Steroid myopathy and rehabilitation in patients with cancer.
Vera Tsetlina, Ray A Stanford, Grigory Syrkin and 1 others
PMID 38381659WHAT IT FOUND
No guidelines exist for diagnosing or treating steroid myopathy in cancer patients.
Reviews suggest minimizing steroid doses and using resistance training to prevent muscle loss, but high-intensity exercise may worsen atrophy. Evidence for dietary or pharmacological interventions remains limited.
Key findings
01There are no accepted guidelines for diagnosing steroid myopathy and a lack of high-quality evidence for management strategies.
02Resistance training shows strong evidence for mitigating steroid myopathy in adults, whereas high-intensity activities may increase atrophy.
03Switching from fluorinated to nonfluorinated glucocorticoids and minimizing dose and duration are recommended to reduce myopathy risk.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a narrative and scoping review, not a systematic review with meta-analysis, so it does not provide pooled effect estimates. Most evidence on exercise therapy comes from rodent models (19 of 24 studies), limiting direct applicability to human patients. There are no accepted guidelines for diagnosis, making clinical identification reliant on subjective history and physical exam. Data on pediatric populations is lacking, particularly regarding exercise therapy and long-term trajectories.
The easy way to misread this
Do not interpret the review's support for exercise as a blanket recommendation for all physical activity. High-intensity exercise may increase muscle atrophy in patients with steroid myopathy, and resistance training is the specific modality supported by evidence.