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    Moderators of Exercise Effects on Cancer-related Fatigue: A Meta-analysis of Individual Patient Data.

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    Author
    VAN Vulpen, JK; Sweegers, MG; Peeters, PHM; Courneya, KS; Newton, RU; Aaronson, NK; Jacobsen, PB; Galvão, DA; Chinapaw, MJ; Steindorf, K; ...
    Date
    2020-02
    Source Title
    Medicine and Science in Sports and Exercise
    Publisher
    Ovid Technologies (Wolters Kluwer Health)
    University of Melbourne Author/s
    Short, Camille
    Affiliation
    Melbourne School of Psychological Sciences
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    VAN Vulpen, J. K., Sweegers, M. G., Peeters, P. H. M., Courneya, K. S., Newton, R. U., Aaronson, N. K., Jacobsen, P. B., Galvão, D. A., Chinapaw, M. J., Steindorf, K., Irwin, M. L., Stuiver, M. M., Hayes, S., Griffith, K. A., Mesters, I., Knoop, H., Goedendorp, M. M., Mutrie, N., Daley, A. J. ,... Buffart, L. M. (2020). Moderators of Exercise Effects on Cancer-related Fatigue: A Meta-analysis of Individual Patient Data.. Med Sci Sports Exerc, 52 (2), pp.303-314. https://doi.org/10.1249/MSS.0000000000002154.
    Access Status
    Access this item via the Open Access location
    URI
    http://hdl.handle.net/11343/253953
    DOI
    10.1249/MSS.0000000000002154
    Open Access URL
    https://www.pure.ed.ac.uk/ws/files/112990808/Moderators_of_Exercise_Effects_on_Cancer_related.96496.pdf
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6962544
    Abstract
    PURPOSE: Fatigue is a common and potentially disabling symptom in patients with cancer. It can often be effectively reduced by exercise. Yet, effects of exercise interventions might differ across subgroups. We conducted a meta-analysis using individual patient data of randomized controlled trials (RCT) to investigate moderators of exercise intervention effects on cancer-related fatigue. METHODS: We used individual patient data from 31 exercise RCT worldwide, representing 4366 patients, of whom 3846 had complete fatigue data. We performed a one-step individual patient data meta-analysis, using linear mixed-effect models to analyze the effects of exercise interventions on fatigue (z score) and to identify demographic, clinical, intervention- and exercise-related moderators. Models were adjusted for baseline fatigue and included a random intercept on study level to account for clustering of patients within studies. We identified potential moderators by testing their interaction with group allocation, using a likelihood ratio test. RESULTS: Exercise interventions had statistically significant beneficial effects on fatigue (β = -0.17; 95% confidence interval [CI], -0.22 to -0.12). There was no evidence of moderation by demographic or clinical characteristics. Supervised exercise interventions had significantly larger effects on fatigue than unsupervised exercise interventions (βdifference = -0.18; 95% CI -0.28 to -0.08). Supervised interventions with a duration ≤12 wk showed larger effects on fatigue (β = -0.29; 95% CI, -0.39 to -0.20) than supervised interventions with a longer duration. CONCLUSIONS: In this individual patient data meta-analysis, we found statistically significant beneficial effects of exercise interventions on fatigue, irrespective of demographic and clinical characteristics. These findings support a role for exercise, preferably supervised exercise interventions, in clinical practice. Reasons for differential effects in duration require further exploration.

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