Abstract
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.
RAS ID
83480
Document Type
Journal Article
Date of Publication
7-1-2025
Volume
33
Issue
7
Funding Information
Alpe d'HuZes Foundation / Dutch Cancer Society (VU 2011–5045)
PubMed ID
40591016
School
Exercise Medicine Research Institute
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Publisher
Springer
Identifier
Daniel A. Galvão: https://orcid.org/0000-0002-8209-2281
Robert U. Newton: https://orcid.org/0000-0003-0302-6129
Recommended Citation
Kenkhuis, M., Doorenbos, M., Mast, I. H., Aaronson, N., van Beurden, M., Bohus, M., Courneya, K. S., Daley, A. J., Galvão, D. A., Goedendorp, M. M., van Harten, W. H., Hayes, S. C., Hiensch, A. E., Irwin, M. L., Kersten, M., Knoop, H., May, A. M., McConnachie, A., van Mechelen, W., Mutrie, N., Newton, R. U., Nollet, F., Oldenburg, H. S., Schmidt, M. E., Schmitz, K. H., Schulz, K., & Taaffe, D. R. (2025). 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. Retrieved from https://ro.ecu.edu.au/ecuworks2022-2026/6645
Comments
Kenkhuis, M., Doorenbos, M., Mast, I. H., Aaronson, N. K., Van Beurden, M., Bohus, M., Courneya, K. S., Daley, A. J., Galvão, D. A., Goedendorp, M. M., Van Harten, W. H., Hayes, S. C., Hiensch, A. E., Irwin, M. L., Kersten, M. J., Knoop, H., May, A. M., McConnachie, A., Van Mechelen, W., . . . Buffart, L. M. (2025). 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. Supportive Care in Cancer, 33. https://doi.org/10.1007/s00520-025-09646-9