The Effectiveness of Mind–Body Exercise on Health‐Related Quality of Life and Mental Health During and After Breast Cancer Treatment: An Umbrella Review of Meta‐Analyses for Randomized Controlled Trials

ABSTRACT

Background

Previous studies regarding mind–body exercise among people with breast cancer mostly focused on one type of mind–body exercise and provided conflicting results.

Aims

This paper aims to systematically synthesize the evidence hierarchy and examine the credibility of previous meta-analyses of different types of mind–body exercises.

Methods

We searched PubMed, Embase, Cochrane Library, Web of Science, and Epitemonikos from database inception to February 2nd, 2024, for meta-analyses of randomized controlled trials. Included meta-analyses examined the effects of mind–body exercises on at least one outcome of health-related quality of life, cancer-related fatigue, depression, anxiety, and sleep quality in breast cancer patients. The random effects estimates (Hedges'G), 95% prediction interval, small study effect, and excess significance bias were calculated. Furthermore, we categorized meta-analyses based on the evidence credibility criteria and assessed quality using A Measurement Tool to Assess Systematic Reviews 2.

Results

The umbrella review included a re-analysis of 16 meta-analyses of 9 articles including 134 randomized controlled trials involving 9469 breast cancer patients and survivors. We identified 3 articles as “low” quality and 6 articles as “critically low” quality. Convincing evidence supported the effectiveness of Yoga intervention in reducing depression symptoms (G = −0.77, 95% Confidence Interval [−0.93, −0.61]). However, 11 meta-analyses were supported by weak evidence (1 for Qigong alleviated depression, 4 for Qigong, Baduanjin, Tai Chi Chuan, and Yoga improved health-related quality of life, 3 for multiple mind–body exercises, Tai Chi Chuan, and Yoga reduced cancer-related fatigue, 2 of Baduanjin and Yoga reduced anxiety, as well as 1 of Yoga improved sleep quality).

Linking Evidence to Action

Mind–body exercises, especially yoga, may be beneficial for improving health-related quality of life and mental health for breast cancer patients. Further high-quality interventions investigating diverse mind–body exercise interventions are warranted to ascertain the effectiveness of health-related quality of life and mental health outcomes.