Evidence map›Paper›PMID 29879968›Full record

ArticleBMC medicine2018

Four-year effects of exercise on fatigue and physical activity in patients with cancer.

Lenja Witlox, Anouk E Hiensch, Miranda J Velthuis, Charlotte N Steins Bisschop, Maartje Los, Frans L G Erdkamp, Haiko J Bloemendal, Marlies Verhaar, Daan Ten Bokkel Huinink, Elsken van der Wall and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Long-term effects of exercise interventions on physical activity in breast cancer patients: a systematic review and meta-analysis of randomized controlled trials.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
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  6. Systematic review and meta-analysis of maintenance of physical activity behaviour change in cancer survivors.The international journal of behavioral nutrition and physical activity · 2019
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  19. Toward a better understanding of the uptake of interventions for cancer-related fatigue: the perspective of healthcare providers, patients, and partners.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Lenja WitloxDepartment of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, PO Box 85500, STR 6.131, 3508 GA, Utrecht, The Netherlands.
Anouk E HienschDepartment of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, PO Box 85500, STR 6.131, 3508 GA, Utrecht, The Netherlands.
Miranda J VelthuisNetherlands Comprehensive Cancer Organisation (IKNL), PO Box 19079, 3501 DB, Utrecht, The Netherlands.
Charlotte N Steins BisschopDepartment of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, PO Box 85500, STR 6.131, 3508 GA, Utrecht, The Netherlands.
Maartje LosDepartment of Medical Oncology, St. Antonius Ziekenhuis, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.
Frans L G ErdkampDepartment of Internal Medicine - Medical Oncology, Obis Medisch Centrum, Dr van der Hoffplein 1, 6166 BG, Sittard-Geleen, The Netherlands.
Haiko J BloemendalDepartment of Internal Medicine, Meander Medical Center, Maatweg 3, 3818 TZ, Amersfoort, The Netherlands.
Marlies VerhaarDepartment of Internal Medicine, Hofpoort Ziekenhuis, Polanerbaan 2, 3447 GN, Woerden, The Netherlands.
Daan Ten Bokkel HuininkDepartment of Internal Medicine, Diakonessenhuis, Bosboomstraat 1, 3582 KE, Utrecht, The Netherlands.
Elsken van der WallDepartment of Medical Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Petra H M PeetersDepartment of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, PO Box 85500, STR 6.131, 3508 GA, Utrecht, The Netherlands.
Anne M MayDepartment of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, PO Box 85500, STR 6.131, 3508 GA, Utrecht, The Netherlands. A.M.May@umcutrecht.nl.

Funding

Duthc Pink Ribbon Foundation 2011.WO02.C100KWF Kankerbestrijding UU 2009-4473ZonMw 171002202, 016156050
6 · The paper itself

Abstract

backgroundIn the earlier randomized controlled Physical Activity during Cancer Treatment (PACT) study, we found beneficial effects of an 18-week supervised exercise program on fatigue in patients with newly diagnosed breast or colon cancer undergoing adjuvant treatment. The present study assessed long-term effects of the exercise program on levels of fatigue and physical activity 4 years after participation in the PACT study.

methodsThe original study was a two-armed, multicenter randomized controlled trial comparing an 18-week supervised exercise program to usual care among 204 breast cancer patients and 33 colon cancer patients undergoing adjuvant treatment. Of the 237 PACT participants, 197 participants were eligible and approached to participate in the 4-year post-baseline measurements, and 128 patients responded. We assessed fatigue and physical activity levels at 4 years post-baseline and compared this to levels at baseline, post-intervention (18 weeks post-baseline), and at 36 weeks post-baseline.

resultsIntention-to-treat mixed linear effects model analyses showed that cancer patients in the intervention group reported significantly higher moderate-to-vigorous total physical activity levels (141.46 min/week (95% confidence interval (CI) 1.31, 281.61, effect size (ES) = 0.22) after 4 years compared to the usual care group. Furthermore, cancer patients in the intervention group tended to experience less physical fatigue at 4 years post-baseline compared to the usual care group (- 1.13, 95% CI -2.45, 0.20, ES = 0.22), although the result was not statistically significant.

conclusionPatients with breast or colon cancer who participated in the 18-week exercise intervention showed significant higher levels of moderate-to-vigorous total physical activity levels and a tendency towards lower physical fatigue levels 4 years post-baseline. Our result indicate that exercising during chemotherapy is a promising strategy for minimizing treatment-related side effects, both short and long term.

trial registrationCurrent Controlled Trials ISRCTN43801571 , Dutch Trial Register NTR2138 . Trial registered on 9 December 2009.

Indexed as

ExerciseExercise TherapyFatigueFemaleHumansMaleMiddle AgedNeoplasmsQuality of LifeCancerChemotherapyExercise interventionFatigueLong-term effectsPhysical activity

Identifiers

PMID29879968
PMCPMC5992660

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.