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Purpose <p>Cancer-related pain resulting from tumors and long-term treatments significantly impacts the quality of life in breast cancer survivors. While exercise has been proven to alleviate pain, a standardized prescription is still lacking. This study explores the efficacy and optimal dosage of various exercise modalities for pain relief in breast cancer survivors, aiming to guide clinical practice and improve long-term outcomes.</p> Methods <p>Bayesian network and dose–response meta-analyses with a random-effects model were used to assess the effect of exercise on pain in breast cancer survivors. The evidence quality was evaluated using the Confidence in Network Meta-Analysis (CINeMA) web application.</p> Results <p>A total of 25 studies involving 1,899 patients were included. An inverted U-shaped dose–response relationship was observed between overall exercise and pain, with an effective dose range of 0–1300 metabolic equivalent of task minutes per week (MET-min/week) and maximum effect at 780 MET-min/week (SMD = 1.15, 95% CrI: 0.7, 1.61). When stratified by exercise type, aerobic exercise (0–140&#xa0;min/week), resistance training (0–140&#xa0;min/week), combined aerobic and resistance training (0–290&#xa0;min/week), yoga (0–220&#xa0;min/week), and walking (0–55&#xa0;min/week) all demonstrated significant associations with pain reduction. The comprehensive ranking suggested that 170&#xa0;min of combined aerobic and resistance training per week (SMD = 1.37, 95% CrI: 0.73, 2.07) may be the most effective type and dose for pain alleviation.</p> Conclusions <p>Combined aerobic and resistance training are recommended as the primary option for pain relief in breast cancer survivors, based on effect sizes, sample sizes, 95% CrI precision. However, due to the very low and low quality of evidence for several exercise modalities, high-quality randomized controlled trials are needed to validate the efficacy of the recommended dose ranges.</p>

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Evidence-based prescription: optimal exercise type and dose for pain management in breast cancer survivors—a systematic review and dose–response network meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月6日

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  • Hao Huang,
  • Xueying Chen,
  • Zhibo Wang,
  • Yifan Zhang

摘要

Purpose

Cancer-related pain resulting from tumors and long-term treatments significantly impacts the quality of life in breast cancer survivors. While exercise has been proven to alleviate pain, a standardized prescription is still lacking. This study explores the efficacy and optimal dosage of various exercise modalities for pain relief in breast cancer survivors, aiming to guide clinical practice and improve long-term outcomes.

Methods

Bayesian network and dose–response meta-analyses with a random-effects model were used to assess the effect of exercise on pain in breast cancer survivors. The evidence quality was evaluated using the Confidence in Network Meta-Analysis (CINeMA) web application.

Results

A total of 25 studies involving 1,899 patients were included. An inverted U-shaped dose–response relationship was observed between overall exercise and pain, with an effective dose range of 0–1300 metabolic equivalent of task minutes per week (MET-min/week) and maximum effect at 780 MET-min/week (SMD = 1.15, 95% CrI: 0.7, 1.61). When stratified by exercise type, aerobic exercise (0–140 min/week), resistance training (0–140 min/week), combined aerobic and resistance training (0–290 min/week), yoga (0–220 min/week), and walking (0–55 min/week) all demonstrated significant associations with pain reduction. The comprehensive ranking suggested that 170 min of combined aerobic and resistance training per week (SMD = 1.37, 95% CrI: 0.73, 2.07) may be the most effective type and dose for pain alleviation.

Conclusions

Combined aerobic and resistance training are recommended as the primary option for pain relief in breast cancer survivors, based on effect sizes, sample sizes, 95% CrI precision. However, due to the very low and low quality of evidence for several exercise modalities, high-quality randomized controlled trials are needed to validate the efficacy of the recommended dose ranges.