School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, Australia.
Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia.
Sports Med. 2023 Sep;53(9):1737-1752. doi: 10.1007/s40279-023-01862-9. Epub 2023 May 22.
Cancer-related pain is common and undertreated. Exercise is known to have a pain-relieving effect in non-cancer pain.
This systematic review aimed to evaluate (1) the effect of exercise on cancer-related pain in all cancers, and (2) whether the effect of exercise differed according to exercise mode, degree of supervision, intervention duration and timing (during or after cancer treatment), pain types, measurement tool and cancer type.
Electronic searches were undertaken in six databases to identify exercise studies evaluating pain in people with cancer, published prior to 11 January 2023. All stages of screening and data extraction were conducted independently by two authors. The Cochrane risk of bias tool for randomised trials (RoB 2) was used and overall strength of evidence was assessed using the GRADE approach. Meta-analyses were performed overall and by study design, exercise intervention and pain characteristics.
In total, 71 studies reported in 74 papers were eligible for inclusion. The overall meta-analysis included 5877 participants and showed reductions in pain favouring exercise (standardised mean difference - 0.45; 95% confidence interval - 0.62, - 0.28). For most (> 82%) of the subgroup analyses, the direction of effect favoured exercise compared with usual care, with effect sizes ranging from small to large (median effect size - 0.35; range - 0.03 to - 1.17). The overall strength of evidence for the effect of exercise on cancer-related pain was very low.
The findings provide support that exercise participation does not worsen cancer-related pain and that it may be beneficial. Better pain categorisation and inclusion of more diverse cancer populations in future research would improve understanding of the extent of benefit and to whom.
CRD42021266826.
癌症相关疼痛很常见，但治疗不足。运动已被证明对非癌症疼痛具有缓解作用。
本系统评价旨在评估（1）运动对所有癌症相关疼痛的影响，以及（2）运动方式、监督程度、干预持续时间和时间（在癌症治疗期间或之后）、疼痛类型、测量工具和癌症类型是否会影响运动的效果。
在六个数据库中进行电子检索，以确定评估癌症患者疼痛的运动研究，这些研究发表于 2023 年 1 月 11 日之前。两位作者独立进行了所有阶段的筛选和数据提取。使用 Cochrane 随机试验偏倚风险工具（RoB 2）评估偏倚风险，并使用 GRADE 方法评估总体证据强度。进行了总体和按研究设计、运动干预和疼痛特征的荟萃分析。
共有 71 项研究报告的 74 篇论文符合纳入标准。总体荟萃分析纳入了 5877 名参与者，结果显示运动有利于减轻疼痛（标准化均数差-0.45；95%置信区间-0.62，-0.28）。对于大多数（>82%）亚组分析，与常规护理相比，运动的效果更有利于运动，效应大小从小到大（中位数效应大小-0.35；范围-0.03 至-1.17）。运动对癌症相关疼痛影响的总体证据强度非常低。
这些发现表明，参加运动不会加重癌症相关疼痛，而且可能有益。在未来的研究中更好地对疼痛进行分类，并纳入更多不同类型的癌症患者，将有助于更好地了解运动的获益程度和适用人群。
PROSPERO 注册号：CRD42021266826。
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