Tian, L., Lu, H.J., Lin, L., & Hu, Y. (2016). Effects of aerobic exercise on cancer-related fatigue: A meta-analysis of randomized controlled trials. Supportive Care in Cancer, 24, 969–983. 

DOI Link


STUDY PURPOSE: To systematically assess and determine the effects of aerobic exercise interventions in the management of cancer-related fatigue (CRF)
TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: The Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Web of Science, China Biology Medicine, China National Knowledge Infrastructure
KEYWORDS: exercise, physical activity, exercise therapy, exercise training, aerobic exercise, physical training, cancer, oncology, neoplasm, cancer treatment, chemotherapy, radiotherapy, hormonal therapy, fatigue, cancer-related fatigue, CRF
INCLUSION CRITERIA: Adults diagnosed with any type of cancer, trials using aerobic exercise interventions with usual care (UC) or no exercise, fatigue as a primary or secondary outcome, containing fatigue scores
EXCLUSION CRITERIA: Focused only on range of motion

Literature Evaluated

EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Two independent reviewers used 12 criteria; studies meeting at least 6 of the 12 criteria were rated as low risk of bias. Meta-analysis was performed using Review Manager Software.

Sample Characteristics

  • SAMPLE RANGE ACROSS STUDIES: 10 of 26 had a sample size less than 30
  • KEY SAMPLE CHARACTERISTICS: 13 studies of breast, 3 of prostate, 2 of colorectal, 2 of nasopharyngeal, 2 of hematological, 1 of gynecologic, and 3 of various types of cancer. The mean age ranged from 40–70.6 years. Twelve studies reported cancer stage from mostly I to III. Eight studies included patients who had completed active treatment.

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment


Exercise was supervised or home-based, 15–50 minutes in length, two to five times per week for 6–24 weeks. Overall aerobic exercise had a small but significant effect (p = 0.01). Studies with patients past active treatment had a moderate effect on fatigue compared to usual care (p < 0.01). Professionally led exercise led to significant improvements in fatigue (p = 0.02). Professionally led exercises lasted 20–30 (p < 0.01) or 50 minutes (p < 0.02), two to three (p < 0.01, p = 0.01) times per week for eight weeks (p < 0.01). No significant difference by exercise type existed.


Structured exercise can have a positive effect on CRF. The effect may be greater when activity is professionally led and after active treatment.


  • The majority of patients had breast cancer, limiting generalizability.
  • Other potential contributing factors to CRF were not reported in these studies.

Nursing Implications

Consistent physical activity should be discussed with patients with cancer to lessen the effects of CRF.

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