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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

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 partici...

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Main Authors: Kenkhuis, Marlou-Floor (Author) , Doorenbos, Meike (Author) , Mast, Isa H. (Author) , Aaronson, Neil K. (Author) , van Beurden, Marc (Author) , Bohus, Martin (Author) , Courneya, Kerry S. (Author) , Daley, Amanda J. (Author) , Galvão, Daniel A. (Author) , Goedendorp, Martine M. (Author) , van Harten, Wim H. (Author) , Hayes, Sandi C. (Author) , Hiensch, Anouk E. (Author) , Irwin, Melinda L. (Author) , Kersten, Marie José (Author) , Knoop, Hans (Author) , May, Anne M. (Author) , McConnachie, Alex (Author) , van Mechelen, Willem (Author) , Mutrie, Nanette (Author) , Newton, Robert U. (Author) , Nollet, Frans (Author) , Oldenburg, Hester S. (Author) , Schmidt, Martina (Author) , Schmitz, Kathryn H. (Author) , Schulz, Karl-Heinz (Author) , Sonke, Gabe S. (Author) , Steindorf, Karen (Author) , Stuiver, Martijn M. (Author) , Taaffe, Dennis R. (Author) , Thorsen, Lene (Author) , Velthuis, Miranda J. (Author) , Wiskemann, Joachim (Author) , Mesters, Ilse (Author) , Ulrich, Cornelia (Author) , van Vulpen, Jonna K. (Author) , Custers, Jose A. E. (Author) , Buffart, Laurien M. (Author)
Format: Article (Journal)
Language:English
Published: July 2025
In: Supportive care in cancer
Year: 2025, Volume: 33, Issue: 7, Pages: 1-17
ISSN:1433-7339
DOI:10.1007/s00520-025-09646-9
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1007/s00520-025-09646-9
Verlag, kostenfrei, Volltext: http://link.springer.com/article/10.1007/s00520-025-09646-9
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Author Notes: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
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Summary: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.
Item Description:Online veröffentllicht: 1. Juli 2025
Gesehen am 09.09.2025
Physical Description:Online Resource
ISSN:1433-7339
DOI:10.1007/s00520-025-09646-9

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