PHYSICAL EXERCISE AS A REHABILITATION INTERVENTION IN CANCER PATIENTS: IMPACT ON FATIGUE, FUNCTIONAL STATUS AND QUALITY OF LIFE – A LITERATURE REVIEW
Keywords:
rehabilitation, cancer, fatigue, exercise, physical activityAbstract
Cancer rehabilitation is a key component of comprehensive care for cancer patients. It has the potential to reduce cancer-related morbidity and healthcare costs by supporting prevention, recovery and maintenance of function. Interventions implemented in different phases improve patients’ physical and psychosocial status and quality of life. Objective: To summarize the existing evidence on the effectiveness of cancer rehabilitation, including the phases of interventions, appropriate settings for care provision and multidisciplinary strategies to optimize outcomes. Methodology: The review includes an analysis of publications, clinical guidelines and empirical studies related to exercise, rehabilitation and multidisciplinary care in patients with cancer. The main focus is on interventions for physical activity, prevention of disability, functional recovery and improvement of quality of life. Results: Oncology rehabilitation includes preventive, restorative, supportive and palliative interventions that are implemented in inpatient, outpatient and home settings. They cover physical activity, training, stretching and prevention of complications such as lymphedema. Effectiveness is assessed through indicators of quality of life, functional mobility, cognitive and psychosocial functions, fatigue and return to work. A multidisciplinary approach ensures optimal clinical outcomes and improves the overall well-being of patients. Conclusion: Oncology rehabilitation is a critical element of cancer patient care. It contributes to the prevention of complications, accelerates recovery and improves quality of life. Its integration into multidisciplinary teams is recommended for optimal clinical outcomes. Physical activity is recognized as an important part of the treatment and supportive care of patients with cancer. It has a positive impact on physical and psychosocial health, helping to mitigate the effects of treatment. However, there are a number of barriers that limit the use of exercise.
References
Batalik, L., Chamradova, K., Winnige, P., et al. (2024). Effect of exercise-based cancer rehabilitation via telehealth: A systematic review and meta-analysis. BMC Cancer, 24, Article 600. https://doi.org/10.1186/s12885-024-12348-w
Batalik, L., Winnige, P., Dosbaba, F., Vlazna, D., & Janikova, A. (2021). Home-based aerobic and resistance exercise interventions in cancer patients and survivors: A systematic review. Cancers, 13(8), 1915. https://doi.org/10.3390/cancers13081915
Bray, F., Laversanne, M., Sung, H., Ferlay, J., Siegel, R. L., Soerjomataram, I., & Jemal, A. (2024). Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 74(3), 229-263.
Brennan, L., Sheill, G., O'Neill, L., O'Connor, L., Smyth, E., & Guinan, E. (2022). Physical therapists in oncology settings: Experiences in delivering cancer rehabilitation services, barriers to care, and service development needs. Physical Therapy, 102(3), pzab287. https://doi.org/10.1093/ptj/pzab287
Broadwell, D. C. (1987). Rehabilitation needs of the patient with cancer. Cancer, 60(3 Suppl), 563–568. https://doi.org/10.1002/1097-0142(19870801)60:3+<563::AID-CNCR2820601521>3.0.CO;2-P
Campbell, K. L., Winters-Stone, K. M., Wiskemann, J., May, A. M., Schwartz, A. L., Courneya, K. S., Zucker, D. S., Matthews, C. E., Ligibel, J. A., Gerber, L. H., Morris, G. S., Patel, A. V., Hue, T. F., Perna, F. M., & Schmitz, K. H. (2019). Exercise guidelines for cancer survivors: Consensus statement from international multidisciplinary roundtable. Medicine & Science in Sports & Exercise, 51(11), 2375–2390. https://doi.org/10.1249/MSS.0000000000002116
Cheville, A., Smith, S., Barksdale, T., & Asher, A. (2020). Cancer rehabilitation. In Braddom's Physical Medicine and Rehabilitation (pp. 568–593.e7). Elsevier. https://doi.org/10.1016/B978-0-323-62539-5.00029-1
Dietz J. H., Jr (1980). Adaptive rehabilitation in cancer: a program to improve quality of survival. Postgraduate medicine, 68(1), 145–153. https://doi.org/10.1080/00325481.1980.11715495
Gimigliano, F., & Negrini, S. (2017). The World Health Organization "Rehabilitation 2030: A call for action". European Journal of Physical and Rehabilitation Medicine, 53(2), 155–168. https://doi.org/10.23736/S1973-9087.17.04746-3
Kudre, D., Chen, Z., Richard, A., Cabaset, S., Dehler, A., Schmid, M., & Rohrmann, S. (2020). Multidisciplinary outpatient cancer rehabilitation can improve cancer patients' physical and psychosocial status – A systematic review. Current Oncology Reports, 22(12), 122. https://doi.org/10.1007/s11912-020-00979-8
Minton, O., Richardson, A., Sharpe, M., Hotopf, M., & Stone, P. (2008). A systematic review and meta-analysis of the pharmacological treatment of cancer-related fatigue. Journal of the National Cancer Institute, 100(16), 1155–1166. https://doi.org/10.1093/jnci/djn250
Mustian, K. M., Peppone, L. J., Palesh, O. G., Janelsins, M. C., Mohile, S. G., Purnell, J. Q., & Darling, T. V. (2009). Exercise and cancer-related fatigue. US Oncology, 5(2), 20–23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156559/
Raj, V. S., Pugh, T. M., Yaguda, S. I., Mitchell, C. H., Mullan, S. S., & Garces, N. S. (2020). The who, what, why, when, where, and how of team-based interdisciplinary cancer rehabilitation. Seminars in Oncology Nursing, 36(1), 150974. https://doi.org/10.1016/j.soncn.2019.150974
Reis, F., Pereira, A. C. C., Almeida, E. P. M., Cecatto, R. B., & Brito, C. M. M. (2024). The impact of a physical exercise program on quality of life, fatigue, physical performance, and level of physical activity in patients with cancer. Revista da Associação Médica Brasileira, 70(Suppl 1), e2024S120. https://doi.org/10.1590/1806-9282.2024S120
Roscoe, C. M. P., Pringle, A., Chandler, C., Faghy, M. A., & Barratt, B. (2022). The role of physical activity in cancer recovery: An exercise practitioner’s perspective. International Journal of Environmental Research and Public Health, 19(6), 3600. https://doi.org/10.3390/ijerph19063600
Sleight, A., Gerber, L. H., Marshall, T. F., Livinski, A., Alfano, C. M., Harrington, S., Flores, A. M., Virani, A., Hu, X., Mitchell, S. A., Varedi, M., Eden, M., Hayek, S., Reigle, B., Kerkman, A., Neves, R., Jablonoski, K., Hacker, E. D., Sun, V., ... Newman, R. (2022). Systematic review of functional outcomes in cancer rehabilitation. Archives of Physical Medicine and Rehabilitation, 103(9), 1807–1826. https://doi.org/10.1016/j.apmr.2022.01.142
Smith, S. R., Zheng, J. Y., Silver, J., Haig, A. J., & Cheville, A. (2020). Cancer rehabilitation as an essential component of quality care and survivorship from an international perspective. Disability and Rehabilitation, 42(1), 8–13. https://doi.org/10.1080/09638288.2018.1514662
Van Vulpen, J. K., Sweegers, M. G., Peeters, P. H., Courneya, K. S., Newton, R. U., Aaronson, N. K., ... & Buffart, L. M. (2020). Moderators of exercise effects on cancer-related fatigue: a meta-analysis of individual patient data. Medicine and science in sports and exercise, 52(2), 303.
World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. https://www.ncbi.nlm.nih.gov/books/NBK566039/
