Physiotherapy & Physical Rehabilitation

Aim: The purpose of this review was to investigate the effectiveness of supervised exercise program in comparison to the unsupervised exercise program in improving quality of life, maintaining functional activity and limiting fatigue in survivors of colorectal cancer by appraising the current evidence.Method: To meet the research question (i.e. What is the effectiveness of a supervised exercise program in comparison to the unsupervised exercise program in improving quality of life maintaining functional activity and limiting fatigue in survivors of colorectal cancer?), various electronic databases (i.e. AMED, MEDLINE, CINAHL, pedro, Academic Search Complete, sportdiscus, psycinfo) were systematically searched for relevant randomised controlled trials that met the inclusion and exclusion criteria. Primary outcomes of all relevant studies were assessed using CASP an Cochrane risk of bias tools. The primary outcome-the quality of life was measured in all eight studies selected for this review. Results: Eight rcts studies involving 996 participants with colorectal cancer were included in this review. The stage of cancer varied (stages I-III, Duke's stage A-C), and the period since therapy varied also across rcts from immediately after the surgery to up to five years. The majority of participants were male with an age range between 55 to 69 years old in both groups. All the selected studies have obtained ethical approval from their respective institutional boards the overall quality of included studies was high to good, indicating a reliable methodological quality and reveals a low risk of bias. Overall there was a significant improvement in the quality of life, functional activity and fatigue in both groups. Moreover, quality of life, functional activity and physical fitness seem to have a positive impact at a short time frame in the supervised group in comparing to the unsupervised group. However, at a longer time frame, the quality of life showed no significant difference between groups. According to fatigue level, after six months there was a significant improvement in fatigue level in the supervised group in comparing to the unsupervised group. Higher doses of exercise improved many parameters in hrqol compared to lower doses. Conclusion: This systematic review overall shows short-term benefits with low to medium intensity aerobics exercises in terms of physical fitness. There was no significant difference in the quality of life at a longer time frame between the supervised and unsupervised group. However, fatigue level showed a considerable improvement in a longer period in the supervised group compared to an unsupervised group.