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Open Access 01-10-2024 | Breast Cancer | Review

Exercise interventions for self-perceived body image, self-esteem and self-efficacy in women diagnosed with breast cancer: a systematic review with meta-analysis and meta-regressions

Authors: María Jesús Casuso-Holgado, Javier Martinez-Calderon, Patricia Martínez-Miranda, María Jesús Muñoz-Fernández, Carlos Bernal-Utrera, Cristina García-Muñoz

Published in: Supportive Care in Cancer | Issue 10/2024

Abstract

Purpose

To synthesise the effectiveness of exercise interventions on self-perceived body image, self-esteem and self-efficacy in women diagnosed with breast cancer who are undergoing or have completed primary adjuvant treatments.

Methods

A systematic review was conducted with meta-analysis and meta-regressions. Five electronic databases were searched from inception to June 2023, and hand searches were performed to explore the reference lists of similar systematic reviews. The established selection criteria were randomised clinical trials that evaluated any type of physical exercise intervention with self-perceived body image, self-esteem and self-efficacy as outcomes. No restrictions were imposed with respect to the control group. Main characteristics were extracted for each study. Meta-analyses, meta-regressions and sensitivity analyses were performed. The certainty of evidence for each outcome was graded using the GRADE approach. The risk of bias was evaluated using the RoB2 Cochrane tool.

Results

Twenty studies, comprising 19 different samples (n = 2030), were included. In general, meta-analysis indicated that physical exercise interventions were not superior to controls for improving self-esteem and body image in women diagnosed with breast cancer. However, subgroup meta-analysis showed a significant difference in self-esteem improvement for resistance exercise (SMD = 0.31; 95% CI = 0.07, 0.55; p = 0.01; I² = 0%) and supervised exercise (SMD = 0.25; 95% CI = 0.08, 0.42; p = 0.0004; I² = 0%) compared with controls. Self-efficacy results were scarce and controversial. In addition, serious concerns were mainly detected in terms of the risk of bias and indirectness of the evidence, which caused the certainty of evidence to be very low for all outcomes.

Conclusion

Supervised exercise and resistance training appear to be effective exercise modalities for improving self-esteem in women diagnosed with breast cancer. In contrast, exercise interventions are not significantly associated with improvements in body image, while results on self-efficacy are controversial. However, due to the study’s limitations, further research is needed.

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Title: Exercise interventions for self-perceived body image, self-esteem and self-efficacy in women diagnosed with breast cancer: a systematic review with meta-analysis and meta-regressions
Authors: María Jesús Casuso-Holgado
Javier Martinez-Calderon
Patricia Martínez-Miranda
María Jesús Muñoz-Fernández
Carlos Bernal-Utrera
Cristina García-Muñoz
Publication date: 01-10-2024
Publisher: Springer Berlin Heidelberg
Keywords: Breast Cancer
Breast Cancer
Psychodynamic Regression
Published in: Supportive Care in Cancer / Issue 10/2024
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-024-08874-9

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