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Comparative effects of different types of mind-body exercise interventions for negative emotions in cancer patients:
Xinyu Zhao1, Xiangtao Chen1, Jian Ma1
1Department of Rehabilitation Medicine, Chongqing University Jiangjin Hospital/Jiangjin Central Hospital of Chongqing, Chongqing 402260, China.
Background:
While the positive impact of mind-body exercises on alleviating negative emotions in cancer patients is well-established, the most effective type of exercise for this population remains unclear. This systematic review and network meta-analysis (NMA) evaluated evidence from randomized controlled trials (RCTs) to compare the effectiveness of various mind-body exercise modalities in improving emotional well-being among cancer patients.
Methods:
Potentially eligible RCTs assessing anxiety and depression in cancer patients in relation to mind-body exercise interventions were retrieved from eight databases from inception to August 2025. Adverse events were set as secondary outcome measures. Review Manager v5.4 and Stata v17.0 were utilized for pairwise meta-analysis and NMA, respectively. The risk of bias was assessed using the Cochrane tool version 2.0, and the Confidence in Network Meta-Analysis web-based tool was employed to evaluate the certainty of evidence.
Results:
Sixty-four RCTs involving 4448 participants were included. Across the studies that reported on adverse events (13 of 64 RCTs), no serious adverse events were documented. Pairwise meta-analysis revealed that the mind-body exercise group outperformed the control group in alleviating anxiety (SMD = -1.14, 95% CI [-1.42, -0.87], p < 0.00001) and depression (SMD = -0.87, 95% CI [-1.10, -0.64], p < 0.00001). In the NMA, treatment rankings for anxiety were: Baduanjin > Qigong > Yoga > Tai Chi > control. For depression, the rankings were Wuqinxi > Baduanjin > Qigong > Tai Chi > Yoga > Pilates > control. However, the certainty for network estimates ranged from moderate to very low, primarily attributed to the risk of bias and imprecision.
Conclusion:
Among the interventions studied, Baduanjin may be associated with relatively greater anxiolytic effects, while Wuqinxi may be more effective in alleviating depressive symptoms among cancer patients. Given the very low to moderate certainty of evidence and the star-shaped network with only indirect comparisons, these preliminary findings should be interpreted with caution.
