Evidence-based practice for fatigue management in adults with cancer: exercise as an intervention.
OBJECTIVE
To review and summarize the current state of the evidence for exercise as an intervention for cancer-related fatigue and to facilitate application to clinical practice.


METHODS
Articles, abstracts, and practice guidelines published through October 2003.


RESULTS
The strength of the evidence of effectiveness of exercise in managing cancer-related fatigue is growing.


CONCLUSIONS
All patients with cancer should be encouraged to maintain an optimum level of physical activity during and following cancer treatment. Patients with breast cancer and other selected patients should receive recommendations for moderate exercise programs. Referrals to physical therapy and/or rehabilitation may benefit certain patients, including those with comorbidities or deconditioning. Published multidisciplinary evidence-based guidelines for exercise programs involving patients with cancer are needed.


CONCLUSIONS
Nurses may participate in implementing exercise interventions with patients with cancer in various roles depending on skill and knowledge--from encouraging physical activity to referring patients to physical therapy and/or rehabilitation programs to prescribing and monitoring exercise in certain patient populations.
Stricker
Carrie Tompkins
CT
University of Pennsylvania Medical Center, Philadelphia, PA, USA. carrie.stricker@uphs.upenn.edu
Drake
Diane
D
Hoyer
Kyle-Anne
KA
Mock
Victoria
V
D000970:Antineoplastic Agents / Q000009:adverse effects; D019317:Evidence-Based Medicine; D005081:Exercise Therapy; D005221:Fatigue / Q000139:chemically induced / Q000209:etiology / Q000451:nursing / Q000628:therapy*; D005260:Female; D006801:Humans; D007372:Interferons / Q000009:adverse effects; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000451:nursing / Q000523:psychology / Q000628:therapy; D009859:Oncology Nursing / Q000193:education; D010166:Palliative Care; D036102:Peripheral Blood Stem Cell Transplantation / Q000523:psychology; D010865:Pilot Projects; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies
D000970:Antineoplastic Agents; D007372:Interferons