Journal Article

DKFZ-2025-01405

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Exercise effects on symptoms of depression and anxiety vary by patient, clinical, and intervention characteristics in cancer survivors: Results from pooled analyses of individual participant data of 26 RCTs.

Kenkhuis, M.-F. ; Doorenbos, M. ; Mast, I. H. ; Aaronson, N. K. ; van Beurden, M. ; Bohus, M. ; Courneya, K. S. ; Daley, A. J. ; Galvão, D. A. ; Goedendorp, M. M. ; van Harten, W. H. ; Hayes, S. C. ; Hiensch, A. E. ; Irwin, M. L. ; Kersten, M. J. ; Knoop, H. ; May, A. M. ; McConnachie, A. ; van Mechelen, W. ; Mutrie, N. ; Newton, R. U. ; Nollet, F. ; Oldenburg, H. S. ; Schmidt, M.DKFZ* ; Schmitz, K. H. ; Schulz, K.-H. ; Sonke, G. S. ; Steindorf, K.DKFZ* ; Stuiver, M. M. ; Taaffe, D. R. ; Thorsen, L. ; Velthuis, M. J. ; Wiskemann, J. ; Mesters, I. ; Ulrich, C. M. ; van Vulpen, J. K. ; Custers, J. A. E. ; Buffart, L. M.

2025
Springer New York,NY

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Please use a persistent id in citations: doi:10.1007/s00520-025-09646-9

Abstract: This study aimed to investigate whether socio-demographic, clinical, and intervention-related variables moderate the effects of exercise on depression and anxiety symptoms in cancer survivors.Data from 26 RCTs in the POLARIS database were analyzed using a one-step individual participant data (IPD) meta-analytic approach with linear mixed models to assess exercise effects on depression and anxiety symptoms (z-scores). Interaction terms were added to these models to explore moderators. Results are presented as betas (corresponding to Cohen's d effect size).Albeit statistically significant, exercise demonstrated negligible effects on symptoms of depression (β = - 0.11; 95% CI = - 0.16; - 0.06) and anxiety (β = - 0.07; 95% CI = - 0.12; - 0.02) compared to controls. The effects of exercise interventions on depressive symptoms were larger for patients who were not living with a partner (β = - 0.23; 95% CI = - 0.35; - 0.11), had a low/medium education level (β = - 0.14; 95% CI = - 0.21; - 0.07), and who had moderate-to-severe symptoms of depression at baseline (β = - 0.30; 95% CI = - 0.43; - 0.16). Patients with moderate-to-severe symptoms of depression at baseline combined with those not living with a partner or a low/medium education level yielded the largest effect size through exercise (β = - 0.61; 95% CI = - 0.89; - 0.33 and β = - 0.37; 95% CI = - 0.57; - 0.17, respectively). Effects on anxiety symptoms were larger for patients with moderate-to-severe symptoms of anxiety at baseline (β = - 0.17; 95% CI = - 0.32; - 0.01) compared to those with no-to-mild symptoms. Sex, age, cancer type, BMI, and intervention-related variables did not moderate the exercise effects.The findings of this study highlight the heterogeneous response to exercise interventions across various patient subgroups. Patients with moderate-to-severe anxiety or depression, those with a low/medium education, and those not living together with a partner may particularly benefit.

Keyword(s): Humans (MeSH) ; Anxiety: therapy (MeSH) ; Anxiety: etiology (MeSH) ; Depression: therapy (MeSH) ; Depression: etiology (MeSH) ; Exercise: psychology (MeSH) ; Randomized Controlled Trials as Topic (MeSH) ; Male (MeSH) ; Female (MeSH) ; Neoplasms: psychology (MeSH) ; Cancer Survivors: psychology (MeSH) ; Middle Aged (MeSH) ; Survivors: psychology (MeSH) ; Exercise Therapy: methods (MeSH) ; Adult (MeSH) ; Anxiety ; Cancer survivors ; Depression ; Distress ; Exercise ; Moderators

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Contributing Institute(s):

1. Bewegung, Krebsprävention und Survivorship (C110)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2025

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DEAL Springer ; DEAL Springer ; Ebsco Academic Search ; Essential Science Indicators ; IF < 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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