SUMMARY OF THE EVIDENCE FOR EXCERISE AND YOGA FOR THE TREATMENT OF CHEMOTHERAPY-INDUCED

SIDE EFFECTS

2007-2017

Author Year Design Cancer Sample Size Summary of Findings

Diagnosis
Zimmer et 2016 Systematic Mixed 14 trials, Cancer-related cognitive impairments, also known as CRCI
al. Review 1237 or chemobrain, are lapses in memory and thought that
patients occur with patients undergoing chemotherapy and other
cancer treatments
Patients reported improvements in cognition after 4 weeks
of a combination of breathing exercises, yoga, and
meditation
Patients who practiced yoga, deep breathing, and
meditation showed significant cognitive improvement over
those who did not after three months of treatment, as well
as significantly decreased inflammatory markers, which
have been linked to impaired memory and thought
Aerobic and anaerobic exercise can decrease inflammatory
markers and cause the birth of new neurons from existing
stem cells
Memory and thought are significantly improved when
exercise is combined with cognitive training, such as the
practice of puzzles or crosswords
Van Moll 2016 Systematic Mixed 14 trials Chemotherapy is known to decrease endurance capacity
et al. Review and muscle strength
Patients who trained under the supervision of physical
therapists saw improvements in endurance of 8-31%, while
those who did not train showed decreases in endurance of
1-32% of pre-chemotherapy baselines
 Muscle strength was measured by the increase or decrease
in each patients one-rep maximum in chest press and leg
press exercises
Patients who exercised under the supervision of physical
therapists saw increases in muscle strength of 4-33%, while
those who did not exercise saw no change
The endurance exercises were performed over an average of
12 weeks, while the muscle strength exercises were
performed over an average of 6 weeks
Exercise regimens should be individualized and should be
performed under the supervision or guidance of a trained
professional, such as a physical therapist
Meneses- 2015 Systematic Mixed 11 studies, Yoga was excluded from this review as it did not meet the
Echavez et Review and 1407 working definition of exercise of, a structured increase of
al. Meta-Analysis patients energy expenditure
Studies analyzed patient responses for changes in fatigue
and quality of life using tested and proven standardized
questionnaires
Implementation of exercise regimens ranged in duration
from 4-28 weeks, and time spent exercising ranged from
15-60 minutes, 3 times per week
Routine walking was shown to significantly decrease
reports of fatigue, as was a combination of walking and
light resistance training, in patients actively undergoing
chemotherapy
No significant differences were found in quality of life with
any exercise intervention compared to patients who did not
exercise
Danhauer 2017 Systematic Mixed 155 All patients involved in the reviewed studies performed
et al. Review individuals yoga under the guidance and supervision of an instructor
Yoga, combined with deep breathing and meditation, was
shown to decrease feelings of anxiety, depression, and
negative affect
 Patients who practiced yoga while undergoing
chemotherapy treatment reported feeling more relaxed,
displayed improvements in memory and thought processes,
and discussed feelings of improved self-esteem and ability
to cope with treatment
Yoga, meditation, and deep breathing exercises, performed
at least once per week for 3 weeks, have been shown to
decrease patient reports of fatigue and have been linked to
an increase in genes related to immune function
Yoga, performed without additional deep breathing and
meditation, has also shown improvements in sleep, pain,
nausea and vomiting, and appetite
It is not known which type of yoga is best, nor is it known
how often and for how long yoga should be practiced to
achieve maximum results
Yoga is a light form of exercise and posturing, which can
easily be customized to an individuals needs and ability,
meaning it carries a low risk for adverse effects
Daley 2007 Randomized Breast 108 women Participants had been treated for breast cancer within 12-36
Controlled Trial Cancer months before this study took place
Patients who performed aerobic exercise at 65-85% of their
age adjusted maximum heart rate three times per week for
eight weeks reported improved quality of life, as
determined by patients filling out the Functional
Assessment of Cancer Therapy questionnaire
Patients who exercised reported lower rates of depression
and increased feelings of self-worth as compared to those
who did not exercise
Exercise was performed for fifty minutes, three times per
week for 24 weeks, under the guidance of a physical
therapist and a personal trainer
Lee et al. 2007 Systematic Mixed 9 articles The biological basis of qigong is yet unknown, but qigong
Review is practiced to promote health maintenance
Qigong is similar to yoga, in that it combines structured
body posturing, deep breathing, and meditation to promote
relaxation and improve health outcomes
Patients who underwent qigong while maintaining
medication regimens prescribed for chemotherapy side
effects saw vast improvements in physical strength and
appetite, and moderate improvements in diarrhea compared
to those who maintained prescribed medication regimens
without qigong
Wang et al. 2011 Randomized Breast 72 women Baseline measurements of patients maximum heart rates
Controlled Trial Cancer were obtained the day before starting chemotherapy.
Baseline maximum heart rate was measured by having
patients walk as quickly as they could for two minutes
Women were to complete 30 minutes of walking per day,
either in one session, or in three 10-minute sessions, 3-5
times per week
Walking was considered sufficient if the patient maintained
a heart rate of 40-60% of their pre-therapy baseline
Quality of life was measured by the Functional Assessment
of Cancer Therapy questionnaire, a scale which ranks
quality of life out of 90 points. The baseline score for the
intervention and control groups was 75 points. At the end of
the study, quality of life improved to 84.3 points in those
women who walked, versus a drop to 66.4 points in those
who did not walk
Though the attrition rate was low in this study, those
subjects who did drop out cited a limited support system as
the primary reason for not continuing their exercise