title: Efficacy of Exercise Interventions in Patients with Acute Leukemia: A Meta-Analysis.
abstract: BACKGROUND
  Decreased physical performance and impaired physiological and psychological fitness have been reported in patients with acute leukemia (AL). We performed a meta-analysis to assess the efficacy of exercise in patients with AL.
  
  
  METHODS
  In this meta-analysis, the electronic databases MEDLINE, Embase, Cochrane, Web of Science, SPORTDiscus, CINAHL and PEDro were searched through November 2015. Three authors participated in the study selection, data extraction and quality assessment. The instrument used for quality assessment was derived from the Cochrane Handbook for Systematic Reviews of Interventions. Analyses were performed according to the recommendations of The Cochrane Collaboration using Review Manager 5.3.
  
  
  RESULTS
  Nine trials (8 randomized controlled trials and 1 quasi-experimental design trial) with 314 AL participants were included in this meta-analysis. The pooled standardized mean differences between the exercise and control groups were 0.45 (95% confidence interval (CI): 0.09 to 0.80, P value = 0.01, P for heterogeneity = 0.23, I2 = 28%) for cardiorespiratory fitness and 0.67 (95% CI: 0.28 to 1.06, P value = 0.0007, P for heterogeneity = 0.14, I2 = 43%) for muscle strength. Based on the data for fatigue, anxiety, and depression, there were no significant differences in these parameters between the exercise and control groups.
  
  
  CONCLUSIONS
  Exercise has beneficial effects on cardiorespiratory fitness, muscle strength and functional mobility; however, no significant improvements in fatigue, anxiety, depression or quality of life were observed. Further large-scale randomized trials are needed to assess the safety, feasibility and efficacy of exercise programs for AL patients.
authors.affiliation: The First Hospital Affiliated with Nanjing Medical University, Nanjing, Jiangsu, PR China.
authors.forename: Yuan
authors.identifier: http://orcid.org/0000-0003-1973-3223
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: College of Aerospace Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, PR China.
authors.forename: Jinjie
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Nursing, The First Hospital Affiliated with Nanjing Medical University, Nanjing, Jiangsu, PR China.
authors.forename: Zejuan
authors.initials: Z
authors.lastname: Gu
authors.affiliation: College of Nursing, Nanjing Medical University, Nanjing, Jiangsu, PR China.
authors.forename: Xiangguang
authors.initials: X
authors.lastname: Yin
mesh_terms: D005081:Exercise Therapy / Q000009:adverse effects*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000534:rehabilitation / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic