Effect of Home- and Community-Based Physical Activity Interventions on Physical Function Among Cancer Survivors: A Systematic Review and Meta-Analysis.

The search was limited to English peer-reviewed articles in selected databases, so studies in other languages or not indexed may have been missed. Only randomized trials available in full text were included, which may have introduced bias by excluding observational studies and abstract-only reports. Incomplete reporting in some trials may have inflated the effect size estimates. The included samples were mostly white, female, and limited to breast, colorectal and prostate cancer, so results may not apply to all cancer survivors. Interventions varied widely in exercise type, duration, number of sessions and setting, making it difficult to identify which program format worked best. Many trials combined behavioural counselling, home-based exercise and supervised exercise, so the contribution of any single component cannot be separated. Most studies measured physical function only at the end of the intervention, and some follow-up studies found that gains were not sustained. Only two studies used objective physical activity measures, while most relied on self-report, which may be affected by reporting bias. Publication bias could not be assessed because fewer than 10 studies were available for each functional measure. Other objective function measures such as gait speed and chair stands were excluded because protocols differed across studies.

This review was funded in part by the Cancer Prevention and Research Institute of Texas and the National Institute on Disability and Rehabilitation Research. One author, Zakkoyya Lewis, began working for Beachbody after completing the study design, analysis and first draft; Beachbody is described as a company that may potentially benefit from the research results. The authors state that this interest was reviewed by UTMB’s Conflicts of Interest Committee and managed with a plan to prevent an apparent conflict.

Do not conclude that home and community-based programs reliably improve all aspects of physical function. Advanced lower-limb function did not show a significant pooled improvement, and many trials combined counselling, home exercise and supervised exercise, so the effect of any single component cannot be separated.