The major reason for undertaking this systematic review was to evaluate the effectiveness of various physiotherapy interventions in both early and traditional palliative care for oncology patients. By synthesizing existing research, this project aims to clarify how different physiotherapy modalities influence patient-reported outcome measures (PROMs) such as fatigue, pain, cachexia, quality of life (QoL), physical functioning (PHF), and psychosocial functioning (PSF).
Secondary objectives include identifying gaps in the current literature, assessing the quality of the available evidence, and providing recommendations for future research in this important area of patient care.
A systematic literature search was conducted in PubMed, Embase, and Web of Science, concluding on December 21, 2023. Inclusion criteria focused on randomized controlled trials (RCTs) examining the impact of physiotherapy interventions on PROMs for oncology patients in palliative care. Two independent reviewers performed the article screening. The Cochrane Risk of Bias Tool 2 was utilized to assess the risk of bias, while the GRADE approach was applied to evaluate the certainty of the evidence. A total of nine RCTs were included in this review.
The majority of the included studies exhibited a high risk of bias, particularly regarding outcome measurement and missing data. Cognitive behavioral therapy (CBT) emerged as the only intervention that significantly reduced fatigue and improved PHF, QoL, and emotional functioning. Graded exercise therapy (GET) did not yield significant results. Combined interventions, such as education with problem-solving or nutritional counseling with physical activity, showed no significant effects. Massage therapy significantly improved QoL and reduced pain, while physical application therapies were effective for pain management. Mindful breathing exercises (MBE) improved QoL but had a non-significant effect on appetite. The overall certainty of the evidence was low.
This systematic review highlights that physiotherapy can positively influence PROMs among oncology patients in palliative care. Specific interventions such as CBT and massage show promising results, but the low quality and high risk of bias in the existing literature emphasize the need for further rigorous research. It is essential to confirm these findings and explore the effectiveness of physiotherapy in the palliative setting.
The implications of this review are significant for clinicians and researchers working in palliative care for oncology patients. The findings suggest that targeted physiotherapy interventions, such as CBT and massage, could be integrated into palliative care plans to improve patients’ quality of life and well-being. At the same time, the results underscore the necessity for more high-quality research to better understand and substantiate the effectiveness of physiotherapy in this crucial area of care.
Quality of Life
Early-integrated Palliative Care
