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Document Type

Abstract

Publication Date

12-1-2024

Abstract

Background/Purpose: Multiple randomized controlled trials (RCTs) have provided substantial support for the positive impact of exercise on the quality of life among individuals with breast cancer. However, there remains a paucity of understanding regarding the optimal exercise interventions within this context. This knowledge gap significantly hinders the capacity of clinical practitioners to accurately recommend suitable exercise regimens for their patients. The aim of this study was to compare and rank the effectiveness of four primary categories of exercise (aerobic, resistance, mind-body, and combined exercise) on improving quality of life in women with breast cancer by network meta-analysis.

Method: Articles published in English and indexed in the PubMed, Web of Science, SPORTDiscus, The Cochrane Library, PsycINFO, EMBASE, and CINAHL Plus databases from their inception to 12 December 2023 were identified. Eligible studies were RCTs that involved exercise and assessed quality of life using specialized tools. Two researchers used the Cochrane Collaboration's tool for RCTs to assess the risk of bias for all included studies. A Frequentist network meta-analysis was conducted using STATA 15.0 to appraise the efficacy of different types of exercise.

Results: A total of 106 studies with 8,514 participants were included. All four types of exercise were effective (standard mean difference [SMD] = 0.36–0.70) in improving quality of life compared to usual care. The surface under the cumulative ranking curve (SUCRA) indicated that combined exercise improved patients' quality of life the best (SMD = 0.70, 95% confidence interval [CI]: 0.58–0.89; SUCRA = 96.4%). For the secondary outcomes, mind-body exercise was the most effective in improving patients' depression (SMD = -0.52, 95% CI: -0.81 – -0.22; SUCRA = 74.4%). It was the only mind-body exercise that significantly improved anxiety (SMD = -0.71, 95% CI: -1.11–-0.31).

Conclusion/Discussion: All types of exercise were effective in improving quality of life among breast cancer women, combined exercise (the combination of aerobic and resistance exercise) has the highest probability of being the optimal exercise type for improving quality of life, and mind-body exercise tends to be most effective in reducing their depression and anxiety. In the future, more long-follow-up, multi-arm RCTs should be conducted, and the optimal composition of combined exercise should be further explored.

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