Effect of exercise on cancer patients with anxiety and depression during chemotherapy:a meta-analysis

YANG Yicheng; WANG Dandan; SHEN Qunce; ZHANG Lei; WU Xueping

doi:10.3969/j.issn.1006-9771.2025.02.008

Abstract：Objective To explore the effect of exercise on anxiety and depression in cancer patients during chemotherapy,as well as the optimal exercise dosage. Methods A PICO framework was constructed,and randomized controlled trials(RCTs)on the effect of exercise on anxi-ety and depression in cancer patients during chemotherapy were retrieved from databases of PubMed,Web of Sci-ence,Cochrane Library,Embase,Medline,CNKI,VIP and Wanfang data,from the establishment to November,2023.The quality of the literature was evaluated with Cochrane Risk of Bias Tool and Physiotherapy Evidence Database(PEDro)scale.Data were synthesized and analyzed using RevMan 5.3,and the risk of bias was evaluat-ed using Stata 18.0. Results A total of 13 RCTs involving 1 340 subjects were included.The scores of PEDro scale were five to eight.Exer-cise interventions significantly improved anxiety(SMD=-0.70,95%CI-1.18 to-0.22,P=0.004)and depres-sion(SMD=-0.89,95%CI-1.43 to-0.34,P=0.002)compared to the control group.Subgroup analyses showed that,the exercise effect on anxiety was less than 45 minutes a time(SMD=-0.26,95%CI-0.46 to-0.05,P=0.01),more than three times a week(SMD=-0.26,95%CI-0.46 to-0.05,P=0.01),and less than twelve weeks(SMD=-0.21,95%CI-0.36 to-0.07,P=0.005).For depression,it was less than 45 minutes a time(SMD=-0.69,95%CI-1.29 to-0.08,P=0.03),more than three times a week(SMD=-0.69,95%CI-1.29 to-0.08,P=0.03),and less than twelve weeks(SMD=-0.52,95%CI-0.92 to-0.13,P=0.01).Moder-ate to high-intensity exercise interventions significantly outperformed the control group in improving anxiety(SMD=-0.21,95%CI-0.37 to-0.06,P=0.007)and depression(SMD=-0.21,95%CI-0.41 to-0.01,P=0.04). Conclusion Exercise interventions can effectively improve anxiety and depression in cancer patients during chemothera-py,and it suggests for high-intensity exercise,less than 45 minutes a time,more than three times a week,and less than twelve weeks.