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Effects of Exercise-Based Interventions on Cancer-Related Cognitive Impairment: A Systematic Review and Network
Wencan Cheng1, Jia Fang1, Huiyuan Li2
1School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China.
Objective:
To assess the short-term (immediately postintervention) and long-term (postintervention follow-up) effects of exercise-based interventions and to compare the effects of different exercise modalities for improving subjective and objective cognitive function.
Data Sources:
A comprehensive literature search was conducted in PubMed, Scopus, Embase, Web of Science, and the Cochrane Library.
Study Selection:
Randomized controlled trials evaluating exercise-based interventions for cognitive outcomes in adult patients with cancer were included.
Data Extraction:
Pairwise and network meta-analyses were conducted to estimate standardized mean differences (SMDs) with 95% confidence intervals (CIs). The surface under the cumulative ranking curve (SUCRA) was used to estimate intervention ranking probability.
Data Synthesis:
Twenty-seven studies (28 articles, 2809 participants) were included. Exercise-based interventions significantly improved short- and long-term subjective cognitive function (SMD=0.44; 95% CI, 0.27-0.61: SMD=0.37; 95% CI, 0.16-0.57, respectively), executive function (SMD=-0.28; 95% CI, -0.43 to -0.14: SMD=-0.32; 95% CI, -0.56 to -0.08, respectively), working memory (SMD=0.27; 95% CI, 0.14-0.41: SMD=0.31; 95% CI, 0.06-0.55, respectively), and processing speed (SMD=-0.16; 95% CI, -0.31 to -0.01: SMD=-0.31; 95% CI, -0.55 to -0.07, respectively). In the short term, combined exercise and nonexercise interventions had the highest SUCRA for subjective cognitive function (SUCRA=93.50%), resistance exercise for executive function (SUCRA=81.60%), multicomponent exercise for working memory (SUCRA=77.74%), and mind-body exercise for processing speed (SUCRA=78.39%). In the long term, aerobic exercise ranked highest for subjective cognitive function (SUCRA=83.81%), and multicomponent exercise ranked first for executive function (SUCRA=75.22%), working memory (SUCRA=86.35%), and processing speed (SUCRA=77.39%).
Conclusions:
Exercise-based interventions provide short- and long-term benefits across subjective and objective cognitive domains in patients with cancer, with varying probabilistic advantages by exercise modality. No single modality demonstrated superiority across all outcomes. Further studies are warranted given the low-to-moderate certainty of evidence.
