Aerobic Physical Activity and Depression Among Patients With Cancer A Systematic Review and Meta-Analysis
OBJECTIVE To evaluate whether APA decreases depression severity in patients with cancer by synthesizing data from published randomized clinical trials (RCTs).
DATA SOURCES Six databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and Scopus) were systematically searched for relevant citations published between January 1, 1980, and July 5, 2023.
STUDY SELECTION This systematic review and meta-analysis included RCTs comparing APA interventions with usual care, waitlist control, or attention control for managing depression in patients with cancer, irrespective of age and cancer type.
DATA EXTRACTION AND SYNTHESIS Two reviewers independently conducted screening and data extraction. Risk of bias was evaluated using the Cochrane Risk of Bias Tool, version 2. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline was followed. Standardized mean differences (SMDs) were calculated using a random-effects model. Data collection and analyses were performed between June 2022 and March 2024.
MAIN OUTCOMES AND MEASURES The primary outcome was severity of self-reported depression reported within 1 month of the end of intervention (short term). Secondary outcomes were severity of self-reported depression between 1 and 6 months post intervention (medium term) and between 6 and 12 months post intervention (long term).
RESULTS This meta-analysis included 25 RCTs with a total of 1931 adults with cancer (age range, 18-80 years). Ten RCTs (40%) had low risk of bias. Aerobic physical activity was associated with decreased self-reported depression among adults with cancer across the 25 included trials (n = 1931 participants; SMD, −0.38 [95% CI, −0.59 to −0.18]; P < .001; I 2 = 76%). This decrease in depression scores was also significant for the secondary outcomes of long-term depression across 3 trials (n = 299 participants; SMD, −0.32 [95% CI, −0.60 to −0.04]; P = .03; I 2 = 31%) but not for medium term depression across 2 trials (n = 143 participants; SMD, −0.27 [95% CI, −0.60 to 0.06]; P =.10; I
2 = 0%).
CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis, APA was associated with modest short-term and long-term reductions of depression among adults with cancer. Future studies should discern the effectiveness of APA in combination with other strategies for managing depression across various populations of patients with cancer.
Matthew Kulchycki, MD; Henry Ratul Halder, MSc; Nicole Askin, MLIS; Rasheda Rabbani, PhD; Fiona Schulte, PhD; Maya M. Jeyaraman, MD; Lillian Sung, MD, PhD; Deepak Louis, MD; Lisa Lix, PhD; Allan Garland, MD, MA; Alyson L. Mahar, PhD; Ahmed Abou-Setta, PhD; Sapna Oberoi, MD, MSc
Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Kulchycki, Garland); Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Halder, Lix); Surveillance and Reporting, Cancer Advanced Analytics, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada (Halder); Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Manitoba, Canada (Askin, Abou-Setta); George & Fay Yee Center for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada (Rabbani, Jeyaraman); Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada (Schulte); Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada (Sung); Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada (Louis, Oberoi); Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (Garland); School of Nursing, Queen’s University, Kingston, Ontario, Canada (Mahar); Division of Cancer Care and Epidemiology, Queen’s Cancer Research Institute, Queen’s University, Kingston, Ontario, Canada (Mahar); Department of Pediatric Hematology-Oncology, Cancer Care Manitoba, Winnipeg, Manitoba, Canada (Oberoi).
Source: Kulchycki M., Halder HR., Askin N. et al. Aerobic Physical Activity and Depression Among Patients With Cancer A Systematic Review and Meta-Analysis. JAMA Network Open. 2024;7(10):e2437964. doi:10.1001/jamanetworkopen.2024.37964.