The quality of evidence is downgraded by imprecise results (wide confidence intervals).
A Cochrane review [Abstract] 1 included 12 studies with a total of 1669 participants with a range of cancer diagnoses. The interventions were multidimensional rehabilitation programs (MDRP) aiming at improving physical and emotional symptoms, such as fatigue, reduced muscle strength and weight gain, anxiety and depression. The interventions consisted of both physical component (e.g. exercise, dietary regime) and a psychosocial component (e.g. counselling, cognitive behavioural therapy, psycho-educational strategies). Control group received standard of care or a lesser form of intervention.
Participants who received MDRP showed a consistent improvement in their physical functioning following the intervention compared to control participants. MDRPs which targeted only one specific behaviour area, such as diet, physical activity or stress, appeared to be more effective than programmes which attempted to address several different behaviours. In addition, programmes that comprised participants with different types of cancer compared to cancer site-specific programmes were more likely to show positive improvements in physical outcomes. The most effective mode of service delivery appeared to be face-to-face contact, with usually a nurse or physical therapist, supplemented with at least one follow-up telephone call. There was no evidence to indicate that MDRPs which lasted longer than six months improved outcomes beyond the level attained at six months. In addition, there was no evidence to suggest that services were more effective if they were delivered by a particular type of health professional.
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