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Meta-Analysis
. 2025 Apr;22(2):e70008.
doi: 10.1111/wvn.70008.

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

Jingsi Wen  1 , Stanley Sai-Chuen Hui  1   2 , Edwin Chun-Yip Chin  1 , Yijian Yang  1 , Cindy Hui-Ping Sit  1
Affiliations
Meta-Analysis

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

Jingsi Wen et al. Worldviews Evid Based Nurs. 2025 Apr.

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.

Keywords: breast cancer; depression; mental health; mind–body therapies; qigong; quality of life; yoga.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flowchart.
FIGURE 2
FIGURE 2
Forest plot of health‐related quality of life and mental health outcomes.
See this image and copyright information in PMC

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