The Effect of Exercise on Cancer-Related Cognitive Impairment and Applications for Physical Therapy: Systematic Review of Randomized Controlled Trials

Overview

Journal Phys Ther

Publisher Oxford University Press

Specialty Rehabilitation Medicine

Date 2020 Feb 18

PMID 32065236

Citations 59

Authors

Kristin L Campbell

Kendra Zadravec

Kelcey A Bland

Elizabeth Chesley

Florian Wolf

Michelle C Janelsins

Affiliations

Soon will be listed here.

Abstract

Background: Cancer-related cognitive impairment (CRCI), often called "chemo-brain" or "chemo-fog," is a common side effect among adults with cancer, which can persist well after treatment completion. Accumulating evidence demonstrates exercise can improve cognitive function in healthy older adults and adults with cognitive impairments, suggesting exercise may play a role in managing CRCI.

Purpose: The purpose was to perform a systematic review of randomized controlled trials (RCTs) to understand the effect of exercise on CRCI.

Data Sources: Relevant literature was retrieved from CINAHL, Medline (Ovid), and EMBASE.

Study Selection: Eligible articles were RCTs that prescribed aerobic, resistance, combined aerobic/resistance, or mind-body (eg, yoga or Qigong) exercise during or following cancer treatment and included cognitive function outcome measures.

Data Extraction: Descriptive information and Cohen d effect sizes were directly extracted or calculated for included trials.

Data Synthesis: Twenty-nine trials were included in the final analysis. A statistically significant effect of exercise on self-reported cognitive function, both during and postadjuvant treatment, was reported in 12 trials (41%) (Cohen d range: 0.24-1.14), most commonly using the EORTC QLQ-C30. Ten trials (34%) performed neuropsychological testing to evaluate cognitive function; however, only 3 trials in women with breast cancer reported a significant effect of exercise (Cohen d range: 0.41-1.47).

Limitations: Few RCTs to date have evaluated the effect of exercise on CRCI as a primary outcome. Twenty-six trials (90%) in this review evaluated CRCI as secondary analyses.

Conclusions: Evidence supporting exercise as a strategy to address CRCI is limited. Future research evaluating CRCI as a primary outcome, including self-reported and objective measures, is needed to confirm the possible role of exercise in preventing and managing cognitive impairments in adults with cancer.

Citing Articles

Changes in EEG Microstate Dynamics and Cognition Post-Chemotherapy in People With Breast Cancer.

Damji S, Sattari S, Zadravec K, Campbell K, Brunet J, Virji-Babul N Brain Behav. 2025; 15(3):e70335.

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Risk factors and prediction model for cancer-related cognitive impairment in thyroid cancer patients.

Ni T, Sun J, He Q, Dai Y, Wang X, Yu E Am J Cancer Res. 2025; 15(1):153-167.

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Efficacy of acupuncture in treating chemotherapy-related cognitive impairment in breast cancer patients: A systematic review and meta-analysis protocol.

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The MASCC COG-IMPACT: An unmet needs assessment for cancer-related cognitive impairment impact developed by the Multinational Association of Supportive Care in Cancer.

Haywood D, Chan A, Chan R, Baughman F, Dauer E, Dhillon H Support Care Cancer. 2025; 33(2):120.

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Effect of physical exercise on white matter microstructure in chemotherapy-treated breast cancer patients: a randomized controlled trial (PAM study).

Koevoets E, Schagen S, May A, Geerlings M, Witlox L, van der Wall E Brain Imaging Behav. 2025; .

PMID: 39804457 DOI: 10.1007/s11682-024-00965-9.

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