The Effects of Physical and Mind–Body Exercise on Anxiety Among Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Controlled Trials
5 affiliations
- 1Division of Physical Education and Sport, Department of Physical Education and Sport, Faculty of Sport Sciences, Ağrı Ibrahim Çeçen University, 04100 Ağrı, Türkiye
- 2Department of Physical Education and Sport, Faculty of Sport Sciences, Gaziantep University, 27310 Gaziantep, Türkiye
- 3Department of Physical Education and Sport, Faculty of Sciences, Physical Education and Informatics, National University of Science and Technology Politehnica Bucharest, Pitesti University Center, 110040 Pitesti, Romania
- 4Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
- 5Department of Physical Education of Sports Teaching, Faculty of Sports Sciences, Atatürk University, 25240 Erzurum, Türkiye
Abstract
Background and Objectives: Anxiety is highly prevalent among breast cancer patients and significantly impairs quality of life. Although both conventional physical exercise (PE) and mind–body interventions (MBE) are used in supportive care, their relative efficacy remains unclear. This systematic review and meta-analysis compared the effects of PE and MBE on anxiety in breast cancer patients. Materials and Methods: PubMed, Web of Science, Embase, PsycINFO, and CINAHL were systematically searched through April 2026 for controlled trials comparing structured PE or MBE with control conditions. Effect sizes were pooled as standardized mean differences (SMDs; Hedges’ g) using a random-effects model with restricted maximum likelihood estimation and modified Hartung–Knapp inference. Subgroup analyses and univariable meta-regressions explored potential moderators. Results: Twenty-four reports (N = 2197) represented 25 independent trials; 22 estimates from 21 reports entered the meta-analysis, and three reports were synthesized narratively. Interventions significantly reduced anxiety on average (SMD = −0.58, 95% CI [−1.01, −0.15], p = 0.011), with substantial heterogeneity (I2 = 85.0%) and a 95% prediction interval of −2.38 to 1.22. Both PE (SMD = −0.67) and MBE (SMD = −0.46) favored intervention numerically, although both subgroup confidence intervals included no effect, with no significant difference between modalities (p = 0.697). A larger, yet non-significant, effect was observed during active treatment (SMD = −0.84, 95% CI [−1.68, 0.01]) compared with survivorship (SMD = −0.34, 95% CI [−0.62, −0.07]); the between-phase comparison was inconclusive (p = 0.291). The comparison across diagnostic stages was also inconclusive (p = 0.366). None of the seven continuous moderators met the multiplicity-adjusted significance threshold. Conclusions: Current findings suggest an average reduction in anxiety following physical and mind–body interventions in breast cancer patients. However, no statistically significant differences were observed between intervention modalities or treatment stages. Very low certainty, substantial heterogeneity and indirect subgroup comparisons limit confidence in the size and consistency of benefit. Overall, individualized interventions may have a role in oncology care, but these findings do not establish superiority, equivalence or differential efficacy between modalities or treatment phases.
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BibTeX
@article{suleymanogulları2026effects,
title = {{The Effects of Physical and Mind–Body Exercise on Anxiety Among Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Controlled Trials}},
author = {Mesut Süleymanoğulları and Cemre Didem Eyipınar and Zarife Pancar and Valentina Stefanica and Nicola Luigi Bragazzi and Halil İbrahim Ceylan},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18193244},
url = {https://europepmc.org/article/PMC/PMC13663974},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Effects of Physical and Mind–Body Exercise on Anxiety Among Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Controlled Trials
AU - Mesut Süleymanoğulları
AU - Cemre Didem Eyipınar
AU - Zarife Pancar
AU - Valentina Stefanica
AU - Nicola Luigi Bragazzi
AU - Halil İbrahim Ceylan
PY - 2026
DA - 2026/10/01
JO - Cancers
DO - 10.3390/cancers18193244
UR - https://europepmc.org/article/PMC/PMC13663974
AB - Background and Objectives: Anxiety is highly prevalent among breast cancer patients and significantly impairs quality of life. Although both conventional physical exercise (PE) and mind–body interventions (MBE) are used in supportive care, their relative efficacy remains unclear. This systematic review and meta-analysis compared the effects of PE and MBE on anxiety in breast cancer patients. Materials and Methods: PubMed, Web of Science, Embase, PsycINFO, and CINAHL were systematically searched through April 2026 for controlled trials comparing structured PE or MBE with control conditions. Effect sizes were pooled as standardized mean differences (SMDs; Hedges’ g) using a random-effects model with restricted maximum likelihood estimation and modified Hartung–Knapp inference. Subgroup analyses and univariable meta-regressions explored potential moderators. Results: Twenty-four reports (N = 2197) represented 25 independent trials; 22 estimates from 21 reports entered the meta-analysis, and three reports were synthesized narratively. Interventions significantly reduced anxiety on average (SMD = −0.58, 95% CI [−1.01, −0.15], p = 0.011), with substantial heterogeneity (I2 = 85.0%) and a 95% prediction interval of −2.38 to 1.22. Both PE (SMD = −0.67) and MBE (SMD = −0.46) favored intervention numerically, although both subgroup confidence intervals included no effect, with no significant difference between modalities (p = 0.697). A larger, yet non-significant, effect was observed during active treatment (SMD = −0.84, 95% CI [−1.68, 0.01]) compared with survivorship (SMD = −0.34, 95% CI [−0.62, −0.07]); the between-phase comparison was inconclusive (p = 0.291). The comparison across diagnostic stages was also inconclusive (p = 0.366). None of the seven continuous moderators met the multiplicity-adjusted significance threshold. Conclusions: Current findings suggest an average reduction in anxiety following physical and mind–body interventions in breast cancer patients. However, no statistically significant differences were observed between intervention modalities or treatment stages. Very low certainty, substantial heterogeneity and indirect subgroup comparisons limit confidence in the size and consistency of benefit. Overall, individualized interventions may have a role in oncology care, but these findings do not establish superiority, equivalence or differential efficacy between modalities or treatment phases.
SN - 2072-6694
ER -