The Effect of Behavioural Graded Activity on Physical Activity Level, Health-Related Quality of Life and Symptom Management in Cancer Patients and Survivors: Systematic Review And Meta-Analysis.

Research output: Unpublished contribution to conferencePoster

Abstract

Backgrounds and Aims Cancer is one of the most prevalent disease in the world, with rising incidence numbers. For the most frequently occurring cancers, the 5-year survival has increased to 70% in most developed countries. However, many cancer patients and survivors will experience a range of side effects and lingering treatment-related problems. The debilitating nature of those side effects result in significant limitations in cognitive functioning, psychosocial functioning, and physical activity levels, which reduce health-related quality of life. Past years, behavioural graded activity (BGA) has demonstrated positive effects on these symptoms and pain in chronic pain populations, and appears foremost in cognitive behavioural therapy or other psychological informed practices (PIP). Therefore, the aims of this systematic review and meta-analysis are to determine (1) the effectiveness of PIP with BGA compared to waitlist controls (WLC) or (2) other interventions, (3) the added value of BGA in PIP compared to PIP alone, (4) and lastly the effectiveness of PIP with BGA compared to BGA alone. Methods: PubMed, Web of Science, and Embase were systematically screened for intervention studies encompassing BGA (graded activity, graded exercise, operant conditioning, etc) and PIP (ACT, behaviour strategies, cognition therapy, CBT, etc). If possible, for each outcome meta-analyses of effect sizes were performed and reported as standardized mean difference (SMD). Subgroup analyses were undertaken based on the methodological quality and quality of the given BGA to investigate significant heterogeneity (I2>30%) across studies. Results: A total of 29 studies were found eligible and 4080 participants were included in this review. Significant effect sizes were found for the outcomes: fatigue ((SMDPIP+BGA vs WLC=-0.86[-1.18;-0.54], I2=61%), (SMDPIP+BGA vs Other intervention=-0.30[-0.44;-0.16], I2=32%), (SMDPIP+BGA vs Other intervention T<3M=-0.34[-0.58;-0.10], I2=47%)), depression (SMDPIP+BGA vs WLC=-0.78[-1.15;-0.40], I2=0%), psychological symptoms (SMDPIP+BGA vs WLC=-0.58[-0.82;-0.34], I2=51%), social impairment (SMDPIP+BGA vs WLC=-0.33[-0.58;-0.08], I2=0%), global quality of life (SMDPIP+BGA vs WLC=-0.47[-0.77;-0.16], I2=48%), functional impairment (SMDPIP+BGA vs WLC=-0.72[-0.95;-0.50], I2=0%), physical activity (subjective (SMDPIP+BGA vs WLC=-0.58[-0.84;-0.32], I2=47%), (SMDPIP+BGA vs Other intervention=-0.26[-0.41;-0.11], I2=44%)) and objective (SMDPIP+BGA vs WLC=-0.51[-0.90;-0.13], I2=0%)). After withdrawing the studies that did not provide qualitative BGA, depression (SMDPIP+BGA vs Other intervention=-0.45[-1.28;-0.37], I2=86%) and physical activity (subjective (SMDPIP+BGA vs Other intervention T<3M=-0.39[-0.70;-0.08], I2=44%)) became significant as well, but without a substantial decrease of heterogeneity. Conclusions: The effectiveness of PIP with BGA in comparison of WLC is promising on different outcomes (fatigue, psychological symptoms, depression, social impairment, quality of life and physical activity) but the added value of BGA alone could not be demonstrated. However, further trials with good methodology, should be performed to form a solid conclusion.
Original languageEnglish
Publication statusUnpublished - 9 Jun 2021
EventIASP 2021 Virtual World Congress on Pain - Online
Duration: 9 Jun 202118 Jun 2021

Conference

ConferenceIASP 2021 Virtual World Congress on Pain
Period9/06/2118/06/21

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