Physical therapist Primary care clinician Sutter Health Novato California Novato, California, United States
Objective(s): To systematically review the evidence regarding rehabilitation interventions targeting physical therapy function in adults with a history of cancer and describe the breadth of evidence as well as strengths and limitations across a range of functional domain. This systematic review summarizes the literature on the health effects of physical therapy during cancer rehabilitation and evaluates the methodological rigour of studies in this area to date.
Data Sources: Relevant studies were identified through a systematic search of PubMed and Embase . Data on study design, recruitment strategy, participants, exercise intervention, adherence rates, and outcomes were extracted. Methodological rigour was assessed using a structured rating system.
Study Selection: Prospective, controlled trials including single and multiarm cohorts investigating rehabilitative interventions for cancer survivors at any point in the continuum of care were included. Secondary data analyses and pilot/feasibility studies were excluded. Full-text review identified 362 studies for inclusion. Improvements in physical functioning, strength, physical activity levels, quality of life, fatigue, immune function, haemoglobin concentrations, potential markers of recurrence, and body composition were reported.
Data Extraction: Extraction was performed by coauthor teams and quality and bias assessed using the American Academy of Neurology (AAN) Classification of Evidence Scheme class.
Data Synthesis: Studies for which the functional primary endpoint achieved significance were categorized into 9 functional areas foundational to cancer rehabilitation: quality of life , activities of daily living, fatigue , functional mobility, exercise behavior, cognition, communication, sexual function, return to work . Averaging results found within each of the functional domains, 71% of studies reported statistically significant results after cancer rehabilitation intervention(s) for at least 1 functional outcome.
Conclusions: These findings provide evidence supporting the efficacy of rehabilitative interventions for individuals with a cancer history. The findings should be balanced with the understanding that many studies had moderate risk of bias and/or limitations in study quality by AAN criteria. These results may provide a foundation for future work to establish clinical practice guidelines for rehabilitative interventions across cancer disease types
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