The effect of exercise on cancer-related cognitive impairment and applications for physical therapy : Systematic review of randomized controlled trials

Journal article

Campbell, Kristin L., Zadravec, Kendra, Bland, Kelcey A., Chesley, Elizabeth, Wolf, Florian and Janelsins, Michelle C.. (2020). The effect of exercise on cancer-related cognitive impairment and applications for physical therapy : Systematic review of randomized controlled trials. Physical Therapy. 100(3), pp. 523-542. https://doi.org/10.1093/ptj/pzz090
AuthorsCampbell, Kristin L., Zadravec, Kendra, Bland, Kelcey A., Chesley, Elizabeth, Wolf, Florian and Janelsins, Michelle C.
Abstract

Background
Cancer-related cognitive impairment (CRCI), often called “chemo-brain” or “chemo-fog,” is a common side effect among adults with cancer, which can persist well after treatment completion. Accumulating evidence demonstrates exercise can improve cognitive function in healthy older adults and adults with cognitive impairments, suggesting exercise may play a role in managing CRCI.

Purpose
The purpose was to perform a systematic review of randomized controlled trials (RCTs) to understand the effect of exercise on CRCI.

Data Sources
Relevant literature was retrieved from CINAHL, Medline (Ovid), and EMBASE.

Study Selection
Eligible articles were RCTs that prescribed aerobic, resistance, combined aerobic/resistance, or mind-body (eg, yoga or Qigong) exercise during or following cancer treatment and included cognitive function outcome measures.

Data Extraction
Descriptive information and Cohen d effect sizes were directly extracted or calculated for included trials.

Data Synthesis
Twenty-nine trials were included in the final analysis. A statistically significant effect of exercise on self-reported cognitive function, both during and postadjuvant treatment, was reported in 12 trials (41%) (Cohen d range: 0.24–1.14), most commonly using the EORTC QLQ-C30. Ten trials (34%) performed neuropsychological testing to evaluate cognitive function; however, only 3 trials in women with breast cancer reported a significant effect of exercise (Cohen d range: 0.41–1.47).

Limitations
Few RCTs to date have evaluated the effect of exercise on CRCI as a primary outcome. Twenty-six trials (90%) in this review evaluated CRCI as secondary analyses.

Conclusions
Evidence supporting exercise as a strategy to address CRCI is limited. Future research evaluating CRCI as a primary outcome, including self-reported and objective measures, is needed to confirm the possible role of exercise in preventing and managing cognitive impairments in adults with cancer.

Year2020
JournalPhysical Therapy
Journal citation100 (3), pp. 523-542
PublisherOxford University Press
ISSN0031-9023
Digital Object Identifier (DOI)https://doi.org/10.1093/ptj/pzz090
Scopus EID2-s2.0-85081944705
Research or scholarlyResearch
Page range523-542
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online17 Feb 2020
Publication process dates
Accepted02 Jul 2019
Deposited10 May 2021
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