Optimal Exercise Dose for Improving Multidimensional Health Outcomes in Colorectal Cancer Patients: A Systematic Review, Meta-Analysis and Meta-Regression.
8 affiliations
- 1School of Sports Science, Qufu Normal University, Qufu, China.
- 2Department of Sport Leisure, Sungshin Women's University, Seoul, Republic of Korea.
- 3School of Education and Arts, Jiujiang Polytechnic University of Science and Technology, Jiujiang, China.
- 4School of Philosophy and Sociology, Jilin University, Changchun, China.
- 5College of Wesley Creative Convergence, Hyupsung University, Hwaseong-si, Republic of Korea.
- 6Department of Sports Science, Chungwoon University, Hongseong-eup, Republic of Korea.
- 7Department of Exercise Therapy, Gachon University, Seoul, Republic of Korea.
- 8College of Physical Education, Jilin University, Changchun, China.
Abstract
This study aimed to investigate the dose-response relationships between exercise prescription parameters and a range of health outcomes in patients with colorectal cancer (CRC). The following PRISMA guidelines, a systematic search of five databases was conducted. The inclusion criteria were randomized controlled trials (RCTs) of exercise interventions lasting ≥ 4 weeks in patients with CRC. Robust Variance Estimation (RVE) was used to synthesize the overall effects of exercise interventions across six outcome domains, including cardiorespiratory fitness (CRF) and muscular fitness (MF). Univariable RVE regression models and MetaForest analyses were employed to examine the moderating effects of two groups of variables: exercise prescription moderators and patient background characteristics. Risk of bias was assessed using the Cochrane tool, and the quality of evidence was evaluated using the GRADE approach. A total of 26 RCTs, involving 1731 CRC patients and 266 effect sizes, were included. CRF (ES = 0.35, p < 0.01) and MF (ES = 0.45, p < 0.01) showed statistically significant improvements. Regression analyses revealed threshold effects for both CRF and MF, with maximal improvements requiring sustained engagement in moderate-to-high intensity exercise. Subgroup analyses indicated that prehabilitation interventions were the most effective, while interventions during active treatment exhibited a decline-rebound trend over time. Based on these findings, high-frequency and moderate-to-high volume interventions with individualized load regulation are recommended during the pre-treatment phase. During active treatment, a more cautious approach is advised, involving reduced exercise volume during peak symptom periods and gradual progression during recovery.
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BibTeX
@article{wang2026optimal,
title = {{Optimal Exercise Dose for Improving Multidimensional Health Outcomes in Colorectal Cancer Patients: A Systematic Review, Meta-Analysis and Meta-Regression.}},
author = {Jingyu Wang and Yuxuan He and Zhouluo Wang and So-Eun Lee and Yoo-Jin Shim and Si-Eun Lee and Hye-Ryeon Kim and Kyung-Hee Lee and Ziqian Wang and Yongqi Miao and Seung-Wook Choi},
journal = {European journal of sport science},
year = {2026},
month = nov,
doi = {10.1002/ejsc.70283},
url = {https://europepmc.org/article/MED/42969067},
note = {CC BY},
}
RIS
TY - JOUR
TI - Optimal Exercise Dose for Improving Multidimensional Health Outcomes in Colorectal Cancer Patients: A Systematic Review, Meta-Analysis and Meta-Regression.
AU - Jingyu Wang
AU - Yuxuan He
AU - Zhouluo Wang
AU - So-Eun Lee
AU - Yoo-Jin Shim
AU - Si-Eun Lee
AU - Hye-Ryeon Kim
AU - Kyung-Hee Lee
AU - Ziqian Wang
AU - Yongqi Miao
AU - Seung-Wook Choi
PY - 2026
DA - 2026/11/01
JO - European journal of sport science
DO - 10.1002/ejsc.70283
UR - https://europepmc.org/article/MED/42969067
AB - This study aimed to investigate the dose-response relationships between exercise prescription parameters and a range of health outcomes in patients with colorectal cancer (CRC). The following PRISMA guidelines, a systematic search of five databases was conducted. The inclusion criteria were randomized controlled trials (RCTs) of exercise interventions lasting ≥ 4 weeks in patients with CRC. Robust Variance Estimation (RVE) was used to synthesize the overall effects of exercise interventions across six outcome domains, including cardiorespiratory fitness (CRF) and muscular fitness (MF). Univariable RVE regression models and MetaForest analyses were employed to examine the moderating effects of two groups of variables: exercise prescription moderators and patient background characteristics. Risk of bias was assessed using the Cochrane tool, and the quality of evidence was evaluated using the GRADE approach. A total of 26 RCTs, involving 1731 CRC patients and 266 effect sizes, were included. CRF (ES = 0.35, p < 0.01) and MF (ES = 0.45, p < 0.01) showed statistically significant improvements. Regression analyses revealed threshold effects for both CRF and MF, with maximal improvements requiring sustained engagement in moderate-to-high intensity exercise. Subgroup analyses indicated that prehabilitation interventions were the most effective, while interventions during active treatment exhibited a decline-rebound trend over time. Based on these findings, high-frequency and moderate-to-high volume interventions with individualized load regulation are recommended during the pre-treatment phase. During active treatment, a more cautious approach is advised, involving reduced exercise volume during peak symptom periods and gradual progression during recovery.
SN - 1746-1391
SN - 1536-7290
ER -