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The Effect of Resistance Training on Body Composition During and After Cancer Treatment: A Systematic Review and Meta-Analysis

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A Letter to the Editor to this article was published on 12 November 2021

A Commentary to this article was published on 13 September 2021

Abstract

Background

Changes in body composition during cancer treatments have been linked with poorer outcomes, and increased morbidity and mortality. The effect of resistance training (RT) on body composition in cancer cohorts is debated.

Objective

We conducted a systematic review and meta-analysis to determine the effect of RT on body composition during and after treatment.

Methods

We searched five electronic databases for articles up to 1 February 2021 and included randomized controlled trials that compared RT with a non-exercise control in adults with cancer. Risk of bias was assessed using the RoB 2 tool. Pairwise, random-effects meta-analysis was used to synthesize the available data.

Results

Overall, we included 15 studies (n = 1368). After treatment (11 studies), RT increased lean mass with moderate heterogeneity {0.41 kg [95% confidence interval (CI) 0.05, 0.76], p = 0.029; I2 = 47.1%, p = 0.02} and decreased fat mass with substantial heterogeneity (− 0.59 kg [95% CI − 1.05, − 0.12], p = 0.019; I2 = 69.1%, p < 0.001). During treatment (4 studies), RT did not increase lean mass (0.71 kg [95% CI − 0.04, 1.45], p = 0.05; I2 = 0.0%, p = 0.75) or reduce fat mass (0.00 kg [95% CI − 5.31, 5.30], p = 0.99; I2 = 0.0%, p = 0.62), both with no heterogeneity.

Conclusion

Modest improvements in body composition were observed following RT after cancer treatment; however, no changes were observed during treatment. These adaptations are markedly lower than those observed in healthy cohorts but may be clinically meaningful for the cancer survivorship population. At present it is unclear if these diminished adaptations are due to ineffective exercise prescriptions in cancer cohorts or due to an innate anabolic resistance as a result of cancer and its treatments.

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Abbreviations

BMI:

Body mass index

RT:

Resistance training

RM:

Repetition maximum

DXA:

Dual-energy X-ray absorptiometry

MRI:

Magnetic resonance imaging

CT:

Computerized tomography

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Authors and Affiliations

  1. Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, NSW, Australia

    Briana Clifford, Sean Koizumi, Michael A. Wewege, Lauren Ha, Eliza Macdonald & Amanda D. Hagstrom

  2. Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia

    Michael A. Wewege & Hayley B. Leake

  3. IIMPACT in Health, University of South Australia, Adelaide, SA, Australia

    Hayley B. Leake

  4. Exercise Science Department, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Ciaran M. Fairman

Authors
  1. Briana Clifford
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  2. Sean Koizumi
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  3. Michael A. Wewege
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  4. Hayley B. Leake
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  5. Lauren Ha
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  8. Amanda D. Hagstrom
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Corresponding author

Correspondence to Amanda D. Hagstrom.

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Funding

The authors disclose no funding was received for this project. Michael A. Wewege was supported by a Postgraduate Scholarship from the National Health and Medical Research Council of Australia, a School of Medical Sciences Top-Up Scholarship from the University of New South Wales, and a PhD Supplementary Scholarship from Neuroscience Research Australia. Hayley B. Leake was supported by an Australian Government Research Training Program Scholarship.

Conflicts of interest

Briana Clifford, Sean Koizumi, Michael A. Wewege, Hayley B. Leake, Lauren Ha, Eliza Macdonald, Ciaran M. Fairman and Amanda D. Hagstrom declare they have no conflicts of interest.

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Availability of data and material

The data and R script used in the meta-analysis are also available on the Open Science Framework (osf.io/x6z72).

Author contributions

Conceptualization: BC, ADH. Methodology: BC, ADH, MAW. Formal analysis: MAW. Investigation: all authors. Project administration: ADH. Validation: ADH, BC. Supervision: ADH. Visualization: MAW. Writing—original draft: BC, ADH. Writing—review and editing: all authors.

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Clifford, B., Koizumi, S., Wewege, M.A. et al. The Effect of Resistance Training on Body Composition During and After Cancer Treatment: A Systematic Review and Meta-Analysis. Sports Med 51, 2527–2546 (2021). https://doi.org/10.1007/s40279-021-01542-6

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  • DOI: https://doi.org/10.1007/s40279-021-01542-6

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