Cancer is a chronic disease requiring long-term treatment. Exercise interventions are increasingly being recognized as an important part of treatment and supportive cancer care for patients and survivors. Previous reviews have evaluated the benefits of exercise interventions in populations of patients under supervision at a center, but none have explored the possibilities of a home-based (HB) approach in exercise during cancer rehabilitation and the period immediately following the end of cancer treatment. The aim of this descriptive systematic review was to identify the literature focusing on the health effects of HB exercise interventions in cancer survivors and to evaluate the methodological quality of the examined studies. Relevant studies were identified by a systematic search of PubMed and the Web of Science until January 2021. Nine randomized controlled trials were included. Most studies were on aerobic and resistance exercises, and the frequency, duration, intensity, and modality varied across the different interventions. Improvements in cardiorespiratory fitness (CRF), physical activity (PA) levels, fatigue, health-related quality of life (HRQOL), and body composition have been reported. However, all the studies were limited in methodology and the reporting of results. Nevertheless, the evidence in this new area, despite the methodological limitations of the studies, suggests that HB exercise interventions are feasible, and may provide physiological and psychological benefits for cancer survivors during the rehabilitation period. A methodologically rigorous design for future research is essential for making progress in this field of study.

Department of Internal Medicine Hematology and Oncology University Hospital Brno 62500 Brno Czech Republic

Department of Neurology University Hospital Brno 62500 Brno Czech Republic

Department of Public Health Faculty of Medicine Masaryk University 62500 Brno Czech Republic

Department of Rehabilitation University Hospital Brno 62500 Brno Czech Republic

Faculty of Medicine Masaryk University 62500 Brno Czech Republic

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Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A., Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J. Clin. 2020:1–41. doi: 10.3322/caac.21660. PubMed DOI

Shapiro C.L. Cancer survivorship. N. Engl. J. Med. 2018;379:2438–2450. doi: 10.1056/NEJMra1712502. PubMed DOI

Bower J.E. Cancer-related fatigue—Mechanisms, risk factors, and treatments. Nat. Rev. Clin. Oncol. 2014;11:597–609. doi: 10.1038/nrclinonc.2014.127. PubMed DOI PMC

Vejpongsa P., Yeh E.T. Prevention of anthracycline-induced cardiotoxicity: Challenges and opportunities. J. Am. Coll. Cardiol. 2014;64:938–945. doi: 10.1016/j.jacc.2014.06.1167. PubMed DOI

Awad S., Tan B.H., Cui H., Bhalla A., Fearon K.C.H., Parsons S.L., Catton J.A., Lobo D.N. Marked changes in body composition following neoadjuvant chemotherapy for oesophagogastric cancer. Clin. Nutr. 2012;31:74–77. doi: 10.1016/j.clnu.2011.08.008. PubMed DOI

Curigliano G., Mayer E.L., Burstein H.J., Winer E.P., Goldhirsch A. Cardiac toxicity from systemic cancer therapy: A comprehensive review. Prog. Cardiovasc. Dis. 2010;53:94–104. doi: 10.1016/j.pcad.2010.05.006. PubMed DOI

Phillips J.L., Currow D.C. Cancer as a chronic disease. Collegian. 2010;17:47–50. doi: 10.1016/j.colegn.2010.04.007. PubMed DOI

Schmitz K.H., Campbell A.M., Stuiver M.M., Pinto B.M., Schwartz A.L., Morris G.S., Ligibel J.A., Cheville A., Galvão D.A., Alfano C.M. Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer. CA. Cancer J. Clin. 2019;69:468–484. doi: 10.3322/caac.21579. PubMed DOI PMC

Spence R.R., Heesch K.C., Brown W.J. Exercise and cancer rehabilitation: A systematic review. Cancer Treat. Rev. 2010;36:185–194. doi: 10.1016/j.ctrv.2009.11.003. PubMed DOI

Schmitz K.H., Holtzman J., Courneya K.S., Mâsse L.C., Duval S., Kane R. Controlled physical activity trials in cancer survivors: A systematic review and meta-analysis. Cancer Epidemiol. Biomark. Prev. 2005;14:1588–1595. doi: 10.1158/1055-9965.EPI-04-0703. PubMed DOI

Kruijsen-Jaarsma M., Revesz D., Bierings M.B., Buffart L.M., Takken T. Effects of exercise on immune function in patients with cancer: A systematic review. Exerc. Imunol. Rev. 2013;19:120–143. PubMed

Stubblefield M.D. The underutilization of rehabilitation to treat physical impairments in breast cancer survivors. PM R. 2017;9:317–323. doi: 10.1016/j.pmrj.2017.05.010. PubMed DOI

IJsbrandy C., Hermens R.P.M., Boerboom L.W.M., Gerritsen W.R., van Harten W.H., Ottevanger P.B. Implementing physical activity programs for patients with cancer in current practice: Patients’ experienced barriers and facilitators. J. Cancer Surviv. 2019;13:703–712. doi: 10.1007/s11764-019-00789-3. PubMed DOI PMC

Rossi A., Garber C.E., Ortiz M., Shankar V., Goldberg G.L., Nevadunsky N.S. Feasibility of a physical activity intervention for obese, socioculturally diverse endometrial cancer survivors. Gynecol. Oncol. 2016;142:304–310. doi: 10.1016/j.ygyno.2016.05.034. PubMed DOI

Stefani L., Klika R., Mascherini G., Mazzoni F., Lunghi A., Petri C., Petreni P., Di Costano F., Maffulli N., Galanti G. Effects of a home-based exercise rehabilitation program for cancer survivors. J. Sports Med. Phys. Fitness. 2019;59:846–852. doi: 10.23736/S0022-4707.18.08908-9. PubMed DOI

Scherrenberg M., Wilhelm M., Hansen D., Völler H., Cornelissen V., Frederix I., Kemps H., Dendale P. The future is now: A call for action for cardiac telerehabilitation in the COVID-19 pandemic from the secondary prevention and rehabilitation section of the European Association of Preventive Cardiology. Eur. J. Prev. Cardiol. 2020;27:1–21. doi: 10.1177/2047487320939671. PubMed DOI PMC

Smart N.A., Waldron M., Ismail H., Giallauria F., Vigorito C., Cornelissen V., Dieberg G. Validation of a new tool for the assessment of study quality and reporting in exercise training studies. Int. J. Evid. Based Healthc. 2015;13:9–18. doi: 10.1097/XEB.0000000000000020. PubMed DOI

McNeil J., Brenner D.R., Stone C.R., O’Reilly R., Ruan Y., Vallance J.K., Courneya K.S., Thorpe K.E., Klein D.J., Friedenreich C.M. Activity Tracker to Prescribe Various Exercise Intensities in Breast Cancer Survivors. Med. Sci. Sports Exerc. 2019;51:930–940. doi: 10.1249/MSS.0000000000001890. PubMed DOI

Alibhai S.M.H., Santa Mina D., Ritvo P., Tomlinson G., Sabiston C., Krahn M., Durbano S., Matthew A., Warde P., O’Neill M., et al. A phase II randomized controlled trial of three exercise delivery methods in men with prostate cancer on androgen deprivation therapy. BMC Cancer. 2019;19:2. doi: 10.1186/s12885-018-5189-5. PubMed DOI PMC

Gehring K., Kloek C.J., Aaronson N.K., Janssen K.W., Jones L.W., Sitskoorn M.M., Stuiver M.M. Feasibility of a home-based exercise intervention with remote guidance for patients with stable grade II and III gliomas: A pilot randomized controlled trial. Clin. Rehabil. 2018;32:352–366. doi: 10.1177/0269215517728326. PubMed DOI PMC

Møller T., Andersen C., Lillelund C., Bloomquist K., Christensen K.B., Ejlertsen B., Tuxen M., Oturai P., Breitenstein U., Kolind C., et al. Physical deterioration and adaptive recovery in physically inactive breast cancer patients during adjuvant chemotherapy: A randomised controlled trial. Sci. Rep. 2020;10:9710. doi: 10.1038/s41598-020-66513-9. PubMed DOI PMC

Hvid T., Lindegaard B., Winding K., Iversen P., Brasso K., Solomon T.P., Pedersen B.K., Hojman P. Effect of a 2-year home-based endurance training intervention on physiological function and PSA doubling time in prostate cancer patients. Cancer Causes Control. 2016;27:165–174. doi: 10.1007/s10552-015-0694-1. PubMed DOI

Cornette T., Vincent F., Mandigout S., Antonini M.T., Leobon S., Labrunie A., Venat L., Lavau-Denes S., Tubiana-Mathieu N. Effects of home-based exercise training on VO2 in breast cancer patients under adjuvant or neoadjuvant chemotherapy (SAPA): A randomized controlled trial. Eur. J. Phys. Rehabil. Med. 2016;52:223–232. PubMed

Van Waart H., Stuiver M.M., van Harten W.H., Geleijn E., Kieffer J.M., Buffart L.M., de Maaker-Berkhof M., Boven E., Schrama J., Geenen M.M., et al. Effect of Low-Intensity Physical Activity and Moderate to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial. J. Clin. Oncol. 2015;33:1918–1927. doi: 10.1200/JCO.2014.59.1081. PubMed DOI

Husebø A.M., Dyrstad S.M., Mjaaland I., Søreide J.A., Bru E. Effects of scheduled exercise on cancer-related fatigue in women with early breast cancer. Sci. World J. 2014;15:1–9. doi: 10.1155/2014/271828. PubMed DOI PMC

Pinto B.M., Papandonatos G.D., Goldstein M.G., Marcus B.H., Farrell N. Home-based physical activity intervention for colorectal cancer survivors. Psychooncology. 2013;22:54–64. doi: 10.1002/pon.2047. PubMed DOI

Stevinson C., Lawlor D.A., Fox K.R. Exercise interventions for cancer patients: Systematic review of controlled trials. Cancer Causes Control. 2004;15:1035–1056. doi: 10.1007/s10552-004-1325-4. PubMed DOI

Maltser S., Cristian A., Silver J.K., Morris G.S., Stout N.L. A Focused Review of Safety Considerations in Cancer Rehabilitation. PM & R. 2017;9:415–428. doi: 10.1016/j.pmrj.2017.08.403. PubMed DOI PMC

Kampshoff C.S., Jansen F., van Mechelen W., May A.M., Brug J., Chinapaw M.J., Buffart L.M. Determinants of exercise adherence and maintenance among cancer survivors: A systematic review. Int. J. Behav. Nutr. Phys. Act. 2014;11:80. doi: 10.1186/1479-5868-11-80. PubMed DOI PMC

Courneya K.S., Segal R.J., Gelmon K., Reid R.D., Mackey J.R., Friedenreich C.M., Proulx C., Lane K., Ladha A.B., Vallance J.K., et al. Predictors of supervised exercise adherence during breast cancer chemotherapy. Med. Sci. Sports Exerc. 2008;40:1180–1187. doi: 10.1249/MSS.0b013e318168da45. PubMed DOI

Kampshoff C.S., van Mechelen W., Schep G., Nijziel M.R., Witlox L., Bosman L., Chinapaw M.J., Brug J., Buffart L.M. Participation in and adherence to physical exercise after completion of primary cancer treatment. Int. J. Behav. Nutr. Phys. Act. 2016;13:100. doi: 10.1186/s12966-016-0425-3. PubMed DOI PMC

Scott J.M., Zabor E.C., Schwitzer E., Koelwyn G.J., Adams S.C., Nilsen T.S., Moskowitz C.S., Matsoukas K., Iyengar N.M., Dang C.T., et al. Efficacy of Exercise Therapy on Cardiorespiratory Fitness in Patients with Cancer: A Systematic Review and Meta-Analysis. J. Clin. Oncol. 2018;36:2297–2305. doi: 10.1200/JCO.2017.77.5809. PubMed DOI PMC

Gilchrist S.C., Barac A., Ades P.A., Alfano C.M., Franklin B.A., Jones L.W., La Gerche A., Ligibel J.A., Lopez G., Madan K. American Heart Association Exercise, Cardiac Rehabilitation, and Secondary Prevention Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; and Council on Peripheral Vascular Disease. Cardio-Oncology Rehabilitation to Manage Cardiovascular Outcomes in Cancer Patients and Survivors: A Scientific Statement from the American Heart Association. Circulation. 2019;139:997–1012. doi: 10.1161/CIR.0000000000000679. PubMed DOI PMC

Brown J.C., Troxel A.B., Ky B., Damjanov N., Zemel B.S., Rickels M.R., Rhim A.D., Rustgi A.K., Courneya K.S., Schmitz K.H. Dose-response Effects of Aerobic Exercise Among Colon Cancer Survivors: A Randomized Phase II Trial. Clin. Colorectal. Cancer. 2018;17:32–40. doi: 10.1016/j.clcc.2017.06.001. PubMed DOI PMC

Cormie P., Zopf E.M., Zhang X., Schmitz K.H. The Impact of Exercise on Cancer Mortality, Recurrence, and Treatment-Related Adverse Effects. Epidemiol. Rev. 2017;39:71–92. doi: 10.1093/epirev/mxx007. PubMed DOI

Schneider C.M., Hsieh C.C., Sprod L.K., Carter S.D., Hayward R. Effects of supervised exercise training on cardiopulmonary function and fatigue in breast cancer survivors during and after treatment. Cancer. 2007;110:918–925. doi: 10.1002/cncr.22862. PubMed DOI

Brown J.C., Huedo-Medina T.B., Pescatello. L.S., Pescatello S.M., Ferrer R.A., Johnson B.T. Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: A meta-analysis. Cancer Epidemiol. Biomark. Prev. 2011;20:123–133. doi: 10.1158/1055-9965.EPI-10-0988. PubMed DOI

Irwin M.L. Physical activity interventions for cancer survivors. Br. J. Sports Med. 2009;43:32–38. doi: 10.1136/bjsm.2008.053843. PubMed DOI

Maginador G., Lixandrão M.E., Bortolozo H.I., Vechin F.C., Sarian L.O., Derchain S., Telles G.D., Zopf E., Ugrinowitsch C., Conceição M.S. Aerobic Exercise-Induced Changes in Cardiorespiratory Fitness in Breast Cancer Patients Receiving Chemotherapy: A Systematic Review and Meta-Analysis. Cancers. 2020;12:2240. doi: 10.3390/cancers12082240. PubMed DOI PMC

Van Waart H., Stuiver M.M., van Harten W.H., Sonke G.S., Aaronson N.K. Design of the Physical exercise during Adjuvant Chemotherapy Effectiveness Study (PACES): A randomized controlled trial to evaluate effectiveness and cost-effectiveness of physical exercise in improving physical fitness and reducing fatigue. BMC Cancer. 2010;10:673. doi: 10.1186/1471-2407-10-673. PubMed DOI PMC

Angadi S.S., Mookadam F., Lee C.D., Tucker W.J., Haykowsky M.J., Gaesser G.A. High-intensity interval training vs. moderate-intensity continuous exercise training in heart failure with preserved ejection fraction: A pilot study. J. Appl. Physiol. 2015;119:753–758. doi: 10.1152/japplphysiol.00518.2014. PubMed DOI

Papathanasiou J.V., Petrov I., Tokmakova M.P., Dimitrova D.D., Spasov L., Dzhafer N.S., Tsekoura D., Dionyssiotis Y., Ferreira A.S., Lopes A.J., et al. Group-based cardiac rehabilitation interventions. A challenge for physical and rehabilitation medicine physicians: A randomized controlled trial. Eur. J. Phys. Rehabil. Med. 2020;56:479–488. doi: 10.23736/S1973-9087.20.06013-X. PubMed DOI

Cardinale D., Iacopo F., Cipolla C.M. Cardiotoxicity of Anthracyclines. Front. Cardiovasc. Med. 2020;7:26. doi: 10.3389/fcvm.2020.00026. PubMed DOI PMC

Mercurio V., Pirozzi F., Lazzarinim E., Marone G., Rizzo P., Agnetti G., Tocchetti C.G., Ghigo A., Ameri P. Models of Heart Failure Based on the Cardiotoxicity of Anticancer Drugs. J. Card. Fail. 2016;22:449–458. doi: 10.1016/j.cardfail.2016.04.008. PubMed DOI

Gielen S., Laughlin M.H., O’Conner C., Duncker D.J. Exercise training in patients with heart disease: Review of beneficial effects and clinical recommendations. Prog. Cardiovasc. Dis. 2015;57:347–355. doi: 10.1016/j.pcad.2014.10.001. PubMed DOI

Peçanha T., Goessler K.F., Roschel H., Gualano B. Social isolation during the COVID-19 pandemic can increase physical inactivity and the global burden of cardiovascular disease. Am. J. Physiol. Heart Circ. Physiol. 2020;318:1441–1446. doi: 10.1152/ajpheart.00268.2020. PubMed DOI PMC

Besnier F., Gayda M., Nigam A., Juneau M., Bherer L. Cardiac Rehabilitation During Quarantine in COVID-19 Pandemic: Challenges for Center-Based Programs. Arch. Phys. Med. Rehabil. 2020;101:1835–1838. doi: 10.1016/j.apmr.2020.06.004. PubMed DOI PMC

Peretti A., Amenta F., Tayebati S.K., Nittari G., Mahdi S.S. Telerehabilitation: Review of the State-of-the-Art and Areas of Application. JMIR Rehabil. Assist. Technol. 2017;4:e7. doi: 10.2196/rehab.7511. PubMed DOI PMC

Aragaki D., Luo J., Weiner E., Zhang G., Darvish B. Cardiopulmonary Telerehabilitation. Phys. Med. Rehabil. Clin. N. Am. 2021 doi: 10.1016/j.pmr.2021.01.004. in press. PubMed DOI

Etiwy M., Akhrass Z., Gillinov L., Alashi A., Wang R., Blackburn G., Gillinov S.M., Phelan D., Gillinov A.M., Houghtaling P.L., et al. Accuracy of wearable heart rate monitors in cardiac rehabilitation. Cardiovasc. Diagn. Ther. 2019;9:262–271. doi: 10.21037/cdt.2019.04.08. PubMed DOI PMC

Gilgen-Ammann R., Schweizer T., Wyss T. RR interval signal quality of a heart rate monitor and an ECG Holter at rest and during exercise. Eur. J. Appl. Physiol. 2019;119:1525–1532. doi: 10.1007/s00421-019-04142-5. PubMed DOI

Liu N., Huang R., Baldacchino T., Sud A., Sud K., Khadra M., Kim J. Telehealth for Noncritical Patients with Chronic Diseases During the COVID-19 Pandemic. J. Med. Internet Res. 2020;22:e19493. doi: 10.2196/19493. PubMed DOI PMC

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