Follow-up effects of exercise-based interventions on physical performance in cancer survivors: a systematic review and meta-analysis

Alexander M. Brooks; Brent Cunningham; Madelin R. Siedler; Sarah Burkart; Mark A. Sarzynski; Nathan H. Parker; Ciaran M. Fairman

doi:10.1007/s11764-026-02030-4

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Follow-up effects of exercise-based interventions on physical performance in cancer survivors: a systematic review and meta-analysis

Journal article

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Follow-up effects of exercise-based interventions on physical performance in cancer survivors: a systematic review and meta-analysis

Alexander M. Brooks, Brent Cunningham, Madelin R. Siedler, Sarah Burkart, Mark A. Sarzynski, Nathan H. Parker and Ciaran M. Fairman

Journal of Cancer Survivorship, Vol.Advanced access

02-May-2026

DOI: https://doi.org/10.1007/s11764-026-02030-4

PMID: 42069881

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Abstract

exercise oncology

cancer survivorship

cardiorespiratory fitness

muscular strength

walking capacity

Purpose Physical performance impairments are common in cancer survivors and can limit daily activities, quality of life, and long-term health. Although structured exercise programs have proven beneficial for improving physical performance, maintenance of these benefits is unclear. This study aimed to systematically evaluate whether improvements in physical performance are maintained following structured exercise oncology interventions. Methods A systematic search was conducted for randomized controlled trials (RCTs) published between January 1990 and March 2025. Eligible trials engaged adult cancer survivors in structured exercise interventions and reported objective measures of cardiorespiratory fitness, muscular strength, and/or walking capacity at the end of the intervention and ≥ 3 months after program completion. Data were pooled using random-effects meta-analyses with weighted mean differences (WMD) used to summarize effects. Results Twenty-four RCTs (2289 participants; mean follow-up post-intervention = 8 months) were included. Exercise significantly improved cardiorespiratory fitness at post-intervention (WMD = + 1.76 ml/kg/min; p = 0.008); however, improvements were attenuated at follow-up (WMD = + 1.24 ml/kg/min; p = 0.130). Similarly, upper and lower body strength improved post-intervention (WMD = + 3.35 kg; p = 0.001; WMD = + 12.7 kg; p = 0.045), but effects diminished at follow-up (WMD = + 1.80 kg; p = 0.081; WMD = + 10.0 kg; p = 0.093). In contrast, walking capacity increased post-intervention (WMD = + 40.3 m; p = 0.002) and remained elevated at follow-up (WMD = + 49.4 m; p = 0.006). Certainty of evidence ranged from very low to low across outcomes, primarily due to risk of bias, inconsistency, and imprecision in effect estimates. Conclusions Structured exercise interventions were found to produce short-term improvements in physical performance among cancer survivors. Although gains in cardiorespiratory fitness and muscular strength appeared to persist at follow-up, they were attenuated compared with post-intervention and supported by very low certainty evidence. In contrast, walking capacity demonstrated sustained improvements at follow-up, though the certainty of evidence remained low. Future work is needed to identify longer-term effects (> 12 months) and develop strategies to better maintain improved physical performance. Implications for Cancer Survivors While exercise programs can improve physical performance, these benefits may not persist without ongoing support. Cancer survivors should be encouraged to continue self-directed exercise after program completion, and exercise programs should incorporate strategies to maintain longer-term improvements in physical performance.

Details

Title: Follow-up effects of exercise-based interventions on physical performance in cancer survivors: a systematic review and meta-analysis
Authors: Alexander M. Brooks (Corresponding Author) - University of South Carolina
Brent Cunningham - University of the Sunshine Coast
Madelin R. Siedler - College of Saint Benedict and Saint John's University
Sarah Burkart - University of South Carolina
Mark A. Sarzynski - University of South Carolina
Nathan H. Parker - Moffitt Cancer Center
Ciaran M. Fairman - University of South Carolina
Publication details: Journal of Cancer Survivorship, Vol.Advanced access
Publisher: Springer New York LLC
DOI: 10.1007/s11764-026-02030-4
ISSN: 1932-2267
PMID: 42069881
Copyright note: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Data Availability: The datasets generated and analyzed during the current study are available in the open science repository, (osf.io/nf5rk).
Organisation Unit: School of Health
Language: English
Record Identifier: 991228953502621
Output Type: Journal article

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