muscle performance in patients undergoing allo-geneic bone marrow transplant. Bone Marrow Transplant 32: 723–728.

    Google Scholar 

  92. Petersson L-M, Nordin K, Glimelius B, Brekkan E, Sjödén P-O, Berglund G (2002) Differential effects of cancer rehabilitation depending on diagnosis and patients cognitive coping style. Psychosom Med 64: 971–980.

    Google Scholar 

  93. Dimeo FC, Stieglitz RD, Novelli-Fischer U, Fetscher S, Keul J (1999) Effects of physical activity on the fatigue and psychologic status of cancer patients during chemotherapy. Cancer 85: 2273–2277.

    Google Scholar 

  94. Niesen-Vertommen S (1999) The recovery patterns and effects of exercise rehabilitation on the physiological and psychological health of children who have survived treatment for a malignancy [dissertation]. Vancouver: University of British Columbia.

    Google Scholar 

  95. Dimeo FC, Tilmann MH, Bertz H, Kanz L, Mertelsmann R, Keul J (1997) Aerobic exercise in the rehabilitation of cancer patients after high-dose chemotherapy and autologous peripheral stem cell transplantation. Cancer 79: 1717–1722.

    Google Scholar 

  96. Dimeo F, Fetscher S, Lange W, Mertelsmann R, Keul J (1997) Effects of aerobic exercise on the physical performance and incidence of treatment-related complications after high-dose chemotherapy. Blood 90: 3390–3394.

    Google Scholar 

  97. Berglund G, Bolund C, Gustavsson U-L, Sjoden P-O (1994) A randomized study of a rehabilitation program for cancer patients: the 'starting again' group. Psychooncology 3: 109–120.

    Google Scholar 

  98. Berglund G, Bolund C, Gustafsson UL, Sjoden PO(1994) One-year follow-up of the 'starting Again' group rehabilitation programme for cancer patients. Eur J Cancer 30: 1744–1751.

    Google Scholar 

  99. Berglund G, Bolund C, Gustavsson UL, Sjoden PO (1993) Starting again-a comparison study of a group of rehabilitation program for cancer patients. Acta Oncol 32: 15–21.

    Google Scholar 

  100. Buettner L, Gavon SJ (1981) Personality changes and physiolog-ical effects of a personalized tness enrichment program for cancer patients [dissertation]. Bowling Green: Bowling Green State University.

    Google Scholar 

  101. Courneya K, Friendenreich CM, Quinney HA, Fields ALA, Jones LW, Fairey AS (2003) A randomised trial of exercise and quality of life in colorectal cancer survivors. Eur J Cancer Care 12: 347–357.

    Google Scholar 

  102. Coleman E, Hall-Barrow J, Coon S, Stewart CB (2003) Facili-tating exercise adherence for patients with multiple myeloma. Clin J Oncol Nurs 7: 529–535.

    Google Scholar 

  103. Coleman E, Coon S, Hall-Barrow J, Richards K, Gaylor D, Stewart CB (2003) Feasibility of exercise during treatment for multiple myeloma. Cancer Nurs 26: 410–419.

    Google Scholar 

  104. Wall LM (2000) Changes in hope and power in lung cancer patients who exercise. Nurs Sci Q 13: 234–242.

    Google Scholar 

  105. Na YM, Kim MY, Kim YK, Ha YR, Yoon DS (2000) Exercise therapy effect on natural killer cell cytotoxic activity in stomach cancer patients after curative surgery. Arch Phys Med Rehabil 81: 777–779.

    Google Scholar 

  106. Cunningham BA, Morris G, Cheney CL, Buergel N, Aker SN, Lenssen P (1986) Effects of resistive exercise on skeletal muscle in marrow transplant recipients receiving total parenteral nutrition. J Parenter Enteral Nutr 10: 558–563.

    Google Scholar 

  107. Egger M, Dickersin K, Davey Smith G (2001) Problems and limitations in conducting systematic reviews. In: Egger M, Davey Smith G, Altman DG, eds. Systematic Reviews in Health Care: Meta-analysis in Context, 2nd edn. London: BMJ Publishing Group, pp. 43–68.

    Google Scholar 

  108. Easterbrook P, Berlin JA, Gopalan R, Matthews DR (1991) Publication bias in clinical research. Lancet 337: 867–872.

    Google Scholar 

  109. Ioannidis JPA (1998) Effect of the statistical signficance of results on the time to completion and publication of randomized efficacy trials. JAMA 279: 281–286.

    Google Scholar 

  110. Egger M, Zellweger-Zahner T, Schneider M, Junker C, Lengeler C, Antes G (1997) Language bias in randomised controlled trials published in English and German. Lancet 350: 326–329.

    Google Scholar 

  111. Nieminen P, Isohanni M (1999) Bias against European journals in medical publication databases. Lancet 353: 1592.

    Google Scholar 

  112. Schulz KF, Chalmers I, Hayes RJ, Altman DG (1995) Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 273: 408–412.

    Google Scholar 

  113. Moher D, Pham B, Jones A, et al. (1998) Does quality of reports of randomised trials a. ect estimates of intervention efficacy reported in meta-analyses? Lancet 352: 609–613.

    Google Scholar 

  114. Hollis S, Campbell F (1999) What is meant by intention to treat analysis? Survey of published randomised controlled trials. BMJ 319: 670–674.

    Google Scholar 

  115. Moore R, Gavaghan D, Tramer MR, Collins SL, McQuay HJ (1998) Size is everything-large amounts of information are needed to overcome random effects in estimating direction and magnitude of treatment effects. Pain 78: 209–216.

    Google Scholar 

  116. Bland J, Altman DG (1995) Multiple significance tests: the Bonferroni method. BMJ 310: 170–172.

    Google Scholar 

  117. Smith D G, Clemens J, Crede W, Harvey M, Gracely EJ (1987) Impact of multiple comparisons in randomized clinical trials. Am JMed 83: 545–550.

    Google Scholar 

  118. Dimeo F (2001) Effects of exercise on cancer-related fatigue. Cancer 92: 1689–1693.

    Google Scholar 

  119. Alderson P, Roberts I (2000) Should journals publish systematic reviews that nd no evidence to guide practice? Examples from injury research. BMJ 320: 376–377.

    Google Scholar 

  120. Campbell M, Fitzpatrick, R, Haines, A, et al. (2000) Framework for design and evaluation of complex interventions to improve health. BMJ 321: 694–696.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stevinson, C., Lawlor, D.A. & Fox, K.R. Exercise interventions for cancer patients: systematic review of controlled trials. Cancer Causes Control 15, 1035–1056 (2004). https://doi.org/10.1007/s10552-004-1325-4

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-004-1325-4

Navigation