Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Does timing of exercise really matter for people with cancer? A systematic review and meta-analysis (#474)

Germaine A Tan 1 2 , Casey L Peiris 2 3 , Katherine E Harding 1 2 , Nicholas F Taylor 1 2 , Amy M Dennett 1 2
  1. Allied Health Clinical Research Office, Eastern Health, Melbourne, VIC, Australia
  2. School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
  3. Royal Melbourne Hospital, Melbourne, VIC, Australia

Title:  
Does timing of exercise really matter for people with cancer? A systematic review and meta-analysis. 
 
Aim:  
To determine the effect of earlier vs. later initiation of exercise rehabilitation for people with cancer on physical (including physical activity, physical functioning), psychosocial (including quality of life) and health service (including hospital length of stay, readmissions, service-related costs) outcomes.   
 
Method: 
Randomised controlled trials were included if exercise rehabilitation was delivered with time-limited, structured, supervised aerobic and/or resistance training as the main component for people with cancer at any stage or treatment. Trials had to have a comparator group receiving exercise at a different time to the intervention group (e.g., late vs. early initiated exercise). The primary outcome of interest was physical activity. Other outcomes included patient health outcomes (including cardiorespiratory fitness, functional walking capacity, strength, fatigue, quality of life) and health service outcomes (including hospital length of stay, readmissions, costs). Clinically homogenous data was combined using meta-analysis; overall quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations approach. 
 
Results: 
Fifteen trials were included. Trials included 1,338 participants with breast (n=6), colorectal (n=3), haematological (n=3), head and neck (n=3), lung (n=1), prostate (n=2) and testicular (n=1) cancers. There was low-quality evidence demonstrating similar improvements in physical activity (SMD –0.03, 95% CI –0.60 to 0.54), fitness (SMD 0.17, 95% CI –0.14 to 0.48), functional walking capacity (SMD 0.78, 95% CI –0.6 to 0.54), fatigue (SMD –0.11, 95% CI –0.55 to 0.33) and quality of life (SMD 0.22, 95% CI –0.14 to 0.58) regardless of exercise timing. Limited data was available for health service outcomes with no difference in hospital length of stay (MD 0, 95% CI –0.86 to 0.86). 
 
Conclusion: 
People with cancer can achieve similar health benefits when exercise rehabilitation is initiated at any time following diagnosis.