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@ARTICLE{Kenkhuis:302865,
      author       = {M.-F. Kenkhuis and M. Doorenbos and I. H. Mast and N. K.
                      Aaronson and M. van Beurden and M. Bohus and K. S. Courneya
                      and A. J. Daley and D. A. Galvão and M. M. Goedendorp and
                      W. H. van Harten and S. C. Hayes and A. E. Hiensch and M. L.
                      Irwin and M. J. Kersten and H. Knoop and A. M. May and A.
                      McConnachie and W. van Mechelen and N. Mutrie and R. U.
                      Newton and F. Nollet and H. S. Oldenburg and M. Schmidt$^*$
                      and K. H. Schmitz and K.-H. Schulz and G. S. Sonke and K.
                      Steindorf$^*$ and M. M. Stuiver and D. R. Taaffe and L.
                      Thorsen and M. J. Velthuis and J. Wiskemann and I. Mesters
                      and C. M. Ulrich and J. K. van Vulpen and J. A. E. Custers
                      and L. M. Buffart},
      title        = {{E}xercise effects on symptoms of depression and anxiety
                      vary by patient, clinical, and intervention characteristics
                      in cancer survivors: {R}esults from pooled analyses of
                      individual participant data of 26 {RCT}s.},
      journal      = {Supportive care in cancer},
      volume       = {33},
      number       = {7},
      issn         = {0941-4355},
      address      = {New York,NY},
      publisher    = {Springer},
      reportid     = {DKFZ-2025-01405},
      pages        = {647},
      year         = {2025},
      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.},
      keywords     = {Humans / Anxiety: therapy / Anxiety: etiology / Depression:
                      therapy / Depression: etiology / Exercise: psychology /
                      Randomized Controlled Trials as Topic / Male / Female /
                      Neoplasms: psychology / Cancer Survivors: psychology /
                      Middle Aged / Survivors: psychology / Exercise Therapy:
                      methods / Adult / Anxiety (Other) / Cancer survivors (Other)
                      / Depression (Other) / Distress (Other) / Exercise (Other) /
                      Moderators (Other)},
      cin          = {C110},
      ddc          = {610},
      cid          = {I:(DE-He78)C110-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40591016},
      pmc          = {pmc:PMC12213934},
      doi          = {10.1007/s00520-025-09646-9},
      url          = {https://inrepo02.dkfz.de/record/302865},
}