Adamsen 2009.

Study characteristics
Methods	Study design: RCT Number randomized: 269; 135 to the exercise group and 134 to the control group Study start and stop dates: participants recruited from March 2004 to March 2007 Length of intervention: 6 weeks Length of follow‐up: to end of the intervention
Participants	Type cancer: various Participants had 21 different cancer diagnoses, including 17 solid tumors (i.e. cancer of the breast, bowel, ovaries, testes, esophagus, brain, cervix, pharynx, pancreas, stomach, and other), and 4 hematologic malignancies (i.e. Hodgkin lymphoma, NHL(Non‐Hodgkin’s lymphoma), acute leukemia, and chronic leukemia) Time since cancer diagnosis, median (range) days: exercise group: 83 (34 to 280) days control group: 89.5 (31 to 271) days Time beyond active treatment: not reported Inclusion criteria: had received at least 1 cycle of chemotherapy for advance disease or as adjuvant disease 18 to 65 years old Eligibility criteria related to interest, ability to exercise, or both: had a WHO performance status of 0 or 1 Exclusion criteria: people with brain or bone metastases, thrombocytopenia (< 50 x 109/L), myocardial infraction within the past 3 months, or uncontrolled hypertension (diastolic pressure > 95 mm Hg) Gender, n (%): exercise group: male, 34 (25.2%); female, 101 (74.8%) control group: male, 39 (29.1%); female, 95 (70.9%) Current age, mean (SD) years exercise group: 47.2 (10.7) years control group: 47.2 (10.6) years Age at cancer diagnosis: not reported Ethnicity/race: not reported Education level; completed secondary school or higher, n (%) exercise group: 104 (77.0) control group: 106 (79.7) SES: not reported Employment status: not reported Comorbidities: not reported Past exercise history; physical activity level pre‐illness, n (%) exercise group: sedentary, 10 (7.5%); walking or cycling for pleasure, 40 (30.1%); regular physical exercise (at least 3 hours/week), 74 (55.6%); intense physical activity (> 4 hours/week), 9 (6.8%) control group: sedentary, 5 (4.0%); walking or cycling for pleasure, 34 (27.0%); regular physical exercise, 75 (59.5%); intense physical activity 12 (9.5%) On hormone therapy: not reported
Interventions	135 participants assigned to the exercise intervention, including: high‐ and low‐intensity activities, including: high intensity: Mondays, Wednesdays, and Fridays in high‐intensity physical training for 90 minutes followed by 30 minutes relaxation training. The program included 90 minutes of body awareness followed by 30 minutes of relaxation training on Tuesdays. The participants received 30 minutes of massage on Mondays and Fridays low‐intensity physical training comprised 3 psychosocial components: relaxation (30 minutes 4 times per week), body awareness and restorative training (90 minutes once per week), and massage (30 minutes twice per week). Type exercise (aerobic/anaerobic): aerobic and anaerobic Intensity of the exercise intervention: the intervention activities were equivalent to a total of 43 metabolic equivalent of task (MET) hours per week Frequency: 9 hours per week Duration of individual sessions: 90 minutes for high intensity, 30 minutes for low‐intensity exercise Duration of exercise program: 6 weeks Total number of exercise sessions: 24 sessions (3 sessions per week for 6 weeks) Format: group Facility: facility based Professionally led: professionally led by trained nurse specialists and physical therapists Adherence: 70.8% 134 participants assigned to control group, including: usual care Contamination of control group: not reported
Outcomes	Primary outcome included: fatigue, assessed using the EORTC QLQ‐C30 Other outcomes included subscales of the QLQ C‐30, including: global health status/QoL physical functioning role functioning emotional functioning cognitive functioning social functioning pain Additional HRQoL outcomes included subscales from the MOS SF‐36, including: physical functioning role physical bodily pain vitality social functioning role emotional mental health physical component scale mental component scale Outcomes were measured at baseline and at 6 weeks: exercise group: n = 135 at baseline, n = 118 at 6 weeks control group: n = 134 at baseline, n = 117 at 6 weeks Subgroup analysis: none conducted or specified Adverse events: not reported
Notes	Country: Denmark Funding: The Lundbeck Foundation, The Novo Nordic Foundation, The Egmont Foundation, The Danish Cancer Society, The Svend Andersen Foundation, The Aase and Ejnar Danielsen Foundation, The Beckett Foundation, The Wedell‐Wedellsborg Foundation, The Hede Nielsen Family Foundation, The Gangsted Foundation, Copenhagen University Hospital
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomization was done by computer (CITMAS)
Allocation concealment (selection bias)	Low risk	The allocation sequence was executed by the clinical research unit
Blinding of participants and personnel (performance bias) All outcomes	High risk	Owing to the nature of the intervention, it was not possible to conceal allocation to the intervention from the participants
Blinding of outcome assessment (detection bias) All outcomes	High risk	Allocation to the intervention was not concealed from the study personnel
Incomplete outcome data (attrition bias) All outcomes	Low risk	Missing outcome data were assumed to be missing at random
Selective reporting (reporting bias)	Low risk	There appears to be no selective reporting of outcomes
Other bias	High risk	Since the control group was allowed to engage in or increase levels of physical activity, this could bias the effect of the overall intervention. Further, it is unclear whether there was a possibility of contamination of the control group