The effects of different types of exercise interventions on psychological resilience during cancer treatment: A network meta-analysis and systematic review

Abstract

This systematic review and network meta-analysis evaluated the comparative effectiveness of different exercise interventions on psychological resilience among cancer patients during treatment. A comprehensive search of seven electronic databases identified randomized controlled trials published between January 2000 and December 2024. Seventeen studies comprising 1781 participants with various cancer diagnoses were included. Network meta-analysis revealed significant positive effects of exercise interventions on psychological resilience (SMD = 0.42, 95% CI: 0.35–0.49, p < 0.001). Mind-body exercises demonstrated the strongest effect (SMD = 0.57, 95% CI: 0.42–0.72), followed by multimodal interventions (SMD = 0.48, 95% CI: 0.36–0.60), resistance training (SMD = 0.41, 95% CI: 0.28–0.54), and aerobic exercise (SMD = 0.32, 95% CI: 0.21–0.43). Surface under the cumulative ranking curve analysis ranked mind-body interventions highest (SUCRA =0 .92). Subgroup analyses revealed stronger effects in hematological malignancies (SMD = 0.63) and breast cancer (SMD = 0.52), with optimal outcomes for moderate-intensity interventions lasting 8–12 weeks. Heterogeneity was moderate (I2 = 53.4%) but largely explained by cancer type and intervention characteristics. Sensitivity analyses confirmed the robustness of findings across methodological assumptions. This study provides compelling evidence that exercise interventions, particularly mind-body approaches, effectively enhance psychological resilience during cancer treatment, with implications for integrating targeted exercise prescriptions into comprehensive cancer care.