LAUSR

OBJECTIVE To systematically review the evidence regarding rehabilitation interventions targeting optimal physical or cognitive function in adults with a history of cancer, and describe the breadth of evidence as well as strengths and limitations across a range of functional domains DATA SOURCES: PubMed, CINAHL Plus, Scopus, Web of Science, EMBASE. The time scope was January 2008 - April 2019. STUDY SELECTION Prospective, controlled trials including single- and multi-arm cohorts investigating rehabilitative interventions for cancer survivors at any point in the continuum of care were included, if studies included a primary functional outcome measure. Secondary data analyses and pilot/feasibility studies were excluded. Full text review identified 362 studies for inclusion. DATA EXTRACTION Extraction was performed by co-author teams, and quality and bias assessed using the American Academy of Neurology (AAN) Classification of Evidence Scheme (Class I-IV). DATA SYNTHESIS Studies for which the functional primary endpoint achieved significance were categorized into 9 functional areas foundational to cancer rehabilitation: 1) quality of life (109 studies); 2) activities of daily living (61 studies); 3) fatigue (59 studies); 4) functional mobility (55 studies); 5) exercise behavior (37 studies); 6) cognition (20 studies); 7) communication (10 studies); 8) sexual function (6 studies); and 9) return to work (5 studies). Most studies were categorized as class III in quality/bias. Averaging results found within each of the functional domains, 71% of studies reported statistically significant results following cancer rehabilitation intervention(s) for at least one functional outcome. CONCLUSIONS These findings provide evidence supporting the efficacy of rehabilitative interventions for individuals with a cancer history. The findings should be balanced with the understanding that many studies had moderate risk of bias and/or limitations in study quality by AAN criteria. These results may provide a foundation for future work to establish clinical practice guidelines for rehabilitative interventions across cancer disease types.