scholarly journals Can Exercise Counteract Cancer Cachexia? A Systematic Literature Review and Meta-Analysis

2020 ◽  
Vol 19 ◽  
pp. 153473542094041 ◽  
Author(s):  
Timo Niels ◽  
Annika Tomanek ◽  
Nils Freitag ◽  
Moritz Schumann

Background: Cancer-cachexia is associated with chronic inflammation, impaired muscle metabolism and body mass loss, all of which are classical targets of physical exercise. Objectives: This systematic review and meta-analysis aimed to determine the effects of exercise on body and muscle mass in cachectic cancer hosts. Data Sources: PubMed/Medline, EMBASE, CINHAL, ISI Web of Science, and Cochrane Library were searched until July 2019. Study Selection: Trials had to be randomized controlled trials or controlled trials including cancer patients or animal models with cachexia-inducing tumors. Only sole exercise interventions over at least 7 days performed in a controlled environment were included. Data Extraction: Risk of bias was assessed and a random-effects model was used to pool effect sizes by standardized mean differences (SMD). Results: All eligible 20 studies were performed in rodents. Studies prescribed aerobic (n = 15), strength (n = 3) or combined training (n = 2). No statistical differences were observed for body mass and muscle weight of the gastrocnemius, soleus, and tibialis muscles between the exercise and control conditions (SMD = ‒0.05, 95%CI-0.64-0.55, P = 0.87). Exercise duration prior to tumor inoculation was a statistical moderator for changes in body mass under tumor presence ( P = 0.04). Limitations: No human trials were identified. A large study heterogeneity was present, probably due to different exercise modalities and outcome reporting. Conclusion: Exercise does not seem to affect cancer-cachexia in rodents. However, the linear regression revealed that exercise duration prior to tumor inoculation led to reduced cachexia-severity, possibly strengthening the rationale for the use of exercise in cancer patients at cachexia risk.

Author(s):  
Hyun Suk Lee ◽  
Junga Lee

(1) Background: Exercise interventions for overweight and obese individuals help reduce accumulated visceral fat, which is an indicator of cardiometabolic risk, but the effectiveness of these interventions is controversial. The purpose of this meta-analysis was to investigate the effectiveness of exercise interventions in overweight and obese individuals in order to reduce weight, body mass index (BMI), and accumulated visceral fat, and increase lean body mass. (2) Methods: Databases were used to select eligible studies for this meta-analysis. Randomized controlled trials with control and experimental groups were included. The degrees of effectiveness of the exercise interventions were computed to assess the benefits on reducing weight, BMI, and accumulated visceral fat, and increasing lean body mass. (3) Results: Sixteen studies were included in this meta-analysis. Participation in exercise interventions reduced weight (d = −0.58 (95% confidence interval (CI), −0.84–−0.31; p < 0.001; k = 9)), BMI (d = −0.50 (95% CI, −0.78–−0.21; p < 0.001; k = 7)), and accumulated visceral fat (d = −1.08 (95% CI, −1.60–−0.57; p < 0.001; k = 5)), but did not significantly increase lean body mass (d = 0.26 (95% CI, −0.11–0.63; p = 0.17; k = 6)). The average exercise intervention for overweight and obese individuals was of moderate to vigorous intensity, 4 times per week, 50 min per session, and 22 weeks duration. (4) Conclusions: Participating in exercise interventions has favorable effects on weight, BMI, and accumulated visceral fat. Further studies considering different modalities, intensities, durations, and measurements of fatness need to be conducted.


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Jing Wang ◽  
Yanling Wang ◽  
Mengting Tong ◽  
Hongming Pan ◽  
Da Li

Objectives. Cancer cachexia (CCA) is an intractable and ineffective metabolic syndrome that attacks 50–80% of cancer patients. It reduces patient’s life quality, affects the efficacy of treatment, and then increases their mortality; however, there are no established therapeutic strategies for CCA in the world. In this study, we assess the positive and negative effects of cannabinoid in the treatment of CCA. Methods. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Web of Science, and PubMed up to December 2017. Results. Of the 256 screened studies, three studies with a total of 592 participants were included. Compared with placebo, cannabinoid increased the appetite (MD 0.27, 95% CI -0.51 to 1.04; n= 3) but failed to improve the overall quality of life (QOL; MD -12.39, 95% CI [-24.21 to -0.57; n = 2), and a total of 441 patients had 607 adverse events (AEs; 496 in the cannabinoid group and 111 in the placebo group). Conclusions. Our analysis showed cannabinoid is effective in increasing appetite in cancer patients. However, it declines the quality of life, which may be due to the side effects of cannabinoid.


2019 ◽  
Vol 34 (1) ◽  
pp. 96-104
Author(s):  
Heontae Kim ◽  
Joel Reece ◽  
Minsoo Kang

Objective: To compile and quantify the effectiveness of accumulated short-bout exercise interventions on reducing the obesity indices in adults using meta-analysis. Data Source: PubMed, PsycINFO, CINAHL, Cochrane Library, and SportDiscus. Study Inclusion and Exclusion Criteria: (1) Description of a short-bout exercise trial (<30 minutes); (2) obesity indices must be measured pre- and postintervention; and (3) only adults and published in English. Data Extraction: Two independent reviewers extracted data and assessed the quality of the studies included. Of 3257 articles retrieved, 18 studies met the inclusion criteria. Based on the Downs and Black checklist, the methodological quality of the included studies was fairly robust. Data Synthesis: Pooled effect sizes (ESs) were calculated using a random effects model. Results: Average intervention length was approximately 16 weeks (ranged from 4 to 72 weeks). All weighted mean ES values for each obesity index measure were non-negative, ranging from small to large (ES = 0.33-0.96) in magnitude. Weighted mean ES for body mass (BM; n = 18; ES = 0.51, 95% confidence interval [CI] = 0.22-0.80), body mass index (BMI; n = 13; ES = 0.61, 95% CI = 0.24-0.97), waist circumference (n = 9; ES = 0.44, 95% CI = 0.15-0.73), body fat percentage (BF%; n = 8; ES = 0.33, 95% CI = 0.09-0.58), skinfold (n = 7; ES = 0.96, 95% CI = 0.39 -1.53), and fat mass (FM; n = 6; ES = 0.55, 95% CI = 0.21-0.90) were statistically significant. Moderator effects of intervention length (weeks) were observed for BM (Qbetween [Cochran’s Q: a measure of heterogeneity between studies] = 6.83, P < .05); BMI (Qbetween = 13.93, P < .05); and FM (Qbetween = 10.41, P < .05). Intervention length >10 weeks was more effective than shorter (≤10) intervention period for reducing BM, BMI, and FM. Conclusion: Accumulated short bouts of exercise have a beneficial effect on reducing the obesity indices among adults. The current study can help health researchers and practitioners in designing their intervention programs, which can be applied within schools, clinics, and communities.


2021 ◽  
Vol 10 (14) ◽  
pp. 3184
Author(s):  
João Gustavo Claudino ◽  
José Afonso ◽  
Javad Sarvestan ◽  
Marcel Bahia Lanza ◽  
Juliana Pennone ◽  
...  

We performed a systematic review with meta-analysis of randomized controlled trials (RCTs) to assess the effects of strength training (ST), as compared to alternative multimodal or unimodal exercise programs, on the number of falls in older adults (≥60 years). Ten databases were consulted (CINAHL, Cochrane Library, EBSCO, EMBASE, PEDro, PubMed, Scielo, Scopus, SPORTDiscus and Web of Science), without limitations on language or publication date. Eligibility criteria were as follows: RCTs with humans ≥60 years of age of any gender with one group performing supervised ST and a group performing another type of exercise training, reporting data pertaining falls. Certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Meta-analysis used a random effects model to calculate the risk ratio (RR) for number of falls. Five RCTs with six trials were included (n = 543, 76% women). There was no difference between ST and alternative exercise interventions for falls (RR = 1.00, 95% CI 0.77–1.30, p = 0.99). The certainty of evidence was very low. No dose–response relationship could be established. In sum, ST showed comparable RR based on number of falls in older adults when compared to other multimodal or unimodal exercise modalities, but evidence is scarce and heterogeneous, and additional research is required for more robust conclusions. Registration: PROSPERO CRD42020222908.


2018 ◽  
Vol 25 (7) ◽  
pp. 389-401 ◽  
Author(s):  
Jen-Wu Huang ◽  
Yi-Ying Lin ◽  
Nai-Yuan Wu

Object The purpose of this study was to evaluate the clinical effectiveness of telemedicine on changes in body mass index for overweight and obese people as well as for diabetes and hypertension patients. Methods A systematic review of articles published before 31 August 2014, was conducted using searches of Medline, Cochrane Library, EMBASE, and CINAHL Plus. The inclusion criteria were randomised controlled trials that compared telemedicine interventions with usual care or standard treatment in adults and reported a change in body mass index. A meta-analysis was conducted for eligible studies, and the primary outcome was a change in body mass index. Subgroup analysis was performed for the type of telemedicine, main purpose of intervention, and length of intervention. Results Twenty-five randomised controlled trials comprising 6253 people were included in the qualitative and quantitative analyses. The length of intervention ranged from nine weeks to two years. The meta-analysis revealed significant differences in body mass index changes (pooled difference in means = –0.49, 95% confidence interval –0.63 to –0.34, p < 0.001) between the telemedicine and control groups. The subgroup analyses found that either Internet-based or telephone-based intervention was associated with greater changes in body mass index than in controls. Telemedicine intervention was effective in improving body mass index whether it was used for diabetes control, hypertension control, weight loss, or increasing physical activity and was also effective for people with and without diabetes or hypertension. However, only interventions with a duration ≥ 6 months significantly decreased body mass index compared to controls. Conclusion Both patients with chronic disease and overweight/obese people could benefit from telemedicine interventions. We suggest that an effective telemedicine approach should be longer than six months and emphasise the importance of post-interventional follow-ups.


2018 ◽  
Vol 17 (4) ◽  
pp. 1048-1058 ◽  
Author(s):  
Jiro Nakano ◽  
Kaori Hashizume ◽  
Takuya Fukushima ◽  
Kazumi Ueno ◽  
Emi Matsuura ◽  
...  

Objective. This study aimed to conduct a meta-analysis to establish the effect of exercise interventions on physical symptoms, including fatigue, nausea/vomiting, pain, dyspnea, insomnia, loss of appetite, constipation, and diarrhea in cancer patients and survivors. Methods. We searched articles published before April 2017 using the following databases: Cochrane Library, PubMed/MEDLINE, CINAHL, Scopus, PEDro, Health & Medical Collection, and Psychology Database. Randomized controlled trials (RCTs) of exercise intervention in cancer patients, which evaluated cancer-related physical symptoms using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, were included. Symptom scale data were extracted for meta-analysis. Subgroup analyses were performed for exercise types (aerobic, resistance, and mixed exercise programs). Results. Of the 659 articles, 10 RCTs were included in the meta-analysis, of which the mean PEDro score was 5.43 (SD = 1.28). Fatigue, pain, dyspnea, and insomnia were significantly lower in the intervention group than in the control group at postintervention in cancer patients. However, exercise intervention did not promote or suppress nausea/vomiting, loss of appetite, constipation, and diarrhea in cancer patients. The effect of exercise type on each symptom was not different. Conclusion. Exercise intervention was confirmed to improve fatigue, pain, and insomnia and might have reduced dyspnea in cancer patients. However, the benefits of exercise on nausea/vomiting, loss of appetite, constipation, and diarrhea were not shown in any exercise type. Further research is warranted to examine the effects of exercise interventions on physical symptoms in cancer patients.


2021 ◽  
Author(s):  
Panpan Xiao ◽  
Siqing Ding ◽  
Yinglong Duan ◽  
Lijun Li ◽  
Yi Zhou ◽  
...  

Abstract BackgroundFatigue is a common symptom in cancer patients that can occur throughout the course of cancer, with a prevalence ranging from 75% to 100%. Nonpharmacological intervention is currently mainly used to address cancer-related fatigue (CRF). Light therapy has been gradually used to treat CRF and has been found to be effective. However, to date, there is no systematic review on light therapies for reducing CRF to verify its effectiveness. This is a protocol for a systematic review that aims to evaluate the effectiveness of light therapies for treating fatigue in cancer survivors. This systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database.MethodsThis protocol was designed in accordance with the PRISMA-P guidelines. We will search the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library), Embase (OVID), and CINAHL databases as well as relevant sources of gray literature. Randomized controlled trials (RCTs) and quasi-experimental trials that have evaluated the use of light therapy among cancer patients at any survival phase, with fatigue as an outcome measure, will be included. Two members of the review team will independently extract data from the selected studies and assess their methodological quality using the Cochrane Collaboration Risk of Bias Tool.DiscussionThis systematic review and meta-analysis will build upon previous evaluations of light therapies in patients during and after cancer treatment. Due to the multifactorial nature of CRF and the growing demand for etiological-based intervention research, this review seeks to highlight a gap in current practice and to strengthen the evidence base of randomized controlled trials in the area.Systematic review registrationCRD42020215446


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ting-Hao Chen ◽  
Tao-Hsin Tung ◽  
Pei-Shih Chen ◽  
Shu-Hui Wang ◽  
Chuang-Min Chao ◽  
...  

Purpose. Aromatherapy massage is an alternative treatment in reducing the pain of the cancer patients. This study was to investigate whether aromatherapy massage could improve the pain of the cancer patients.Methods. We searched PubMed and Cochrane Library for relevant randomized controlled trials without language limitations between 1 January 1990 and 31 July 2015 with a priori defined inclusion and exclusion criteria. The search terms included aromatherapy, essential oil, pain, ache, cancer, tumor, and carcinoma. There were 7 studies which met the selection criteria and 3 studies were eventually included among 63 eligible publications.Results. This meta-analysis included three randomized controlled trials with a total of 278 participants (135 participants in the massage with essential oil group and 143 participants in the control (usual care) group). Compared with the control group, the massage with essential oil group had nonsignificant effect on reducing the pain (standardized mean difference = 0.01; 95% CI[-0.23,0.24]).Conclusion. Aromatherapy massage does not appear to reduce pain of the cancer patients. Further rigorous studies should be conducted with more objective measures.


Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4478
Author(s):  
Nico De Lazzari ◽  
Timo Niels ◽  
Mitra Tewes ◽  
Miriam Götte

Exercise therapy is a common supportive strategy in curative cancer treatment with strong evidence regarding its positive effects on, for example, cancer-related fatigue, health- related quality of life, and physical function. In the field of advanced cancer patients, knowledge about exercise as a useful supportive strategy is missing. The aim of this systematic review was to evaluate the feasibility and safety of exercise interventions as well as its effects on lowering the symptom burden. We included randomized controlled trials and nonrandomized controlled trials with advanced cancer patients receiving any type of exercise intervention. After an extensive literature search (in accordance to PRIMSA guidelines) in PubMed, Cochrane Library, and SPORTDiscus, 14 studies including 940 participants with different cancer entities were eligible. The results indicated the safety of exercise. In total, 493 participants received exercise interventions, with nine adverse events and no severe adverse events. The median recruitment rate was 68.33%, and adherence to exercise intervention was 86%. Further research with a high-quality and larger sample size is needed to clarify the potential of exercise with advanced cancer patients. Different advanced cancer entities have distinguished symptoms, and future research should construct entities-specific trial populations to figure out the best supportive exercise interventions.


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