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Physical activity interventions to improve daily walking activity in cancer survivors.

Knols RH, de Bruin ED, Shirato K, Uebelhart D, Aaronson NK - BMC Cancer (2010)

Bottom Line: Data were pooled using random-effects calculations.Studies that define a step goal appear to be more effective in improving daily walking activity than studies that do not do so.However, the current results should be interpreted with caution because of the observed clinical and statistical heterogeneity.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.

ABSTRACT

Background: Cancer patients may benefit from physical exercise programs. It is unclear, however, how sustained levels of physical activity are best achieved in this population. A systematic review was performed to summarize the current evidence of the effect of physical activity interventions on daily walking activity enhancement in cancer survivors, and to review the literature for its methodological quality.

Methods: A search in Medline, PEDro and the Cochrane databases was performed for English literature citations (randomized controlled trials; 'RCTs'). In a first step, one reviewer abstracted data from the included studies on patients, physical activity interventions and outcomes. Two independent reviewers reviewed the methodological quality of these studies. Data were pooled using random-effects calculations.

Results: Our search identified 201 citations. Five RCTs that reported changes in daily step activity over time were identified, and were reviewed for methodological quality and substantive results. The median score across studies for methodological quality based on the PEDro criteria was 8. These 5 RCTs evaluated 660 participants with a mean age of 53.6 (SD 4.2) years. The mean change in daily step activity for patients with a physical exercise intervention was 526 daily steps (SD 537), with a range from -92 to 1299 daily steps. The data of three studies reporting the effect of combined physical activity and counseling on daily walking activity in breast cancer survivors were pooled, however; the I(2) was 79%, indicating statistical heterogeneity between the three trials.

Conclusion: The 5 RCTs reviewed were of good methodological quality. Together they suggest that combined physical activity and counseling improves daily step activity in (breast) cancer survivors. Studies that define a step goal appear to be more effective in improving daily walking activity than studies that do not do so. However, the current results should be interpreted with caution because of the observed clinical and statistical heterogeneity. Future studies are warranted to evaluate the effects of goal targeted physical activity, with or without counseling, on daily walking in various cancer populations.

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Difference in effect-size of daily walking activity in breast cancer patients assigned to a physical activity intervention with step goal definition versus a control group: q-value = 9.508, df(Q) = 2, p = 0.009, I2 = 79%.
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Figure 2: Difference in effect-size of daily walking activity in breast cancer patients assigned to a physical activity intervention with step goal definition versus a control group: q-value = 9.508, df(Q) = 2, p = 0.009, I2 = 79%.

Mentions: Statistical heterogeneity between the three trials was observed in meta-analyses after pooling; q-value = 9.508, df(Q) = 2, p = 0.009, I2 = 79% (figure 2). The effect-size (ES) for the three studies combined was 0.4 (95%CI: lower limit 0.0, upper limit 0.7, p = 0.028). The evaluation of potential publication bias indicated that 2 missing studies would increase the p-value to greater than 0.05.


Physical activity interventions to improve daily walking activity in cancer survivors.

Knols RH, de Bruin ED, Shirato K, Uebelhart D, Aaronson NK - BMC Cancer (2010)

Difference in effect-size of daily walking activity in breast cancer patients assigned to a physical activity intervention with step goal definition versus a control group: q-value = 9.508, df(Q) = 2, p = 0.009, I2 = 79%.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2921399&req=5

Figure 2: Difference in effect-size of daily walking activity in breast cancer patients assigned to a physical activity intervention with step goal definition versus a control group: q-value = 9.508, df(Q) = 2, p = 0.009, I2 = 79%.
Mentions: Statistical heterogeneity between the three trials was observed in meta-analyses after pooling; q-value = 9.508, df(Q) = 2, p = 0.009, I2 = 79% (figure 2). The effect-size (ES) for the three studies combined was 0.4 (95%CI: lower limit 0.0, upper limit 0.7, p = 0.028). The evaluation of potential publication bias indicated that 2 missing studies would increase the p-value to greater than 0.05.

Bottom Line: Data were pooled using random-effects calculations.Studies that define a step goal appear to be more effective in improving daily walking activity than studies that do not do so.However, the current results should be interpreted with caution because of the observed clinical and statistical heterogeneity.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.

ABSTRACT

Background: Cancer patients may benefit from physical exercise programs. It is unclear, however, how sustained levels of physical activity are best achieved in this population. A systematic review was performed to summarize the current evidence of the effect of physical activity interventions on daily walking activity enhancement in cancer survivors, and to review the literature for its methodological quality.

Methods: A search in Medline, PEDro and the Cochrane databases was performed for English literature citations (randomized controlled trials; 'RCTs'). In a first step, one reviewer abstracted data from the included studies on patients, physical activity interventions and outcomes. Two independent reviewers reviewed the methodological quality of these studies. Data were pooled using random-effects calculations.

Results: Our search identified 201 citations. Five RCTs that reported changes in daily step activity over time were identified, and were reviewed for methodological quality and substantive results. The median score across studies for methodological quality based on the PEDro criteria was 8. These 5 RCTs evaluated 660 participants with a mean age of 53.6 (SD 4.2) years. The mean change in daily step activity for patients with a physical exercise intervention was 526 daily steps (SD 537), with a range from -92 to 1299 daily steps. The data of three studies reporting the effect of combined physical activity and counseling on daily walking activity in breast cancer survivors were pooled, however; the I(2) was 79%, indicating statistical heterogeneity between the three trials.

Conclusion: The 5 RCTs reviewed were of good methodological quality. Together they suggest that combined physical activity and counseling improves daily step activity in (breast) cancer survivors. Studies that define a step goal appear to be more effective in improving daily walking activity than studies that do not do so. However, the current results should be interpreted with caution because of the observed clinical and statistical heterogeneity. Future studies are warranted to evaluate the effects of goal targeted physical activity, with or without counseling, on daily walking in various cancer populations.

Show MeSH
Related in: MedlinePlus