This individual patient data meta-analysis aimed to evaluate the effects of exercise on quality of life (QoL) and physical function (PF) in patients with cancer, and to identify moderator effects of demographic (age, sex, marital status, education), clinical (body mass index, cancer type, presence of metastasis), intervention-related (intervention timing, delivery mode and duration, and type of control group), and exercise-related (exercise frequency, intensity, type, time) characteristics. Relevant published and unpublished studies were identified in September 2012 via PubMed, EMBASE, PsycINFO, and CINAHL, reference checking and personal communications. Principle investigators of all 69 eligible trials were requested to share IPD from their study. IPD from 34 randomised controlled trials (n=4519 patients) that evaluated the effects of exercise compared to a usual care, wait-list or attention control group on QoL and PF in adult patients with cancer were retrieved and pooled. Linear mixed-effect models were used to evaluate the effects of the exercise on post-intervention outcome values (z-score) adjusting for baseline values. Moderator effects were studies by testing interactions. Exercise significantly improved QoL (β=0.15, 95%CI=0.10;0.20) and PF (β=0.18, 95%CI=0.13;0.23). The effects were not moderated by demographic, clinical or exercise characteristics. Effects on QoL (βdifference_in_effect=0.13, 95%CI=0.03;0.22) and PF (βdifference_in_effect=0.10, 95%CI=0.01;0.20) were significantly larger for supervised than unsupervised interventions. In conclusion, exercise, and particularly supervised exercise, effectively improves QoL and PF in patients with cancer with different demographic and clinical characteristics during and following treatment. Although effect sizes are small, there is consistent empirical evidence to support implementation of exercise as part of cancer care.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Smartphone apps are a promising tool for delivering accessible and appealing physical activity interventions. Objective: This systematic review and meta-analysis aimed to determine the effectiveness of smartphone apps for increasing objectively measured physical activity in adults. Methods: Seven electronic databases (Embase, Emcare, Medline, Scopus, Sport Discus, The Cochrane Library and Web of Science) were searched from 2007 to January 2018. Following the PICOS format, studies were eligible if they were randomised-controlled trials involving adults, used a smartphone app as the primary or stand-alone component of the physical activity intervention, used a no or minimal intervention control condition, and measured objective physical activity either in the form of minutes of moderate to vigorous physical activity (MVPA) or steps. Study quality was assessed using a 25-item tool based on the CONSORT Checklist. A meta-analysis of study effects was conducted using a random-effects model approach. Sensitivity analyses were conducted to examine whether intervention effectiveness differed on the basis of intervention length, target behaviour (physical activity alone, vs physical activity in combination with other health behaviours) or target population (general adult population vs specific health populations). Results: Following the removal of duplicates, a total of 6170 studies were identified from the original database search. Nine studies, involving a total of 1740 participants, were identified as meeting eligibility criteria for inclusion in this review. Of these, six studies could be included in a meta-analysis of the effects of physical activity apps on steps/day. In comparison to the control conditions, smartphone apps produced a non-significant (P = .19) increase in participants’ average steps per day, with mean difference between groups of 476.75 steps/day (95% CI = -229.57 to 1183.07). Sensitivity analyses suggested that physical activity programs with a duration < 3 months were more effective than apps evaluated across > 3 months (P = .01) and that physical activity apps that targeted physical activity in isolation were more effective than apps that targeted physical activity in combination with diet (P = .04). Physical activity app effectiveness did not appear to differ on the basis of target population. Conclusions: This meta-analysis provides modest evidence supporting the effectiveness of smartphone apps to increase physical activity. To date, apps have been most effective in the short term (e.g. up to 3 months). Future research is needed to understand the time course of intervention effects and to investigate strategies to sustain intervention effects over time.

To examine the effectiveness of interventions aimed at improving physical activity, diet, and/or weight-related behaviors amongst university/college students. Five online databases were searched (January 1970 to April 2014). Experimental study designs were eligible for inclusion. Data extraction was performed by one reviewer using a standardized form developed by the researchers and checked by a second reviewer. Data were described in a narrative synthesis and meta-analyses were conducted when appropriate. Study quality was also established. Forty-one studies were included; of these, 34 reported significant improvements in one of the key outcomes. Of the studies examining physical activity 18/29 yielded significant results, with meta-analysis demonstrating significant increases in moderate physical activity in intervention groups compared to control. Of the studies examining nutrition, 12/24 reported significantly improved outcomes; only 4/12 assessing weight loss outcomes found significant weight reduction. This appears to be the first systematic review of physical activity, diet and weight loss interventions targeting university and college students. Tertiary institutions are appropriate settings for implementing and evaluating lifestyle interventions, however more research is needed to improve such strategies.