Sasha Riley, Lauren C. Bates, Cameron K. Stopforth, Kaileigh Moertl, Kyle M. Edgar, Lee Stoner, FACSM, Erik D. Hanson, FACSM. University of North Carolina at Chapel Hill, Chapel Hill, NC.

Introduction and Objective: Breast (BCa) and prostate (PCa) cancer are the most common malignancies. While survival rates are high, many survivors experience decreased quality of life (QoL) during and after treatment. Supervised and group exercise improves QoL in cancer survivors. However, those living in a rural community and those with restrictions due to the COVID-19 pandemic can experience decreased access to exercise facilities. Home-based exercise may provide a feasible alternative for cancer survivors. The objective of this meta-analysis was to consolidate the literature investigating the effects of home-based exercise on QoL in BCa/PCa survivors. All study types were eligible for inclusion. Methods: Electronicdatabases were searched from inception to July 2021. Effect sizes were calculated using pre- and post-QoL values for the exercise group(s) for each article. To account for the use of different QoL measures between-studies, standardized mean differences (SMD) were calculated. Effects estimates were pooled using a 3-level model with restricted maximum likelihood estimation. An SMD of <0.2, 0.2, 0.5, and 0.8 was defined as trivial, small, moderate, and large respectively. Results: Seventeen articles with 23 effects (n=639) met inclusion criteria. Home-based exercise led to small improvements in QoL [SMD=0.30, (95% CI 0.01, 0.60), p=0.042]. The QoL measurement type was a significant effect moderator (p=0.002), with the largest increase in QoL for the European Organization for Research and Treatment of Cancer QLQ-C30 [SMD=0.71 (95% CI 0.38, 1.03), p<0.001]. Neither intervention duration (p=0.148) or type (p=0.795), cancer type (p=0.483), or age (p=0.279) were significant effect moderators. Conclusions: Home-based exercise improves QoL in BCa/PCa survivors, independent of cancer type, intervention duration and type, or age. Therefore, home-based exercise is an efficacious alternative option to improve QoL for BCa and PCa survivors who live in rural communities, who lack access to supervised training, or who cannot use gym facilities due to lasting pandemic safety restrictions.

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