Thirty studies were included: 9 randomised controlled trials (n=667), 8 quasi-randomised studies (n=269), 3 case-controlled studies (n=298), 6 before-and-after designs (n=306), 1 cross-sectional study (n=335) and 3 case studies/series (n=110).
Nine of the experimental studies recruited fewer than 20 participants. The appraisal for methodological quality illustrated that many studies were considered to have limited internal and external validity; studies had small sample sizes, were often not randomised and failed to incorporate blinding. The more recent studies were found to be more robust than earlier ones.
Several studies reported beneficial effects during cancer treatment, particularly in reducing fatigue, of moderate exercise on an exercise bicycle, walking for 20 to 30 minutes at least three times a week, or structured exercise programmes (through treadmills, aerobic equipment and strength training).
A relationship between exercise and improved quality of life after cancer treatment was demonstrated in 7 studies. Improvements in cardiopulmonary function, strength, sleep, self-esteem and weight, depression, anxiety and tiredness were also reported in one study, and weight, nausea, fatigue and functional ability reported in another.