Mindfulness-based physical activity for mental health and resilience in cancer patients: A systematic review and network meta-analysis

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This systematic review and network meta-analysis examined the comparative effectiveness of mindfulness-based physical activity interventions on psychological outcomes in cancer patients. Following PRISMA-NMA guidelines, we searched 12 databases from inception to December 2023, identifying 30 randomized controlled trials (3518 participants) that met inclusion criteria. The network meta-analysis revealed significant benefits across psychological domains, with differential effectiveness among intervention modalities. Mindfulness-Based Stress Reduction (MBSR) demonstrated superior efficacy for anxiety (SMD = −0.45, 95% CrI: −0.59 to −0.31) and depression (SMD = −0.41, 95% CrI: −0.55 to −0.27), while mindful walking yielded optimal improvements for quality of life (SMD = 0.52, 95% CrI: 0.36 to 0.68). Subgroup analyses identified cancer type, treatment stage, and intervention format as significant moderators of effectiveness, with stronger effects observed during active treatment compared to post-treatment periods. Medium-duration interventions (8–12 weeks) delivered in supervised group formats showed optimal outcomes. Network inconsistency was minimal (global inconsistency factor: 0.11, p = 0.42), and publication bias assessment suggested no significant bias. Our findings provide robust evidence supporting the integration of mindfulness-based physical activity interventions into cancer care, with MBSR recommended for addressing anxiety and depression, and mindful walking for enhancing quality of life. These findings highlight the importance of tailoring intervention selection to specific psychological outcomes and patient characteristics, potentially improving psychological resilience throughout the cancer journey.

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