This systematic review aimed to synthesize study findings exploring the impact of exercise on physical function in those with cancer and frailty to understand the effectiveness of exercise in this population. It aimed to determine if adults with cancer who are frail and participate in an exercise program have better functional outcomes compared to those who do not.
Five databases were searched from inception to March 2024 for randomized control trials (RCTs) that investigated the impact of exercise on functional outcomes in individuals with cancer who are frail and ≥18 years. Title/abstract, full text review, and data extraction were done in duplicate. Cochrane risk of bias 2 was used to assess risk of bias and GRADE for certainty of results.
Eleven RCTs with 1,419 participants were included in this review. No adverse events were reported from any of the exercise interventions. Meta-analysis did not find a significant difference between intervention and control groups for submaximal walking tests (95% CI: 0.24 (-0.05-0.53), Short Physical Performance Battery (SPPB) (95% CI: -0.50 (-1.15-0.15)), and grip strength (95% CI: 1.83 (-0.75 to 4.41). However, positive trends emerged for those participating in exercise programs related to submaximal walking test, grip strength, sit to stand, SPPB, and timed up and go scores.
The results from this review suggest that those with a cancer diagnosis who are frail may benefit from exercise and that it is a safe intervention in this population. However, future research is needed due to the few RCTs investigating exercise in this population, with high heterogeneity of existing interventions. This leads to low certainty in the results of the current study. Further research with more consistent methodologies, standardized frailty measures, and validated functional outcomes is required to strengthen the understanding of the impact of exercise in this population.
Physiotherapists need to screen individuals living with and beyond cancer for frailty to understand the severity that cancer and cancer treatments have on the degree of frailty. Specifically, screening will allow for early intervetnion to minimize functional loss associated with frailty. Furhter, physiotherapists should engage this population in appropriate exercise to help reduce the risk of developing frailty and reducing its adverse effects.
exercise
frailty
