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Peters M, Butson G, Mizrahi D, Denehy L, Lynch BM, Swain CTV. Physical activity and pain in people with cancer: a systematic review and meta-analysis. Support Care Cancer 2024; 32:145. [PMID: 38321248 PMCID: PMC10847204 DOI: 10.1007/s00520-024-08343-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/24/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE Physical activity can provide analgesic benefit but its effect on cancer-related pain is unclear. This review synthesised and appraised the evidence for the effect of physical activity on pain in people living with or beyond cancer. METHODS A systematic search of Ovid Medline and Embase was performed to identify randomised controlled trials (RCTs), randomised cross-over studies (RXTs), and prospective observational studies that examined physical activity and pain outcomes in adults living with or beyond cancer. Meta-analyses were performed to generate effect estimates. Risk of bias was assessed, and the GRADE system was used to assess evidence quality. RESULTS One hundred twenty-one studies (n = 13,806), including 102 RCTs, 6 RXTs, and 13 observational studies, met the criteria for inclusion. Meta-analyses of RCTs identified a decrease in pain intensity (n = 3734; standardised mean difference (SMD) - 0.30; 95% confidence interval (CI) - 0.45, - 0.15) and bodily pain (n = 1170; SMD 0.28; 95% CI 0.01, 0.56) but not pain interference (n = 207; SMD - 0.13, 95% CI - 0.42, 0.15) following physical activity interventions. Individual studies also identified a reduction in pain sensitivity but not analgesic use, although meta-analysis was not possible for these outcomes. High heterogeneity between studies, low certainty in some effect estimates, and possible publication bias meant that evidence quality was graded as very low to low. CONCLUSION Physical activity may decrease pain in people living with and beyond cancer; however, high heterogeneity limits the ability to generalise this finding to all people with cancer or to specific types of cancer-related pain.
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Affiliation(s)
- Mitchell Peters
- Cancer Science Unit, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Grace Butson
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - David Mizrahi
- The Daffodil Centre, The University of Sydney, a Joint Venture With Cancer Council NSW, Sydney, NSW, Australia
| | - Linda Denehy
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Department of Physiotherapy, Faculty of Medicine, Dentistry and Health Sciences, Melbourne School of Health Sciences, University of Melbourne, Level 7, Alan Gilbert Building, 161 Barry St, Melbourne, VIC, 3010, Australia
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Christopher T V Swain
- Department of Physiotherapy, Faculty of Medicine, Dentistry and Health Sciences, Melbourne School of Health Sciences, University of Melbourne, Level 7, Alan Gilbert Building, 161 Barry St, Melbourne, VIC, 3010, Australia.
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia.
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Van Dijck S, De Groef A, Kothari J, Dams L, Haenen V, Roussel N, Meeus M. Barriers and facilitators to physical activity in cancer survivors with pain: a systematic review. Support Care Cancer 2023; 31:668. [PMID: 37922014 DOI: 10.1007/s00520-023-08141-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/23/2023] [Indexed: 11/05/2023]
Abstract
PURPOSE Pain post-treatment is a debilitating symptom in the growing population of cancer survivors. While physical activity is an integral part of pain management, low levels of physical activity are often observed in this population. The aim of this systematic review is to gain insight into the barriers and facilitators to physical activity in cancer survivors afflicted with pain. METHODS In December 2021, a systematic search was conducted using PubMed and Web of Science. All studies exploring barriers and/or facilitators to physical activity in cancer survivors with pain were included. The methodological quality of the evidence was appraised with the Mixed Methods Appraisal Tool (version 2018). RESULTS Six articles were included. Current literature was limited and mostly focused on female breast cancer survivors. The identified barriers and facilitators could be categorized into six different domains: the logistical, symptoms, cognitive, clinical, social, and knowledge domain. The barrier of pain was reported as a barrier on its own that is closely linked to other barriers in this specific population. CONCLUSION Barriers and facilitators to physical activity were categorized in six different domains. The barrier of pain distinguishes itself and brings along additional obstacles such as anxiety, fear, and avoidance behavior. Current evidence is limited and focuses mostly on female breast cancer survivors. Further research in larger cohorts representing various subsets of cancer survivors with pain is warranted, as well as studies that implement these insights in physical activity interventions.
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Affiliation(s)
- Sophie Van Dijck
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium.
- Pain in Motion International Research Group, Brussels, Belgium.
| | - An De Groef
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Louvain, Belgium
| | - Janan Kothari
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
| | - Lore Dams
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Louvain, Belgium
| | - Vincent Haenen
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Louvain, Belgium
| | - Nathalie Roussel
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
| | - Mira Meeus
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
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