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Is physical activity effective against cancer-related fatigue in lung cancer patients? An umbrella review of systematic reviews and meta-analyses

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Abstract

Objectives

To discuss the effects of physical activity on cancer-related fatigue (CRF) in lung cancer patients, summarize the types of physical activity in the published reviews, assess the quality of the evidence, and provide suggestions for the clinical selection of exercise intervention.

Methods

PubMed, EMBASE, Web of Science, and the Cochrane Database of Systematic Reviews were searched through 8 November 2021 to identify relevant systematic reviews and meta-analyses. We also performed a manual search of the reference lists of included articles as supplements. Two researchers independently performed literature screening, data extraction, and quality assessment. The umbrella review has been registered in the International Prospective Register of Systematic Review (PROSPERO) registry (CRD42021292548).

Results

From the 13 systematic reviews or meta-analyses identified, 10 physical activity interventions were included. The most mentioned intervention was aerobic combined with resistance exercise; however, no reduction of the symptoms of CRF was observed in lung cancer patients by this exercise intervention. Most of the patients who performed aerobic exercises alone showed improvement in CRF after the intervention. In addition, Tai Chi and breathing exercises have been shown to improve fatigue, but more high-quality research is still needed to support its effectiveness.

Conclusions

Aerobic exercise, respiratory muscle training, aerobic combined with balance training, and other exercise interventions have been shown to improve CRF in lung cancer patients. But it should be noted that according to the different treatment methods and disease stages of patients, individualized rehabilitation programs should be developed for patients. Due to the low methodological quality and evidence quality of some systematic reviews and meta-analyses included in this study, more high-quality clinical studies and systematic reviews are still needed for validation in the future. This umbrella review helps to identify effective ways of exercise to improve fatigue in lung cancer patients before dedicated evidence-based medical guidelines are established.

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Data Availability

Data will be available upon request for the purposes of data transparency.

Abbreviations

CRF:

Cancer-Related Fatigue

ACSM:

American College of Sports Medicine

PROSPERO:

International Prospective Register of Systematic Review

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

MeSH:

Medical Subject Headings

AMSTAR:

A MeaSurement Tool to Assess Systematic Reviews

GRADE:

Grading of Recommendations Assessment, Development, and Evaluation

CERQual:

Confidence in the Evidence from Reviews of Qualitative research

RCT:

Randomized Control Trial

HIIT:

High Intensity Interval Training

BFI:

Brief Fatigue Inventory

FACT-F:

Functional Assessment of Cancer Therapy-Fatigue

MFI-20:

Multidimensional Fatigue Inventory with 20 questions

FACT-L:

Functional Assessment of Cancer Therapy-Lung

VAS-F:

Visual Analogue Scale-Fatigue

EORTC-QLQ-C30:

European organization for Research and Treatment of Cancer-Quality of Life Questionnaire C30

FACIT-F:

Functional Assessment of Chronic Illness Therapy-Fatigue

CRDQ:

Chronic Respiratory Disease Questionnaire

MFSI-SF:

Multidimensional Fatigue Symptom Inventory- Short Form

NR:

Not Reported

CI:

Confidence Interval

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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, Henan, China

    Weiqian Hou, Liwen Zhai, Conghui Li, Yao Yang & Yi Zhu

  2. Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000, Henan, China

    Weiqian Hou, Liwen Zhai, Conghui Li & Yao Yang

  3. University of Health and Rehabilitation Sciences, Qingdao, 266000, Shandong, China

    Yujie Yang

  4. Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada

    Shanshan Gu

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  1. Weiqian Hou
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  2. Liwen Zhai
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  3. Yujie Yang
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  4. Shanshan Gu
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  5. Conghui Li
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  6. Yao Yang
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  7. Yi Zhu
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Contributions

All authors contributed to the study’s conception and design. The authors’ responsibilities were as follows—Yi Zhu, Weiqian Hou: study design; Weiqian Hou, Liwen Zhai, Yao Yang: literature search and literature screening; Weiqian Hou, Liwen Zhai: data extraction; Weiqian Hou, Liwen Zhai, Conghui Li, Yao Yang: assessment of quality and data synthesis; Weiqian Hou, Liwen Zhai: drafting of the manuscript; Yi Zhu, Yujie Yang, Shanshan Gu: revision of the manuscript; Yi Zhu: supervision. All authors read and approved the final manuscript.

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Correspondence to Yi Zhu.

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The study is an umbrella review of published material; therefore, ethics approval was not required.

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Weiqian Hou and Liwen Zhai are the co-first authors.

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Hou, W., Zhai, L., Yang, Y. et al. Is physical activity effective against cancer-related fatigue in lung cancer patients? An umbrella review of systematic reviews and meta-analyses. Support Care Cancer 31, 161 (2023). https://doi.org/10.1007/s00520-023-07627-4

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