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
Bibliographic record
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.032 | 0.072 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.012 | 0.034 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".