Cancer therapies have increased patient survival rates, yet side effects such as cardiotoxicity and neurotoxicity can lead to autonomic nervous and cardiovascular systems dysfunction. This would result in a parasympathetic and sympathetic activity imbalance. Heart rate variability (HRV), which reflects autonomic modulation, is a valuable physiological tool because it correlates with cancer-related fatigue, stress, depression and mortality in cancer patients. To analyze the effects of exercise programs on the autonomic modulation, measured by the HRV, of cancer patients and survivors. The PRISMA guidelines were followed, and the quality of the articles was assessed with the PEDro scale. The meta-analysis statistic procedure was performed by using Revman 5.3 software. Results: From the 252 articles found, six studies were included in the review involving 272 participants aged 30 to 75 years. Exercise programs had a mean length of 10.4 ± 4.6 weeks, a frequency of 3 ± 1.4 days/week, and a mean duration of 78 ± 23.9 minutes. In time-domain HRV measures, exercise may increase in standard deviation of normal to normal intervals (p<0.00001, with a mean difference (MD) of 12.79 ms from 9.03 to 16.55) and a decreased root mean square of successive RR interval differences (p=0.002, with a MD of 13.08 ms from 4.90 to 21.27) in comparison to control groups. Frequency domain data reveal that exercise group improve significantly more than the control groups in low-frequency (absolute power: p<0.0001, with a SMD of 0.97 from 0.61 to 1.34; relative power: p=0.04, with a MD= -7.70 from -15.4 to -0.36), high-frequency (absolute power: p=0.001, with a SMD of 1.49 from 0.32 to 2.66; relative power: p=0.04, with a MD of 8.00 nu from 0.20 to 15.80) and low-to-high frequency ratio (p= 0.007 with a MD of -0.32 from -0.55 to -0.09). Exercise programs could lead to positive effects on the autonomic modulation of cancer patients and survivors. More beneficial changes may occur with resistance and endurance workouts. However, due to the low number of interventions further research is needed to substantiate our findings and to provide insights regarding the exercise intensity required to improve patient’s autonomic modulation.

中文翻译：

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运动能减少癌症患者和幸存者的自主神经功能障碍吗？系统评价和荟萃分析

癌症疗法提高了患者的存活率，但心脏毒性和神经毒性等副作用会导致自主神经和心血管系统功能障碍。这将导致副交感神经和交感神经活动失衡。反映自主神经调节的心率变异性 (HRV) 是一种有价值的生理工具，因为它与癌症患者的癌症相关疲劳、压力、抑郁和死亡率相关。分析锻炼计划对通过 HRV 测量的癌症患者和幸存者自主神经调节的影响。遵循PRISMA指南，并使用PEDro量表评估文章的质量。荟萃分析统计程序使用 Revman 5.3 软件进行。结果：从找到的 252 篇文章中，该评价纳入了六项研究，涉及 272 名 30 至 75 岁的参与者。锻炼计划的平均长度为 10.4 ± 4.6 周，频率为 3 ± 1.4 天/周，平均持续时间为 78 ± 23.9 分钟。在时域 HRV 测量中，运动可能会增加正常到正常间隔的标准偏差（p<0.00001，从 9.03 到 16.55 的平均差异 (MD) 为 12.79 ms）和连续 RR 间隔差异的均方根降低（与对照组相比，p=0.002，从 4.90 到 21.27 的 MD 为 13.08 毫秒）。频域数据显示，运动组在低频方面的改善明显大于对照组（绝对功率：p<0.0001，SMD为0.97，从0.61到1.34；相对功率：p=0.04，MD=-7.70） -15.4 到 -0.36），高频（绝对功率：p=0.001，SMD 为 1.49，从 0.32 到 2.66；相对功率：p=0.04，MD 为 8.00 nu，从 0.20 到 15.80）和低频到高频比（p=0.007，MD 为 -0.32，从 -0.55 到 -0.09）。锻炼计划可能会对癌症患者和幸存者的自主神经调节产生积极影响。阻力和耐力训练可能会发生更有益的变化。然而，由于干预措施的数量较少，需要进一步的研究来证实我们的发现，并提供有关改善患者自主调节所需的运动强度的见解。锻炼计划可能会对癌症患者和幸存者的自主神经调节产生积极影响。阻力和耐力训练可能会发生更有益的变化。然而，由于干预措施的数量较少，需要进一步的研究来证实我们的发现，并提供有关改善患者自主调节所需的运动强度的见解。锻炼计划可能会对癌症患者和幸存者的自主神经调节产生积极影响。阻力和耐力训练可能会发生更有益的变化。然而，由于干预措施的数量较少，需要进一步的研究来证实我们的发现，并提供有关改善患者自主调节所需的运动强度的见解。