Home-based walking and resistance training interventions for breast cancer survivors: a systematic review

Objective: Breast cancer survivors (BCS) frequently experience long-term physical and psychological effects after treatment. Home-based exercise programs may support self-care. This systematic review and meta-analysis evaluated the effectiveness and characteristics of home-based walking and resistance training programs for BCS. Methods: PubMed, CINAHL, Cochrane Library, and ICHUSHI web (a Japanese database) were searched for randomized controlled trials (RCTs) published between December 2013 and December 2022. Eligible studies included home-based exercise interventions for BCS after primary treatment. Two reviewers independently performed screening, data extraction, and risk of bias assessment using the Cochrane Risk of Bias tool. Results: Eighteen RCTs (n=1,720) were included. Meta-analysis showed a moderate improvement in physical function (effect size=0.49; 95% CI: 0.06-0.91) and a small, non-significant improvement in quality of life (QOL) (effect size=0.24; 95% CI: -0.09 to 0.51). Fatigue improved significantly with telerehabilitation interventions. Effective programs typically lasted approximately 12 weeks, combined aerobic and resistance training, and incorporated exercise instruction, monitoring, counseling, feedback, or healthcare professional support. Psychological outcomes did not improve significantly. Conclusion: Home-based walking and resistance training can moderately improve physical function in BCS; however, evidence regarding QOL and psychological health remains inconclusive. Further high-quality RCTs are needed to develop effective, scalable exercise models for home and community settings.