TY - JOUR
T1 - Systematic Review of Functional Outcomes in Cancer Rehabilitation
AU - Sleight, Alix
AU - Gerber, Lynn H.
AU - Marshall, Timothy F.
AU - Livinski, Alicia
AU - Alfano, Catherine M.
AU - Harrington, Shana
AU - Flores, Ann Marie
AU - Virani, Aneesha
AU - Hu, Xiaorong
AU - Mitchell, Sandra A.
AU - Varedi, Mitra
AU - Eden, Melissa
AU - Hayek, Samah
AU - Reigle, Beverly
AU - Kerkman, Anya
AU - Neves, Raquel
AU - Jablonoski, Kathleen
AU - Hacker, Eileen Danaher
AU - Sun, Virginia
AU - Newman, Robin
AU - McDonnell, Karen Kane
AU - L'Hotta, Allison
AU - Schoenhals, Alana
AU - DPT, Nicole L.Stout
N1 - Funding Information:
This research was internally funded in part by the Behavioral Research Program in the Division of Cancer Control and Population Sciences at the National Cancer Institute. The ideas and opinions expressed herein are those of the authors. They do not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. Karen Kane McDonnell is supported by an American Cancer Society Mentored Research Scholar Grant #MRSG-17-152-01.
Publisher Copyright:
© 2022
PY - 2022
Y1 - 2022
N2 - Objective: To systematically review the evidence regarding rehabilitation interventions targeting optimal physical or cognitive 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 domains. Data Sources: PubMed, Cumulative Index to Nursing and Allied Health Plus, Scopus, Web of Science, and Embase. The time scope was January 2008 to April 2019. 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, if studies included a primary functional outcome measure. Secondary data analyses and pilot/feasibility studies were excluded. Full-text review identified 362 studies for inclusion. 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 I-IV). Data Synthesis: Studies for which the functional primary endpoint achieved significance were categorized into 9 functional areas foundational to cancer rehabilitation: (1) quality of life (109 studies), (2) activities of daily living (61 studies), (3) fatigue (59 studies), (4) functional mobility (55 studies), (5) exercise behavior (37 studies), (6) cognition (20 studies), (7) communication (10 studies), (8) sexual function (6 studies), and (9) return to work (5 studies). Most studies were categorized as class III in quality/bias. 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.
AB - Objective: To systematically review the evidence regarding rehabilitation interventions targeting optimal physical or cognitive 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 domains. Data Sources: PubMed, Cumulative Index to Nursing and Allied Health Plus, Scopus, Web of Science, and Embase. The time scope was January 2008 to April 2019. 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, if studies included a primary functional outcome measure. Secondary data analyses and pilot/feasibility studies were excluded. Full-text review identified 362 studies for inclusion. 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 I-IV). Data Synthesis: Studies for which the functional primary endpoint achieved significance were categorized into 9 functional areas foundational to cancer rehabilitation: (1) quality of life (109 studies), (2) activities of daily living (61 studies), (3) fatigue (59 studies), (4) functional mobility (55 studies), (5) exercise behavior (37 studies), (6) cognition (20 studies), (7) communication (10 studies), (8) sexual function (6 studies), and (9) return to work (5 studies). Most studies were categorized as class III in quality/bias. 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.
KW - Functional status
KW - Neoplasms
KW - Rehabilitation
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85126866552&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85126866552&partnerID=8YFLogxK
U2 - 10.1016/j.apmr.2022.01.142
DO - 10.1016/j.apmr.2022.01.142
M3 - Review article
C2 - 35104445
AN - SCOPUS:85126866552
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
ER -
