Introduction

Cancer-related pain is common and undertreated. Exercise is known to have a pain-relieving effect in non-cancer pain.

Objectives

This systematic review aimed to evaluate (1) the effect of exercise on cancer-related pain in all cancers, and (2) whether the effect of exercise differed according to exercise mode, degree of supervision, intervention duration and timing (during or after cancer treatment), pain types, measurement tool and cancer type.

Methods

Electronic searches were undertaken in six databases to identify exercise studies evaluating pain in people with cancer, published prior to 11 January 2023. All stages of screening and data extraction were conducted independently by two authors. The Cochrane risk of bias tool for randomised trials (RoB 2) was used and overall strength of evidence was assessed using the GRADE approach. Meta-analyses were performed overall and by study design, exercise intervention and pain characteristics.

Results

In total, 71 studies reported in 74 papers were eligible for inclusion. The overall meta-analysis included 5877 participants and showed reductions in pain favouring exercise (standardised mean difference − 0.45; 95% confidence interval − 0.62, − 0.28). For most (> 82%) of the subgroup analyses, the direction of effect favoured exercise compared with usual care, with effect sizes ranging from small to large (median effect size − 0.35; range − 0.03 to − 1.17). The overall strength of evidence for the effect of exercise on cancer-related pain was very low.

Conclusion

The findings provide support that exercise participation does not worsen cancer-related pain and that it may be beneficial. Better pain categorisation and inclusion of more diverse cancer populations in future research would improve understanding of the extent of benefit and to whom.

PROSPERO registration number

CRD42021266826.

中文翻译：

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运动对癌症患者疼痛的影响：系统评价与荟萃分析

介绍

癌症相关疼痛很常见且治疗不足。众所周知，运动对非癌性疼痛有缓解作用。

目标

本系统综述旨在评估（1）运动对所有癌症中与癌症相关的疼痛的影响，以及（2）运动的效果是否因运动模式、监督程度、干预持续时间和时机（癌症期间或之后）而不同治疗）、疼痛类型、测量工具和癌症类型。

方法

在六个数据库中进行了电子检索，以确定 2023 年 1 月 11 日之前发表的评估癌症患者疼痛的运动研究。筛选和数据提取的所有阶段均由两位作者独立进行。使用随机试验的 Cochrane 偏倚风险工具 (RoB 2)，并使用 GRADE 方法评估证据的整体强度。根据研究设计、运动干预和疼痛特征进行总体荟萃分析。

结果

总共 74 篇论文中报告的 71 项研究符合纳入条件。总体荟萃分析包括 5877 名参与者，结果表明运动可以减轻疼痛（标准化平均差 − 0.45；95% 置信区间 − 0.62，− 0.28）。对于大多数（> 82％）的亚组分析，与常规护理相比，效果的方向有利于运动，效果大小范围从小到大（中位效果大小 - 0.35；范围 - 0.03 至 - 1.17）。运动对癌症相关疼痛的影响的总体证据强度非常低。

结论

研究结果表明，参与运动不会加重与癌症相关的疼痛，而且可能是有益的。在未来的研究中更好地对疼痛进行分类并纳入更多不同的癌症人群将有助于加深对受益程度和受益对象的理解。

普洛斯彼罗注册号

CRD42021266826。