Effects of Physical Exercises in Patients Under Palliative Chemotherapy

Revisão Sistemática

Abstract

Introduction: Ageing in Brazil moves forward with great strides, approximately 14% of the Brazilian population will be older in 2020. Associated with the aging was the increased prevalence of chronic non-communicable diseases (NCDs) responsible for the prejudice of quality of life and leading causes of death in the world. Tumors are the second most prevalent NCD and require many resources in health, starting with the variety and high cost of your treatment. Chemotherapy is one of the treatments of choice for neoplasm, and when we want to use it for the control of symptoms of the patient with a disease in advanced stage, we opt for the palliative chemotherapy. However, chemotherapy can promote different symptoms in the patient as fatigue or peripheral neuropathy, which is why physical exercises have been strongly recommended in this group of patients. Objective: To verify the effects of physical exercises on patients undergoing palliative chemotherapy. Method: A systematic review, followed by the guidelines PRISMA on electronic database’s Lilacs, MedLine, PEDro, Clinical Trial and Scielo, consulted by keywords: drug therapy, severity of illness index, rehabilitation, physical exercise, and palliative care. We have included articles in Portuguese and English with no delimitation of data, including clinical whose intervention was the application of physical exercise. The assessment of the methodological quality of these articles was made from the application of the scale Cochrane of risk of bias. Results: Ten articles were selected, and the risk of bias was evidenced as follows, (five with low risk; three with uncertain bias; and two assessed with high risk. All the studies observed significant improvement in the intervention group (physical exercise) compared with the control in the following outcomes: quality of life, controlling symptoms and autonomy. As for the type of exercise used in the studies, only five articles have compared different types of exercises (aerobic, resistance or mixed) and found no statistical difference between them. Four other articles used, only, a type of exercise and, only one study used electrostimulation as intervention. Electrostimulation did not promote progress in the level of physical activity, muscular strength of the groups tested, and in control of symptoms (pain and fatigue). Conclusion: Despite the availability of a few studies in the literature, conducting physical exercises seem to contribute to improvement of muscular strength, quality of life, symptom control and maintenance of functionality in patients undergoing palliative chemotherapy.