The effect of exercise on pain in people with cancer: a systematic review with meta-analysis
Date
2023
Authors
Plinsinga, M.L.
Singh, B.
Rose, G.L.
Clifford, B.
Bailey, T.G.
Spence, R.R.
Turner, J.
Coppieters, M.W.
McCarthy, A.L.
Hayes, S.C.
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Journal article
Citation
Sports Medicine, 2023; 53(9):1737-1752
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Abstract
Introduction: Cancer-related pain is common and undertreated. Exercise is known to have a pain-relieving effect in non-cancer pain.
Objectives: This systematic review aimed to evaluate (1) the effect of exercise on cancer-related pain in all cancers, and (2) whether the effect of exercise differed according to exercise mode, degree of supervision, intervention duration and timing (during or after cancer treatment), pain types, measurement tool and cancer type.
Methods: Electronic searches were undertaken in six databases to identify exercise studies evaluating pain in people with cancer, published prior to 11 January 2023. All stages of screening and data extraction were conducted independently by two authors. The Cochrane risk of bias tool for randomised trials (RoB 2) was used and overall strength of evidence was assessed using the GRADE approach. Meta-analyses were performed overall and by study design, exercise intervention and pain characteristics.
Results: In total, 71 studies reported in 74 papers were eligible for inclusion. The overall meta-analysis included 5877 participants and showed reductions in pain favouring exercise (standardised mean difference − 0.45; 95% confidence interval − 0.62, − 0.28). For most (> 82%) of the subgroup analyses, the direction of effect favoured exercise compared with usual care, with effect sizes ranging from small to large (median effect size − 0.35; range − 0.03 to − 1.17). The overall strength of evidence for the effect of exercise on cancer-related pain was very low.
Conclusion: The findings provide support that exercise participation does not worsen cancer-related pain and that it may be beneficial. Better pain categorisation and inclusion of more diverse cancer populations in future research would improve understanding of the extent of benefit and to whom.
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Data source: Supplementary information, https://doi.org/10.1007/s40279-023-01862-9
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Copyright 2023. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. (https://creativecommons.org/licenses/by/4.0/)