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Purpose <p>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.</p> Methods <p>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 <i>d</i> effect size).</p> Results <p>Albeit statistically significant, exercise demonstrated negligible effects on symptoms of depression (<i>β</i> = − 0.11; 95% CI = − 0.16; − 0.06) and anxiety (<i>β</i> = − 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 (<i>β</i> = − 0.23; 95% CI = − 0.35; − 0.11), had a low/medium education level (<i>β</i> = − 0.14; 95% CI = − 0.21; − 0.07), and who had moderate-to-severe symptoms of depression at baseline (<i>β</i> = − 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 (<i>β</i> = − 0.61; 95% CI = − 0.89; − 0.33 and <i>β</i> = − 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 (<i>β</i> = − 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.</p> Conclusion <p>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.</p>

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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

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  • 发表日期：

    2025年7月1日

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  • Marlou-Floor Kenkhuis,
  • Meike Doorenbos,
  • Isa H. Mast,
  • Neil K. Aaronson,
  • Marc van Beurden,
  • Martin Bohus,
  • Kerry S. Courneya,
  • Amanda J. Daley,
  • Daniel A. Galvão,
  • Martine M. Goedendorp,
  • Wim H. van Harten,
  • Sandi C. Hayes,
  • Anouk E. Hiensch,
  • Melinda L. Irwin,
  • Marie José Kersten,
  • Hans Knoop,
  • Anne M. May,
  • Alex McConnachie,
  • Willem van Mechelen,
  • Nanette Mutrie,
  • Robert U. Newton,
  • Frans Nollet,
  • Hester S. Oldenburg,
  • Martina E. Schmidt,
  • Kathryn H. Schmitz,
  • Karl-Heinz Schulz,
  • Gabe S. Sonke,
  • Karen Steindorf,
  • Martijn M. Stuiver,
  • Dennis R. Taaffe,
  • Lene Thorsen,
  • Miranda J. Velthuis,
  • Joachim Wiskemann,
  • Ilse Mesters,
  • Cornelia M. Ulrich,
  • Jonna K. van Vulpen,
  • Jose A. E. Custers,
  • Laurien M. Buffart

摘要

Purpose

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.

Methods

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).

Results

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.

Conclusion

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.