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Effect of Home and Community-Based Physical Activity Interventions on Physical Function among Cancer Survivors: A Systematic Review and Meta-analysis

Published on 22 April 2017

Swartz, M. C.,Lewis, Z. H.,Lyons, E. J.,Jennings, K.,Middleton, A.,Deer, R. R.,Arnold, D.,Dresser, K.,Ottenbacher, K. J.,Goodwin, J. S.

Arch Phys Med Rehabil , 2017

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OBJECTIVE: We reviewed randomized trials to examine the effect of home and community-based physical activity interventions on physical functioning among cancer survivors based on the most prevalent physical function measures. DATA SOURCES: Five electronic databases-Medline Ovid, Pubmed, CINAHL, Web of Science, and PsychINFO-were searched from inception to March 2016 for relevant articles. STUDY SELECTION: Search terms included: community-based interventions, physical functioning, and cancer survivors. A reference librarian trained in systematic reviews conducted the final search. Detail protocol is registered on PROSPERO ( CRD42016036730. DATA EXTRACTION: Four reviewers evaluated eligibility and two reviewers evaluated methodological quality. Data were abstracted from studies that used the most prevalent physical function measurement tools-Medical Outcomes Study Short Form-36, Late Life Function and Disability Instrument, European Organisation for the Research and Treatment of Cancer Quality-of-Life Questionnaire, and six minute walk test. Random or fixed effects models were conducted to obtain overall effect size per physical function measure. DATA SYNTHESIS: Fourteen studies met inclusion criteria and were used to compute standardized mean differences using inverse variance statistical method. The median sample size was 83 participants. The majority of the studies were conducted among breast cancer survivors (n = 7). The interventions produced short-term positive effects on physical functioning with overall effect sizes ranging from small (0.17, 95% CI: 0.07, 0.27) to medium (0.45, 95% CI: 0.23, 0.67). Community-based interventions that met in groups and used behavioral change strategies produced the largest effect sizes. CONCLUSIONS: Home and community-based physical activity interventions may be a potential tool to combat functional deterioration among aging cancer survivors. More studies are needed among other cancer types using clinically relevant objective functional measures (e.g., gait speed) to accelerate translation into the community and clinical practice.