Effectiveness of exercise interventions on functional outcomes in frail adults with a previous or current diagnosis of cancer: a systematic review and meta-analysis

PurposeExercise improves functional outcomes in individuals with frailty and individuals with cancer, but it is unknown how exercise impacts function in individuals with both cancer and frailty. This systematic review aimed to determine if adults with cancer who are frail and participate in an exercise program have better functional outcomes compared to those who do not.MethodsFive databases (OVID Medline, Embase, CINAHL, EMCARE, and Ageline) were searched from inception to March 2024 for RCTs that investigated the impact of exercise on functional outcomes in individuals with cancer who are frail and >= 18 years. Title/abstract, full text review, and data extraction were done in duplicate. Cochrane ROB2 was used to assess risk of bias and GRADE for certainty of results.ResultsEleven RCTs with 1419 participants were included in this review. Meta-analysis did not find a significant difference between intervention and control groups for submaximal walking tests (95% CI 0.24 (- 0.05-0.53), Short Physical Performance Battery (95% CI - 0.50 (- 1.15-0.15)), and grip strength (95% CI 1.83 (- 0.75 to 4.41). However, positive trends emerged for those participating in exercise programs related to submaximal walking test, grip strength, sit to stand, SPPB, and TUG scores.ConclusionThere are few RCTs investigating exercise in this population, with high heterogeneity of existing interventions. This leads to low certainty in the results of the current study.Implications for Cancer SurvivorshipCancer survivors and patients need to be screened for frailty and be engaged in appropriate exercise. Further work should be done investigating appropriate parameters of exercise interventions for this population.