Effects and moderators of exercise on quality of life and physical function in patients with cancer: An individual patient data meta-analysis of 34 RCTs

Laurien M. Buffart, Joeri Kalter, Maike G. Sweegers, Kerry S. Courneya, Robert U. Newton, Neil K. Aaronson, Paul B. Jacobsen, Anne M. May, Daniel A. Galvão, Mai J. Chinapaw, Karen Steindorf, Melinda L. Irwin, Martijn M. Stuiver, Sandi Hayes, Kathleen A. Griffith, Alejandro Lucia, Ilse Mesters, Ellen van Weert, Hans Knoop, Martine M. Goedendorp & 28 others Nanette Mutrie, Amanda J. Daley, Alex McConnachie, Martin Bohus, Lene Thorsen, Karl Heinz Schulz, Camille E. Short, Erica L. James, Ron C. Plotnikoff, Gill Arbane, Martina E. Schmidt, Karin Potthoff, Marc van Beurden, Hester S. Oldenburg, Gabe S. Sonke, Wim H. van Harten, Rachel Garrod, Kathryn H. Schmitz, Kerri M. Winters-Stone, Miranda J. Velthuis, Dennis R. Taaffe, Willem van Mechelen, Marie José Kersten, Frans Nollet, Jennifer Wenzel, Joachim Wiskemann, Irma M. Verdonck- de Leeuw, Johannes Brug

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Abstract

This individual patient data meta-analysis aimed to evaluate the effects of exercise on quality of life (QoL) and physical function (PF) in patients with cancer, and to identify moderator effects of demographic (age, sex, marital status, education), clinical (body mass index, cancer type, presence of metastasis), intervention-related (intervention timing, delivery mode and duration, and type of control group), and exercise-related (exercise frequency, intensity, type, time) characteristics. Relevant published and unpublished studies were identified in September 2012 via PubMed, EMBASE, PsycINFO, and CINAHL, reference checking and personal communications. Principle investigators of all 69 eligible trials were requested to share IPD from their study. IPD from 34 randomised controlled trials (n = 4519 patients) that evaluated the effects of exercise compared to a usual care, wait-list or attention control group on QoL and PF in adult patients with cancer were retrieved and pooled. Linear mixed-effect models were used to evaluate the effects of the exercise on post-intervention outcome values (z-score) adjusting for baseline values. Moderator effects were studies by testing interactions. Exercise significantly improved QoL (β = 0.15, 95%CI = 0.10;0.20) and PF (β = 0.18, 95%CI = 0.13;0.23). The effects were not moderated by demographic, clinical or exercise characteristics. Effects on QoL (βdifference_in_effect = 0.13, 95%CI = 0.03;0.22) and PF (βdifference_in_effect = 0.10, 95%CI = 0.01;0.20) were significantly larger for supervised than unsupervised interventions. In conclusion, exercise, and particularly supervised exercise, effectively improves QoL and PF in patients with cancer with different demographic and clinical characteristics during and following treatment. Although effect sizes are small, there is consistent empirical evidence to support implementation of exercise as part of cancer care.

Original languageEnglish
Pages (from-to)91-104
Number of pages14
JournalCancer treatment reviews
Volume52
DOIs
Publication statusPublished - 1 Jan 2017

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Meta-Analysis
Quality of Life
Exercise
Neoplasms
Demography
Control Groups
Marital Status
PubMed
Body Mass Index
Randomized Controlled Trials
Communication
Research Personnel
Neoplasm Metastasis
Education

Keywords

  • Exercise
  • Individual patient data meta-analysis
  • Neoplasm
  • Physical function
  • Quality of life

Cite this

Buffart, Laurien M. ; Kalter, Joeri ; Sweegers, Maike G. ; Courneya, Kerry S. ; Newton, Robert U. ; Aaronson, Neil K. ; Jacobsen, Paul B. ; May, Anne M. ; Galvão, Daniel A. ; Chinapaw, Mai J. ; Steindorf, Karen ; Irwin, Melinda L. ; Stuiver, Martijn M. ; Hayes, Sandi ; Griffith, Kathleen A. ; Lucia, Alejandro ; Mesters, Ilse ; van Weert, Ellen ; Knoop, Hans ; Goedendorp, Martine M. ; Mutrie, Nanette ; Daley, Amanda J. ; McConnachie, Alex ; Bohus, Martin ; Thorsen, Lene ; Schulz, Karl Heinz ; Short, Camille E. ; James, Erica L. ; Plotnikoff, Ron C. ; Arbane, Gill ; Schmidt, Martina E. ; Potthoff, Karin ; van Beurden, Marc ; Oldenburg, Hester S. ; Sonke, Gabe S. ; van Harten, Wim H. ; Garrod, Rachel ; Schmitz, Kathryn H. ; Winters-Stone, Kerri M. ; Velthuis, Miranda J. ; Taaffe, Dennis R. ; van Mechelen, Willem ; Kersten, Marie José ; Nollet, Frans ; Wenzel, Jennifer ; Wiskemann, Joachim ; Verdonck- de Leeuw, Irma M. ; Brug, Johannes. / Effects and moderators of exercise on quality of life and physical function in patients with cancer : An individual patient data meta-analysis of 34 RCTs. In: Cancer treatment reviews. 2017 ; Vol. 52. pp. 91-104.
@article{9103f589bb5544a59ba2e87b2276042e,
title = "Effects and moderators of exercise on quality of life and physical function in patients with cancer: An individual patient data meta-analysis of 34 RCTs",
abstract = "This individual patient data meta-analysis aimed to evaluate the effects of exercise on quality of life (QoL) and physical function (PF) in patients with cancer, and to identify moderator effects of demographic (age, sex, marital status, education), clinical (body mass index, cancer type, presence of metastasis), intervention-related (intervention timing, delivery mode and duration, and type of control group), and exercise-related (exercise frequency, intensity, type, time) characteristics. Relevant published and unpublished studies were identified in September 2012 via PubMed, EMBASE, PsycINFO, and CINAHL, reference checking and personal communications. Principle investigators of all 69 eligible trials were requested to share IPD from their study. IPD from 34 randomised controlled trials (n = 4519 patients) that evaluated the effects of exercise compared to a usual care, wait-list or attention control group on QoL and PF in adult patients with cancer were retrieved and pooled. Linear mixed-effect models were used to evaluate the effects of the exercise on post-intervention outcome values (z-score) adjusting for baseline values. Moderator effects were studies by testing interactions. Exercise significantly improved QoL (β = 0.15, 95{\%}CI = 0.10;0.20) and PF (β = 0.18, 95{\%}CI = 0.13;0.23). The effects were not moderated by demographic, clinical or exercise characteristics. Effects on QoL (βdifference_in_effect = 0.13, 95{\%}CI = 0.03;0.22) and PF (βdifference_in_effect = 0.10, 95{\%}CI = 0.01;0.20) were significantly larger for supervised than unsupervised interventions. In conclusion, exercise, and particularly supervised exercise, effectively improves QoL and PF in patients with cancer with different demographic and clinical characteristics during and following treatment. Although effect sizes are small, there is consistent empirical evidence to support implementation of exercise as part of cancer care.",
keywords = "Exercise, Individual patient data meta-analysis, Neoplasm, Physical function, Quality of life",
author = "Buffart, {Laurien M.} and Joeri Kalter and Sweegers, {Maike G.} and Courneya, {Kerry S.} and Newton, {Robert U.} and Aaronson, {Neil K.} and Jacobsen, {Paul B.} and May, {Anne M.} and Galv{\~a}o, {Daniel A.} and Chinapaw, {Mai J.} and Karen Steindorf and Irwin, {Melinda L.} and Stuiver, {Martijn M.} and Sandi Hayes and Griffith, {Kathleen A.} and Alejandro Lucia and Ilse Mesters and {van Weert}, Ellen and Hans Knoop and Goedendorp, {Martine M.} and Nanette Mutrie and Daley, {Amanda J.} and Alex McConnachie and Martin Bohus and Lene Thorsen and Schulz, {Karl Heinz} and Short, {Camille E.} and James, {Erica L.} and Plotnikoff, {Ron C.} and Gill Arbane and Schmidt, {Martina E.} and Karin Potthoff and {van Beurden}, Marc and Oldenburg, {Hester S.} and Sonke, {Gabe S.} and {van Harten}, {Wim H.} and Rachel Garrod and Schmitz, {Kathryn H.} and Winters-Stone, {Kerri M.} and Velthuis, {Miranda J.} and Taaffe, {Dennis R.} and {van Mechelen}, Willem and Kersten, {Marie Jos{\'e}} and Frans Nollet and Jennifer Wenzel and Joachim Wiskemann and {Verdonck- de Leeuw}, {Irma M.} and Johannes Brug",
year = "2017",
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doi = "10.1016/j.ctrv.2016.11.010",
language = "English",
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pages = "91--104",
journal = "Cancer treatment reviews",
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publisher = "W.B. Saunders Ltd",

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Buffart, LM, Kalter, J, Sweegers, MG, Courneya, KS, Newton, RU, Aaronson, NK, Jacobsen, PB, May, AM, Galvão, DA, Chinapaw, MJ, Steindorf, K, Irwin, ML, Stuiver, MM, Hayes, S, Griffith, KA, Lucia, A, Mesters, I, van Weert, E, Knoop, H, Goedendorp, MM, Mutrie, N, Daley, AJ, McConnachie, A, Bohus, M, Thorsen, L, Schulz, KH, Short, CE, James, EL, Plotnikoff, RC, Arbane, G, Schmidt, ME, Potthoff, K, van Beurden, M, Oldenburg, HS, Sonke, GS, van Harten, WH, Garrod, R, Schmitz, KH, Winters-Stone, KM, Velthuis, MJ, Taaffe, DR, van Mechelen, W, Kersten, MJ, Nollet, F, Wenzel, J, Wiskemann, J, Verdonck- de Leeuw, IM & Brug, J 2017, 'Effects and moderators of exercise on quality of life and physical function in patients with cancer: An individual patient data meta-analysis of 34 RCTs' Cancer treatment reviews, vol. 52, pp. 91-104. https://doi.org/10.1016/j.ctrv.2016.11.010

Effects and moderators of exercise on quality of life and physical function in patients with cancer : An individual patient data meta-analysis of 34 RCTs. / Buffart, Laurien M.; Kalter, Joeri; Sweegers, Maike G.; Courneya, Kerry S.; Newton, Robert U.; Aaronson, Neil K.; Jacobsen, Paul B.; May, Anne M.; Galvão, Daniel A.; Chinapaw, Mai J.; Steindorf, Karen; Irwin, Melinda L.; Stuiver, Martijn M.; Hayes, Sandi; Griffith, Kathleen A.; Lucia, Alejandro; Mesters, Ilse; van Weert, Ellen; Knoop, Hans; Goedendorp, Martine M.; Mutrie, Nanette; Daley, Amanda J.; McConnachie, Alex; Bohus, Martin; Thorsen, Lene; Schulz, Karl Heinz; Short, Camille E.; James, Erica L.; Plotnikoff, Ron C.; Arbane, Gill; Schmidt, Martina E.; Potthoff, Karin; van Beurden, Marc; Oldenburg, Hester S.; Sonke, Gabe S.; van Harten, Wim H.; Garrod, Rachel; Schmitz, Kathryn H.; Winters-Stone, Kerri M.; Velthuis, Miranda J.; Taaffe, Dennis R.; van Mechelen, Willem; Kersten, Marie José; Nollet, Frans; Wenzel, Jennifer; Wiskemann, Joachim; Verdonck- de Leeuw, Irma M.; Brug, Johannes.

In: Cancer treatment reviews, Vol. 52, 01.01.2017, p. 91-104.

Research output: Contribution to journalReview articleAcademicpeer-review

TY - JOUR

T1 - Effects and moderators of exercise on quality of life and physical function in patients with cancer

T2 - An individual patient data meta-analysis of 34 RCTs

AU - Buffart, Laurien M.

AU - Kalter, Joeri

AU - Sweegers, Maike G.

AU - Courneya, Kerry S.

AU - Newton, Robert U.

AU - Aaronson, Neil K.

AU - Jacobsen, Paul B.

AU - May, Anne M.

AU - Galvão, Daniel A.

AU - Chinapaw, Mai J.

AU - Steindorf, Karen

AU - Irwin, Melinda L.

AU - Stuiver, Martijn M.

AU - Hayes, Sandi

AU - Griffith, Kathleen A.

AU - Lucia, Alejandro

AU - Mesters, Ilse

AU - van Weert, Ellen

AU - Knoop, Hans

AU - Goedendorp, Martine M.

AU - Mutrie, Nanette

AU - Daley, Amanda J.

AU - McConnachie, Alex

AU - Bohus, Martin

AU - Thorsen, Lene

AU - Schulz, Karl Heinz

AU - Short, Camille E.

AU - James, Erica L.

AU - Plotnikoff, Ron C.

AU - Arbane, Gill

AU - Schmidt, Martina E.

AU - Potthoff, Karin

AU - van Beurden, Marc

AU - Oldenburg, Hester S.

AU - Sonke, Gabe S.

AU - van Harten, Wim H.

AU - Garrod, Rachel

AU - Schmitz, Kathryn H.

AU - Winters-Stone, Kerri M.

AU - Velthuis, Miranda J.

AU - Taaffe, Dennis R.

AU - van Mechelen, Willem

AU - Kersten, Marie José

AU - Nollet, Frans

AU - Wenzel, Jennifer

AU - Wiskemann, Joachim

AU - Verdonck- de Leeuw, Irma M.

AU - Brug, Johannes

PY - 2017/1/1

Y1 - 2017/1/1

N2 - This individual patient data meta-analysis aimed to evaluate the effects of exercise on quality of life (QoL) and physical function (PF) in patients with cancer, and to identify moderator effects of demographic (age, sex, marital status, education), clinical (body mass index, cancer type, presence of metastasis), intervention-related (intervention timing, delivery mode and duration, and type of control group), and exercise-related (exercise frequency, intensity, type, time) characteristics. Relevant published and unpublished studies were identified in September 2012 via PubMed, EMBASE, PsycINFO, and CINAHL, reference checking and personal communications. Principle investigators of all 69 eligible trials were requested to share IPD from their study. IPD from 34 randomised controlled trials (n = 4519 patients) that evaluated the effects of exercise compared to a usual care, wait-list or attention control group on QoL and PF in adult patients with cancer were retrieved and pooled. Linear mixed-effect models were used to evaluate the effects of the exercise on post-intervention outcome values (z-score) adjusting for baseline values. Moderator effects were studies by testing interactions. Exercise significantly improved QoL (β = 0.15, 95%CI = 0.10;0.20) and PF (β = 0.18, 95%CI = 0.13;0.23). The effects were not moderated by demographic, clinical or exercise characteristics. Effects on QoL (βdifference_in_effect = 0.13, 95%CI = 0.03;0.22) and PF (βdifference_in_effect = 0.10, 95%CI = 0.01;0.20) were significantly larger for supervised than unsupervised interventions. In conclusion, exercise, and particularly supervised exercise, effectively improves QoL and PF in patients with cancer with different demographic and clinical characteristics during and following treatment. Although effect sizes are small, there is consistent empirical evidence to support implementation of exercise as part of cancer care.

AB - This individual patient data meta-analysis aimed to evaluate the effects of exercise on quality of life (QoL) and physical function (PF) in patients with cancer, and to identify moderator effects of demographic (age, sex, marital status, education), clinical (body mass index, cancer type, presence of metastasis), intervention-related (intervention timing, delivery mode and duration, and type of control group), and exercise-related (exercise frequency, intensity, type, time) characteristics. Relevant published and unpublished studies were identified in September 2012 via PubMed, EMBASE, PsycINFO, and CINAHL, reference checking and personal communications. Principle investigators of all 69 eligible trials were requested to share IPD from their study. IPD from 34 randomised controlled trials (n = 4519 patients) that evaluated the effects of exercise compared to a usual care, wait-list or attention control group on QoL and PF in adult patients with cancer were retrieved and pooled. Linear mixed-effect models were used to evaluate the effects of the exercise on post-intervention outcome values (z-score) adjusting for baseline values. Moderator effects were studies by testing interactions. Exercise significantly improved QoL (β = 0.15, 95%CI = 0.10;0.20) and PF (β = 0.18, 95%CI = 0.13;0.23). The effects were not moderated by demographic, clinical or exercise characteristics. Effects on QoL (βdifference_in_effect = 0.13, 95%CI = 0.03;0.22) and PF (βdifference_in_effect = 0.10, 95%CI = 0.01;0.20) were significantly larger for supervised than unsupervised interventions. In conclusion, exercise, and particularly supervised exercise, effectively improves QoL and PF in patients with cancer with different demographic and clinical characteristics during and following treatment. Although effect sizes are small, there is consistent empirical evidence to support implementation of exercise as part of cancer care.

KW - Exercise

KW - Individual patient data meta-analysis

KW - Neoplasm

KW - Physical function

KW - Quality of life

UR - http://www.scopus.com/inward/record.url?scp=85007593115&partnerID=8YFLogxK

U2 - 10.1016/j.ctrv.2016.11.010

DO - 10.1016/j.ctrv.2016.11.010

M3 - Review article

VL - 52

SP - 91

EP - 104

JO - Cancer treatment reviews

JF - Cancer treatment reviews

SN - 0305-7372

ER -