Physical Activity Levels in People with Cancer Undergoing Chemotherapy: A Systematic Review

Cancer is the second highest cause of death globally1 and a leading cause of death and disability in Australia.2 Chemotherapy is one of the most common components of cancer treatment, but it has significant adverse effects on an individual's physical function and well-being.3 Short-term side effects may include nausea,4,5 cachexia (involuntary decline of weight and muscle mass),6,7 myalgia and pain,4, 5, 6,8 cancer-related fatigue,4,9,10 decreased bone strength,6,11 changes in body composition,5,6,12 peripheral neuropathy,4,5 anemia,5,6,13 psychological distress,14 and reduced quality of life,9,15 among many others. Additionally, there are significant long-term side effects including risk of cardiotoxicity, osteoporosis, stroke, and pulmonary fibrosis.3,6,16

Physical activity (PA) has a positive impact in cancer populations; improving physical and mental functioning during treatment,5,17,18 combating treatment side effects,19 improving chemotherapy completion rates,19 reducing health care costs,20,21 reducing recurrence,16,19 mortality,16,19 and improving quality of life.20,22,23 Quality of life and physical and mental function have been shown to improve significantly in interventions completed during chemotherapy treatment, demonstrating the need for people undergoing chemotherapy to be physically active during treatment.18,24,25

PA is defined as “any bodily movement produced by skeletal muscles that requires energy expenditure.”26 Exercise is a component of PA involving planned, structured. and repetitive movements.26 While optimal PA levels during cancer treatment are unknown, recommendations are the same as World Health Organization (WHO) recommendations: at least 150 minutes of moderate-intensity aerobic PA, or 75 minutes of vigorous-intensity PA per week (or a combination of both), and resistance exercise two or three times per week.27,28 The intensity of moderate-vigorous PA (MVPA) can be established via a variety of subjective and objective measures, such as heart rate or rating of perceived exertion (ie, Borg Scale29). MVPA results in a noticeable change in breathing or muscular effort, and conversation may, or may not, be sustained (ie, talk test).30, 31, 32 This target is supported by many professional organizations, including the Clinical Oncology Society of Australia (COSA),1 Exercise and Sports Science Australia (ESSA),25 American College of Sports Medicine,5 the Canadian Society for Exercise Physiology,33 and others.5

These guidelines may not be feasible or appropriate for all people undergoing chemotherapy, and individualized programming is required for participant safety and benefits. Where reaching the WHO recommendations is not appropriate for an individual, high importance should be placed on avoiding inactivity, reducing sedentary behaviors, and maintaining previous activity levels to prevent deconditioning.5,25,34 Evidence highlights that 30 minutes of MVPA three times per week plus resistance exercise two or three times per week is sufficient to confer many of the known benefits during the cancer continuum5; however, where appropriate, low-intensity activity may be recommended and beneficial.25

Despite the benefits, research suggests that those undergoing treatment for cancer are not meeting recommendations.35, 36, 37, 38 Systematic reviews have been completed regarding PA interventions during or after cancer35,39; however, limited studies have considered levels of PA during chemotherapy across any cancer type.

This systematic review aimed to explore PA levels in adults undergoing chemotherapy for any type of cancer and whether this population were meeting the WHO PA recommendations.27,28 It also aimed to identify PA interventions that successfully increased PA levels in the cancer population.

留言 (0)

沒有登入
gif