Stress, anxiety, and depression following a structured home-based combined exercise program in women undergoing chemotherapy for breast cancer: A randomized controlled trial

This is the authors' abstract. We don't add key points for this paper.

Objective Women undergoing chemotherapy for breast cancer frequently experience stress, anxiety, and depression, which may impair quality of life and treatment adherence. Exercise is a promising non-pharmacological strategy, although evidence regarding structured, remotely supported home-based programs remains inconsistent. To evaluate short-term between-group differences in stress, anxiety, and depression among women assigned to a structured home-based combined exercise program or routine care. Methods In this analyst-blinded randomized controlled trial, 64 women undergoing chemotherapy for breast cancer were randomly allocated 1:1 to an eight-week home-based combined exercise program or routine care. The intervention comprised 24 sessions delivered three times weekly. Each 40-minute session included a 10-minute warm-up, 20-minute aerobic/dynamic exercise component, and 10-minute cool-down. Target estimated intensity was approximately 55% of age-predicted maximum heart rate during weeks 1–4 and approximately 65% during weeks 5–8. Participants received initial face-to-face instruction and subsequent support through WhatsApp and telephone follow-up. Stress, anxiety, and depression were assessed using the DASS-42 at baseline and immediately post-intervention. Primary between-group analyses used baseline-adjusted ANCOVA; mixed-design ANOVA assessed time-by-group interactions. Results All 64 participants completed post-intervention assessment, and no exercise-related adverse events were reported. Adjusted post-intervention scores were lower in the intervention group for stress (mean difference = −3.51, 95% CI −5.97 to −1.06; p = 0.006; partial η 2 = 0.118), anxiety (−5.14, 95% CI −8.05 to −2.23; p < 0.001; partial η 2 = 0.170), and depression (−4.13, 95% CI −7.05 to −1.21; p = 0.006; partial η 2 = 0.116). Significant time-by-group interactions were observed for stress (p = 0.010), anxiety (p = 0.002), and depression (p = 0.014). Conclusion Assignment to the structured home-based combined exercise program was associated with lower short-term stress, anxiety, and depression scores than routine care. Larger multicenter trials with longer follow-up and broader clinical outcomes are needed before routine implementation.