Effects of resistance training on quality of life, fatigue, and pain in patients undergoing cancer treatment: A systematic review and dose-response meta-analysis.

[BACKGROUND] Cancer remains a major global health problem, with multiple treatment modalities generating side effects that can be managed through resistance exercise.

[OBJECTIVE] The objective was to determine the effects of resistance training (RT) on quality of life (QoL), fatigue, and pain in patients undergoing cancer treatment and to determine the prescription of exercise programs.

[METHODS] We searched in PubMed, Web of Science, CINAHL and SCOPUS databases for randomized clinical trials (RCTs) of RT in patients with any type of cancer undergoing any cancer therapy. ROB2 and GRADE were used to assess risk of bias and certainty of the evidence, respectively. A random effects meta-analysis and dose-response association were used.

[RESULTS] Nineteen RCTs were included (n = 989). For RT programs, 6/14 (42.9 %) trials found improvements in QoL, 8/14 (57.1 %) in fatigue, and 2/4 (50 %) in pain. Meta-analysis indicated a significant difference in favor of RT for fatigue (k = 6, SMD=-0.30, 95 % CI -0.46 to -0.14; p < 0.001) and pain reduction (k = 3, SMD=-0.25, 95 % CI -0.48 to - 0.02; p < 0.032) in breast cancer. Dose-response analysis indicates a maximal effect at a cumulative volume of 2800 total repetitions in reducing fatigue. In prostate cancer, there was a trend in favor of RT for fatigue reduction (p = 0.072). No improvement in QoL was observed. Important exercise variables were under-reported (rest between sets: 21 %, pain threshold: 11 %, therapist experience: 16 %, time under tension: 0 %, and internal/external focus: 0 %).

[CONCLUSION] RT provides clinically relevant benefits, particularly in reducing fatigue in breast cancer. Information on program prescription could be significantly improved to provide more transparent and replicable RT protocols.