Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2022; 10(10): 3143-3155
Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3143
Effects of physical exercise on the quality-of-life of patients with haematological malignancies and thrombocytopenia: A systematic review and meta-analysis
Yu-Pei Yang, Shuang-Jun Pan, Shu-Lin Qiu, Tao-Hsin Tung
Yu-Pei Yang, Department of Hematology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
Shuang-Jun Pan, Department of Neurosurgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
Shu-Lin Qiu, Institute for Hospital Management, Tsing Hua University, Shenzhen 518055, Guangdong Province, China
Tao-Hsin Tung, Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
Author contributions: Yang YP and Pan SJ conducted the study and drafted the manuscript; Pan SJ participated in the design and data collection of the study; Yang YP and Qiu SL calculated the results of this study; Tung TH conceived the study and participated in its design and coordination; all of the authors read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tao-Hsin Tung, PhD, Director, Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, No. 150 Ximen Road, Linhai 317000, Zhejiang Province, China. ch2876@yeah.net
Received: August 13, 2021
Peer-review started: August 13, 2021
First decision: October 20, 2021
Revised: November 2, 2021
Accepted: January 25, 2022
Article in press: January 25, 2022
Published online: April 6, 2022
ARTICLE HIGHLIGHTS
Research background

Annually, there are an estimated 1187000 new patients worldwide diagnosed with haematological malignancies, including leukaemia, myeloma, and lymphoma, resulting in 690000 deaths. Effective strategies are needed to alleviate side effects and prevent the physical and psychosocial degeneration of patients in active treatment for haematological malignancies.

Research motivation

The prevailing advice for haematological malignancy patients is to rest and sleep more, especially if they have thrombocytopenia, and to avoid intensive and high-energy physical activity, without taking note of the negative effects such as thromboembolic diseases, pressure ulcers, deconditioning, contractures, fatigue, and atelectasis. Some other studies have not indicated clear findings in relation to this advice.

Research objectives

This study aimed to examine the effects of physical exercise on the quality of life (QoL) of haematological malignancy patients with thrombocytopenia, and to provide an evidence-based medical basis for the application and promotion of physical exercise.

Research methods

This study was conducted using randomized controlled trials (RCTs) to assess the effect of physical exercise on the QoL of haematological malignancy patients with thrombocytopenia. We complied with the checklist of PRISMA[25]. The protocol was registered in the PROSPERO International Prospective Register of Systematic Review (number: CRD42021256897). We searched PubMed, Cochrane Library and Embase databases for all relevant articles published up to 31 July 2021.

Research results

Seven RCTs were selected in the systematic review and three were included in the final meta-analysis. There were significant differences in QoL between physical exercise groups [mean score difference = 8.81; 95% confidence interval (CI): 1.81-15.81, P = 0.01], especially in emotional functioning (mean score difference = 12.34; 95%CI: 4.64-20.04, P = 0.002) and pain (mean score difference = –12.77; 95%CI: -3.91 to -21.63, P = 0.005).

Research conclusions

It has been suggested that physical exercise positively impacts patients with haematological malignancies and thrombocytopenia. This study found evidence that physical exercise improves the QoL of these patients, especially in terms of emotional functioning and pain management.

Research perspectives

Subsequent trials should include an adequate sample size, participants from a wide range of ethnic groups should be recruited and efficacy and safety outcomes should be measured and reported. In addition, the effect exerted by exercise intervention should be examined over longer durations following the intervention. In addition, further studies should include a control group who receive physical exercise and blinded testing of physical and psychological performance.