Effects of exercise interventions on cancer-related fatigue in children with cancer: A meta-analysis

Background Cancer-related fatigue (CRF) emerges as a common symptom in pediatric cancer patients during treatment. Exercise interventions are increasingly being used as CRF interventions to improve CRF in children with cancer. Aim The objective of this meta-analysis was to synthesize the best available evidence concerning the effectiveness of exercise interventions for cancer-related fatigue in children with cancer. Methods Six databases were extensively searched from inception to December 2023 to identify relevant randomized controlled trials. The risk of bias and methodological quality were assessed using the Cochrane appraisal tool. Pooled effects were calculated using a random-effects model. Heterogeneity was assessed using the I-2 test. Results Eight trials (n = 465) were finally included. Exercise was statistically more effective than conventional care in improving CRF in children with cancer (SMD = -0.62, 95% CI [-1.21, -0.03]) with high statistical heterogeneity (p = .004; I-2 = 86%). The results of the subgroup analysis showed that intervention duration <12 weeks (p < .05), exercise frequency >= 3 times/week (p < .05), and exercise duration <45 min/time (p < .05) were more effective in improving CRF in children with cancer. Linking Evidence to Action Our results suggest that exercise interventions are effective in reducing CRF in children with cancer. We recommend exercise frequency >= 3 times/week, exercise duration <45 min/time, and intervention duration <12 weeks.