Effects of Exercise Interventions on Anxiety and Depression in Patients with Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trails

Xiaoyun Su , Qian Xiao , Junyao Zhai , Zhenxing Kong , Xuemei Li

Journal of Science in Sport and Exercise ›› 2024, Vol. 7 ›› Issue (2) : 97 -111.

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Journal of Science in Sport and Exercise ›› 2024, Vol. 7 ›› Issue (2) : 97 -111. DOI: 10.1007/s42978-023-00269-2
Review Article

Effects of Exercise Interventions on Anxiety and Depression in Patients with Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trails

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Abstract

Objective

The purpose of this meta-analysis was to estimate the effect of exercise interventions on anxiety and depression in patients with lung cancer through the analysis of randomized controlled trials (RCTs).

Methods

Meta-Analyses (PRISMA) guidelines were followed. The meta-analysis was conducted in three databases from inception to May 2022. The investigation focused on assessing the impacts exercise interventions on patients with lung cancer, specifically examing RCTs that reported outcomes related to anxiety and depression. Effect sizes were calculated by standardized mean difference (SMD) with 95% confidence interval (CI)statistics. Additionally, subgroup analyses and sensitivity analyses were conducted.

Results

Eleven RCTs involving a total of 987 participants were included in this analysis. The results demonstrated that exercise interventions significantly decreased levels of anxiety (SMD = − 0.65; 95% CI [− 1.79, − 0.52], P = 0.0004) and depression (SMD = − 0.82; 95% CI [− 1.16, − 0.47]; P < 0.01). A subgroup analysis of anxiety, using the HADS scale, showed no heterogeneity (SMD = − 0.23, 95% CI [− 0.45, − 0.02], I2 = 0%). Similarly, for depression, the subgroup analysis showed no heterogeneity (SMD = − 0.53, 95% CI [− 0.75, − 0.31]; P < 0.01; I2 = 0%). Results of subgroup analyses using the SAS (I2 = 90%) and SDS scale (I2 = 92%) showed heterogeneity among studies; however, the scale itself was not a source of heterogeneity. Regarding sensitivity analyses for anxiety and depression, they were all statistically robust.

Conclusion

In summary, the present meta-analysis suggests that exercise interventions may reduce anxiety and depression levels in patients with lung cancer. The exercise programs included in this trial were associated with less anxiety and depression levels.

Keywords

Lung cancer / Exercise protocols / Anxiety / Depression / Meta-analysis / Randomized controlled trial / Medical and Health Sciences / Public Health and Health Services

Cite this article

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Xiaoyun Su, Qian Xiao, Junyao Zhai, Zhenxing Kong, Xuemei Li. Effects of Exercise Interventions on Anxiety and Depression in Patients with Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trails. Journal of Science in Sport and Exercise, 2024, 7(2): 97-111 DOI:10.1007/s42978-023-00269-2

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References

[1]

AkechiT, OkuyamaT, AkizukiN, et al. . Course of psychological distress and its predictors in advanced non-small cell lung cancer patients. Psychooncology [J], 2006, 15: 463-473.

[2]

BadeBC, GanG, LiF, et al. . Randomized trial of physical activity on quality of life and lung cancer biomarkers in patients with advanced stage lung cancer: a pilot study. BMC Cancer [J], 2021, 21: 352.

[3]

BlacklockR, RhodesR, BlanchardC, et al. . Effects of exercise intensity and self-efficacy on state anxiety with breast cancer survivors. Oncol Nurs Forum [J], 2010, 37: 206-212.

[4]

CavalheriV, BurtinC, FormicoVR, et al. . Exercise training undertaken by people within 12 months of lung resection for non-small cell lung cancer. Cochrane Database Syst Rev [J], 2019, 6. Cd009955

[5]

CavalheriV, JenkinsS, CecinsN, et al. . Exercise training for people following curative intent treatment for non-small cell lung cancer: a randomized controlled trial. Braz J Phys Ther [J], 2017, 21: 58-68.

[6]

ChenHM, TsaiCM, WuYC, et al. . Randomised controlled trial on the effectiveness of home-based walking exercise on anxiety, depression and cancer-related symptoms in patients with lung cancer. Br J Cancer [J], 2015, 112: 438-445.

[7]

ChenHM, TsaiCM, WuYC, et al. . Effect of walking on circadian rhythms and sleep quality of patients with lung cancer: a randomised controlled trial. Br J Cancer [J], 2016, 115: 1304-1312.

[8]

ChenYF, HuangXY, ChienCH, et al. . The effectiveness of diaphragmatic breathing relaxation training for reducing anxiety. Perspect Psychiatr Care [J], 2017, 53: 329-336.

[9]

Committee C E a C G E. Clinical Oncology Society of Australia position statement on exercise in cancer care. Med J Aust [J], 2019, 210: 54-54.e51.

[10]

DriessenEJ, PeetersME, BongersBC, et al. . Effects of prehabilitation and rehabilitation including a home-based component on physical fitness, adherence, treatment tolerance, and recovery in patients with non-small cell lung cancer: a systematic review. Crit Rev Oncol Hematol [J], 2017, 114: 63-76.

[11]

EgegaardT, RoholdJ, LillelundC, et al. . Pre-radiotherapy daily exercise training in non-small cell lung cancer: a feasibility study. Rep Pract Oncol Radiother [J], 2019, 24: 375-382.

[12]

FaulLA, JimHS, MintonS, et al. . Relationship of exercise to quality of life in cancer patients beginning chemotherapy. J Pain Symptom Manage [J], 2011, 41: 859-869.

[13]

GaoML, GuYJ, WuQ. Application of high intensity interval training in patients with lung cancer. J Clin Pulmonary Med [J], 2022, 27: 272-275+289

[14]

GinsburgML, QuirtC, GinsburgAD, et al. . Psychiatric illness and psychosocial concerns of patients with newly diagnosed lung cancer. Cmaj [J], 1995, 152: 701-708

[15]

GravierFE, SmondackP, PrieurG, et al. . Effects of exercise training in people with non-small cell lung cancer before lung resection: a systematic review and meta-analysis. Thorax [J], 2022, 77: 486-496.

[16]

HayesSC, NewtonRU, SpenceRR, et al. . The Exercise and Sports Science Australia position statement: exercise medicine in cancer management. J Sci Med Sport [J], 2019, 22: 1175-1199.

[17]

HenshallCL, AllinL, AveyardH. A systematic review and narrative synthesis to explore the effectiveness of exercise-based interventions in improving fatigue, dyspnea, and depression in lung cancer survivors. Cancer Nurs [J], 2019, 42: 295-306.

[18]

HeywoodR, MccarthyAL, SkinnerTL. Safety and feasibility of exercise interventions in patients with advanced cancer: a systematic review. Support Care Cancer [J], 2017, 25: 3031-3050.

[19]

IyerS, RoughleyA, RiderA, et al. . The symptom burden of non-small cell lung cancer in the USA: a real-world cross-sectional study. Support Care Cancer [J], 2014, 22: 181-187.

[20]

JacobsenPB, PhillipsKM, JimHS, et al. . Effects of self-directed stress management training and home-based exercise on quality of life in cancer patients receiving chemotherapy: a randomized controlled trial. Psychooncology [J], 2013, 22: 1229-1235.

[21]

JonesLW, EvesND, HaykowskyM, et al. . Exercise intolerance in cancer and the role of exercise therapy to reverse dysfunction. Lancet Oncol [J], 2009, 10: 598-605.

[22]

JungJY, LeeJM, KimMS, et al. . Comparison of fatigue, depression, and anxiety as factors affecting posttreatment health-related quality of life in lung cancer survivors. Psychooncology [J], 2018, 27: 465-470.

[23]

KuehrL, WiskemannJ, AbelU, et al. . Exercise in patients with non-small cell lung cancer. Med Sci Sports Exerc [J], 2014, 46: 656-663.

[24]

LeeJ. Physiologic and psychologic adaptation to exercise interventions in lung cancer patients undergoing chemotherapy: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer [J], 2021, 29: 2863-2873.

[25]

LiDF, LiH, MaJJ, et al. . Effects of family-based voluntary exercise in patients with lung cancer. Chin J Mod Nurs [J], 2020, 26: 3326-3329

[26]

MaRC, YinYY, WangYQ, et al. . Systematic review and meta-analysis of nonpharmacological interventions for lung cancer fatigue. West J Nurs Res [J], 2021, 43: 392-402.

[27]

MaoY, YangD, HeJ, et al. . Epidemiology of lung cancer. Surg Oncol Clin N Am [J], 2016, 25: 439-445.

[28]

MehnertA, VeersS, HowaldtD, et al. . Effects of a physical exercise rehabilitation group program on anxiety, depression, body image, and health-related quality of life among breast cancer patients. Onkologie [J], 2011, 34: 248-253.

[29]

MikkelsenMK, LundCM, VintherA, et al. . Effects of a 12-week multimodal exercise intervention among older patients with advanced cancer: results from a randomized controlled trial. Oncologist [J], 2022, 27: 67-78.

[30]

MolassiotisA, VuDV, ChingSSY. The effectiveness of qigong in managing a cluster of symptoms (breathlessness-fatigue-anxiety) in patients with lung cancer: a randomized controlled trial. Integr Cancer Ther [J], 2021, 20: 15347354211008253.

[31]

MontazeriA, MilroyR, HoleD, et al. . Anxiety and depression in patients with lung cancer before and after diagnosis: findings from a population in Glasgow, Scotland. J Epidemiol Community Health [J], 1998, 52: 203-204.

[32]

MoranoMT, MesquitaR, Da SilvaGP, et al. . Comparison of the effects of pulmonary rehabilitation with chest physical therapy on the levels of fibrinogen and albumin in patients with lung cancer awaiting lung resection: a randomized clinical trial. BMC Pulm Med [J], 2014, 14: 121.

[33]

MujovicN, MujovicN, SuboticD, et al. . Preoperative pulmonary rehabilitation in patients with non-small cell lung cancer and chronic obstructive pulmonary disease. Arch Med Sci [J], 2014, 10: 68-75.

[34]

Peddle-Mcintyre CJ, Singh F, Thomas R, Newton RU, Galvão DA, Cavalheri V. Exercise training for advanced lung cancer. Cochrane Database Syst Rev. 2019;2(2):Cd012685. https://doi.org/10.1002/14651858.CD012685.pub2

[35]

QuLL, ZhuL, HuangLL, et al. . Improvement effect of psychology-sports-sleep triple rehabilitation intervention on psychological status, sleep quality and cancer-induced fatigue in the patients undergoing lung cancer chemotherapy. China Modern Doctor [J], 2020, 58: 87-90

[36]

QuistM, LangerSW, LillelundC, et al. . Effects of an exercise intervention for patients with advanced inoperable lung cancer undergoing chemotherapy: a randomized clinical trial. Lung Cancer [J], 2020, 145: 76-82.

[37]

Quist M, Sommer MS, Vibe-Petersen J, Stærkind MB, Langer SW, Larsen KR, Trier K, Christensen M, Clementsen PF, Missel M, Henriksen C, Christensen KB, Lillelund C, Langberg H, Pedersen JH. Early initiated postoperative rehabilitation reduces fatigue in patients with operable lung cancer: a randomized trial. Lung Cancer. 2018;126:125–32. https://doi.org/10.1016/j.jtho.2018.08.256.

[38]

QunL, LifangW, HuirongJ. Application of eight-section brocade in postoperative rehabilitation of non-small cell lung cancer patients. Chin Nurs Res [J], 2017, 31: 3755-3759

[39]

Rowntree RA, Hosseinzadeh H. Lung cancer and self-management interventions: a systematic review of randomised controlled trials. Int J Environ Res Public Health. 2022;19(1):536 https://doi.org/10.3390/ijerph19010536.

[40]

Zhong RB, Wang YY, Han BH, Fang WT, Wang Y. Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2022 edition): an interpretation. Chin J Clin Thoracic Cardiovasc Surg. 2022;29:1402–6. https://kns.cnki.net/kcms/detail/1451.1492.R.20220927.20221826.20220004.html.

[41]

SchabathMB, CoteML. Cancer progress and priorities: lung cancer. Cancer Epidemiol Biomarkers Prev [J], 2019, 28: 1563-1579.

[42]

ShamseerL, MoherD, ClarkeM, et al. . Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ [J], 2015, 350. g7647

[43]

SiegelRL, MillerKD, FuchsHE, et al. . Cancer statistics, 2022. CA Cancer J Clin [J], 2022, 72: 7-33.

[44]

SiegelRL, MillerKD, JemalA. Cancer statistics, 2019. CA Cancer J Clin [J], 2019, 69: 7-34.

[45]

SilverstonePH. Poor efficacy of the Hospital Anxiety and Depression Scale in the diagnosis of major depressive disorder in both medical and psychiatric patients. J Psychosom Res [J], 1994, 38: 441-450.

[46]

TemelJS, GreerJA, GoldbergS, et al. . A structured exercise program for patients with advanced non-small cell lung cancer. J Thorac Oncol [J], 2009, 4: 595-601.

[47]

Toohey K, Chapman M, Rushby AM, Urban K, Ingham G, Singh B. The effects of physical exercise in the palliative care phase for people with advanced cancer: a systematic review with meta-analysis. J Cancer Surviv. 2023;17(2):399–41. https://doi.org/10.1007/s11764-021-01153-0.

[48]

WangH, LiuX, RiceSJ, et al. . Pulmonary rehabilitation in lung cancer. Pm r [J], 2016, 8: 990-996.

[49]

YangM, LiuL, GanCE, et al. . Effects of home-based exercise on exercise capacity, symptoms, and quality of life in patients with lung cancer: a meta-analysis. Eur J Oncol Nurs [J], 2020, 49. 101836

[50]

YueT, LiQ, WangR, et al. . Comparison of Hospital Anxiety and Depression Scale (HADS) and Zung Self-Rating Anxiety/Depression Scale (SAS/SDS) in evaluating anxiety and depression in patients with psoriatic arthritis. Dermatology [J], 2020, 236: 170-178.

[51]

ZaboraJ, BrintzenhofeszocK, CurbowB, et al. . The prevalence of psychological distress by cancer site. Psychooncology [J], 2001, 10: 19-28.

[52]

ZhangY, WangS, ChenP, et al. . Tai Chi for stroke rehabilitation: protocol for a systematic review. BMJ Open [J], 2016, 6. e010866

[53]

Zhou J, Wang M. Evaluation and analysis of anxiety and depression scale. Chin J Mental Health. 2006;10;665.

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