title: Physical activity in advanced cancer patients: a systematic review protocol.
abstract: BACKGROUND
  Progressive, incurable cancer is associated with increased fatigue, increased muscle weakness, and reduced physical functioning, all of which negatively impact quality of life. Physical activity has demonstrated benefits on cancer-related fatigue and physical functioning in early-stage cancer patients; however, its impact on these outcomes in end-stage cancer has not been established. The aim of this systematic review is to determine the potential benefits, harms, and effects of physical activity interventions on quality of life outcomes in advanced cancer patients.
  
  
  METHODS
  A systematic review of peer-reviewed literature on physical activity in advanced cancer patients will be undertaken. Empirical quantitative studies will be considered for inclusion if they present interventional or observational data on physical activity in advanced cancer patients. Searches will be conducted in the following electronic databases: CINAHL; CIRRIE Database of International Rehabilitation Research; Cochrane Database of Systematic Reviews (CDSR); Database of Abstracts of Reviews of Effects (DARE); Cochrane Central Register of Controlled Trials (CENTRAL); EMBASE; MEDLINE; PEDro: the Physiotherapy Evidence Database; PQDT; PsycInfo; PubMed; REHABDATA; Scopus; SPORTDiscus; and Web of Science, to identify relevant studies of interest. Additional strategies to identify relevant studies will include citation searches and evaluation of reference lists of included articles. Titles, abstracts, and keywords of identified studies from the search strategies will be screened for inclusion criteria. Two independent reviewers will conduct quality appraisal using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies (EPHPP) and the Cochrane risk of bias tool. A descriptive summary of included studies will describe the study designs, participant and activity characteristics, and objective and patient-reported outcomes.
  
  
  CONCLUSIONS
  This systematic review will summarize the current evidence base on physical activity interventions in advanced cancer patients. The findings from this systematic review will identify gaps to be explored by future research studies and inform future practice guideline development of physical activity interventions in advanced cancer patients.
  
  
  BACKGROUND
  PROSPERO CRD42015026281.
authors.affiliation: Department of Symptom Control and Palliative Care, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada. Sonya.Lowe@ahs.ca.
authors.forename: Sonya S
authors.initials: SS
authors.lastname: Lowe
authors.affiliation: Knowledge Resource Service, Knowledge Management Department, Research Innovation and Analytics, Abdul Khaliq Library, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada.
authors.forename: Maria
authors.initials: M
authors.lastname: Tan
authors.affiliation: Edmonton Zone Palliative Care Program-Palliative Community Consult Team (EZPCP-PCCT), #335, 1090 Youville Drive West, Edmonton, AB, T6L 0A3, Canada.
authors.forename: Joan
authors.initials: J
authors.lastname: Faily
authors.affiliation: Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada.
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Watanabe
authors.affiliation: Faculty of Physical Education and Recreation, University of Alberta, 1-113 University Hall, Edmonton, AB, T6G 2H9, Canada.
authors.forename: Kerry S
authors.initials: KS
authors.lastname: Courneya
mesh_terms: D005081:Exercise Therapy / Q000379:methods*; D005221:Fatigue / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D009043:Motor Activity; D009369:Neoplasms / Q000150:complications / Q000473:pathology / Q000534:rehabilitation*; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D000078202:Systematic Reviews as Topic; D013727:Terminal Care / Q000379:methods*
keywords: Cancer; End of life; Exercise; Neoplasms; Oncology; Palliative care; Physical activity; Quality of life; Systematic review; Terminal illness