Exercise as Rehabilitation for Cancer Patients

OBJECTIVE: To review the literature on the association of exercise and rehabilitation among cancer patients in order to stimulate research in this field. DATA SOURCES: Computerized literature search of databases (Medline, Psychlit, Sportdiscus, Cinahl) and manual search of journals done to identify all empirical studies on exercise and rehabilitation of cancer patients ever conducted and published in any language on this topic. STUDY SELECTION: Eleven studies found, of these, two were unpublished conference proceedings and could not be obtained, two were doctoral dissertations and seven were published research studies. Of the nine studies reviewed, four were randomized controlled trials, three were quasi-experimental studies, and two were retrospective studies (case-control and cohort in design). All of the studies examined breast cancer patients only. DATA EXTRACTION: Qualitative review conducted since the studies had heterogeneous study designs including the type and form of exercise intervention or measurement, the data collection methods, and the outcome variables. DATA SYNTHESIS: Overall, exercise resulted in an improvement of the physiologic parameters observed, including increases in functional capacity and lean tissue, decreases in percent body fat, nausea and fatigue. Improvements in psychologic indicators of well-being and quality of life also found. CONCLUSIONS: Exercise appears to improve breast cancer patients physiologic and psychologic well being; however, the research studies reviewed here have numerous methodologic limitations and these results must be considered as preliminary evidence only. To improve knowledge of how exercise may help the rehabilitation of all types of cancer patients, future research studies are needed that use a wider sample of cancer patients, a well-designed randomized controlled design, an exercise intervention that more closely reflects true life circumstances, that is of long duration, that measures numerous physiologic and psychologic changes, and that examines exercise recruitment and adherence problems that may occur.