Summary of findings 1. Exercise plus usual care compared to usual care for cancer cachexia in adults.
| Exercise plus usual care compared to usual care for cancer cachexia in adults | ||||||
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Patient or population: cancer cachexia in adults Setting: cancer centres Intervention: exercise plus usual care Comparison: usual care | ||||||
| Outcomes | Anticipated absolute effects*(95% CI) | Relative effect (95% CI) | № of participants (studies) |
Certainty of the evidence (GRADE) |
Comments | |
| Risk with usual care | Risk with exercise plus usual care | |||||
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Lean body mass Assessed with: bioimpedance Follow‐up: 8 weeks |
The mean lean body mass was 52.7 kg (95% CI 44.04 to 61.36) |
MD 6.4 kg higher (2.3 lower to 15.1 higher) |
— | 20 (1 study) |
⊕⊝⊝⊝ Very lowa,b,c |
— |
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Adherence to prescribed exercise programmes Assessed with: counting of participants finishing the study Follow‐up: 8 weeks |
Study population | RR 1.00 (0.83 to 1.20 | 20 (1 study) | ⊕⊝⊝⊝ Very lowa,b,c |
The outcome was not planned in the protocol or presented in methods, but it was reported descriptively in the results and conclusion. | |
| 1000 per 1000 | 1000 per 1000 (830 to 1000) | |||||
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Occurrence of adverse events Assessed with: patient's self‐report Follow‐up: 8 weeks |
Study population | Not estimable | 20 (1 study) | ⊕⊝⊝⊝ Very lowa,b,c |
No adverse events were reported during or after the training. | |
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| Muscle strength and endurance | No data | No data | — | — | — | Only baseline data for muscle strength. No evidence to support or refute. |
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Maximal and submaximal exercise capacity Functional capacity assessed with: 6MWT |
No data | No data | — | — | — | Only baseline data. No evidence to support or refute. |
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Fatigue Assessed with: MFI questionnaire (scale 4–20; lower score better) Follow‐up: 8 weeks |
The mean fatigue score was 11.90 (95% CI 8.61 to 15.19) | MD 0.1 lower (4 lower to 3.8 higher) | — | 20 (1 study) | ⊕⊝⊝⊝ Very lowa,b,c |
— |
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Health‐related quality of life Assessed with: FAACT (scale 0–104; higher score better) Follow‐up: 8 weeks |
The mean health‐related quality of life score was 59.50 (95% CI 8.61 to 15.19) | MD 4.9 higher (15.1 lower to 24.9 higher) | — | 20 (1 study) | ⊕⊝⊝⊝ Very lowa,b,c |
— |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). 6MWT: six‐minute walk test; CI: confidence interval; FAACT: Functional Assessment of Anorexia/Cachexia Therapy; MD: mean difference; MFI: Multidimensional Fatigue Inventory; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded one level for serious study limitations: high risk of bias: blinding of participants and personnel; blinding of outcome assessment; other bias. bDowngraded one level for indirectness: outcome timeframe insufficient to produce benefits attributed to exercise. cDowngraded one level for imprecision: wide confidence intervals; few events and studies.