What works to engage cancer patients with fatigue in exercise: a scoping review of RCT-based interventions

This scoping review examines the implementation of exercise interventions aimed at reducing fatigue in patients with cancer. Effective programs typically involve moderate-intensity aerobic or combined aerobic and resistance exercises, performed about 30 min per session, three to five times weekly over 12 weeks. Above these FITT-based parameters, it has been found that exercise effectiveness depends on treatment context, patients' characteristics, and the alignment between program demands and individuals' capacity. The review identifies three key issues: current programs emphasize physical training over holistic rehabilitation, often neglecting patients' broader functional needs; process evaluations of interventions are insufficient, limiting understanding of how and why programs succeed or fail; and methodological weaknesses, including inadequate measures of adherence and a lack of theoretical frameworks, reduce the reliability and generalizability of findings. To enhance exercise effectiveness for fatigue, future interventions should adopt patient-centered, theory-driven approaches that integrate both outcome and process evaluations, addressing physical, emotional, and social dimensions to support long-term engagement and improve quality of life.