Effects of Home-Based Walking on Cancer-Related Fatigue in Patients With Breast Cancer: A Meta-analysis of Randomized Controlled Trials

OBJECTIVE This study was designed to critically evaluate the effect of home-based walking on cancer-related fatigue (CRF) in patients with breast cancer (BC) receiving anticancer treatment. DATA SOURCES Eight databases were systematically searched from inception to March 2021 for randomized controlled trials (RCTs) without language restrictions. STUDY SELECTION Two reviewers (Y.Y. and Z.N.) scanned the titles and abstracts and then read the full texts of potentially eligible trials to screen the literature. Inclusion criteria were studies of home-based walking (HBW) intervention in adult patients with BC, using fatigue as a primary or secondary outcome, and containing extractable fatigue scores. DATA EXTRACTION Two reviewers (Y.Y. and Z.N.) critically and independently assessed the risk of bias using Cochrane Collaboration criteria and extracted correlated data using the designed extraction form. The standardized mean difference (SMD) was used when the outcome assessment tools were different. All of the analyses were performed using Review Manager 5.3. DATA SYNTHESIS Eight RCTs including 764 patients (HBW: 377, control: 387) meeting the inclusion criteria for the meta-analysis were identified. HBW had a significant effect on CRF in patients with BC receiving multiple anticancer treatments (SMD=-0.61; 95% confidence interval [CI], -0.86 to -0.36; P<.001). HBW without other exercises (SMD=-0.83; 95% CI, -1.39 to -0.27; P=.003), walking for a gradually increased duration (SMD=-1.24; 95% CI, -2.20 to -0.28; P=.010), and no restrictions on walking intensity (SMD=-1.03; 95% CI, -1.75 to -0.31; P=.005) demonstrated substantial effects on CRF. Of the 8 included studies, only 3 reported adverse events. CONCLUSIONS HBW can be considered as an alternative therapy for relieving CRF in patients with BC undergoing anticancer treatment.