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Title: Exercise across the Lung Cancer Care Continuum: An Overview of Systematic Reviews.
Austin Authors: Edbrooke, Lara;Bowman, Amy;Granger, Catherine L ;Burgess, Nicola ;Abo, Shaza;Connolly, Bronwen;Denehy, Linda
Affiliation: Department of Physiotherapy, The University of Melbourne, Melbourne, VIC 3010, Australia.
Department of Health Services Research, The Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
Department of Physiotherapy, The Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
Department of Physiotherapy, The University of Melbourne, Melbourne, VIC 3010, Australia.
Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast BT7 1NN, UK.
Issue Date: 27-Feb-2023
Date: 2023
Publication information: Journal of Clinical Medicine 2023; 12(5)
Abstract: Growing evidence supports exercise for people with lung cancer. This overview aimed to summarise exercise intervention efficacy and safety across the care continuum. Eight databases (including Cochrane and Medline) were searched (inception-February 2022) for systematic reviews of RCTs/quasi-RCTs. Eligibility: population-adults with lung cancer; intervention: exercise (e.g., aerobic, resistance) +/- non-exercise (e.g., nutrition); comparator: usual care/non-exercise; primary outcomes: exercise capacity, physical function, health-related quality of life (HRQoL) and post-operative complications. Duplicate, independent title/abstract and full-text screening, data extraction and quality ratings (AMSTAR-2) were completed. Thirty systematic reviews involving between 157 and 2109 participants (n = 6440 total) were included. Most reviews (n = 28) involved surgical participants. Twenty-five reviews performed meta-analyses. The review quality was commonly rated critically low (n = 22) or low (n = 7). Reviews commonly included combinations of aerobic, resistance and/or respiratory exercise interventions. Pre-operative meta-analyses demonstrated that exercise reduces post-operative complications (n = 4/7) and improves exercise capacity (n = 6/6), whilst HRQoL findings were non-significant (n = 3/3). Post-operative meta-analyses reported significant improvements in exercise capacity (n = 2/3) and muscle strength (n = 1/1) and non-significant HRQoL changes (n = 8/10). Interventions delivered to mixed surgical and non-surgical populations improved exercise capacity (n = 3/4), muscle strength (n = 2/2) and HRQoL (n = 3). Meta-analyses of interventions in non-surgical populations demonstrated inconsistent findings. Adverse event rates were low, however, few reviews reported on safety. A large body of evidence supports lung cancer exercise interventions to reduce complications and improve exercise capacity in pre- and post-operative populations. Additional higher-quality research is needed, particularly in the non-surgical population, including subgroup analyses of exercise type and setting.
DOI: 10.3390/jcm12051871
ORCID: 0000-0002-4149-5578
Journal: Journal of Clinical Medicine
PubMed URL: 36902659
Type: Journal Article
Subjects: exercise
lung cancer
overview of reviews
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