Short- and long-term effectiveness of physical activity interventions for women living with and beyond breast cancer: a systematic review and meta-analysis

Physical activity is beneficial for women living with and beyond breast cancer. Many interventions aim to increase physical activity in this population; however, their effectiveness is uncertain. This review examines changes in physical activity levels across short- and long-term timepoints following these interventions. Online databases (CINAHL Ultimate, Medline, ProQuest, PsycINFO, SCOPUS, and Web of Science) were systematically searched for studies evaluating physical activity interventions for women living with and beyond breast cancer, assessing physical activity outcomes at baseline, post-intervention (short-term), and at least 3 months from the end of the intervention (long-term). Random-effects multilevel models were used for meta-analyses. The review included 43 studies with 5295 participants. Of these, 28 had sufficient data for meta-analyses. For between-group analyses, moderate-to-vigorous physical activity (MVPA) showed moderate effects at post-intervention (SMD = 0.46, 95% CI [0.17, 0.75]), while total physical activity showed small-to-moderate effects (SMD = 0.33, [0.15, 0.51]). At long-term follow-up (range 3 months to 5 years), effects were small for MVPA (SMD = 0.24, [0.14, 0.35]) and total physical activity (SMD = 0.25, [0.08, 0.43]). For within-group analyses, MVPA showed small-to-moderate effects (SMD = 0.38, [0.12, 0.63]) at post-intervention, while total physical activity showed moderate effects (SMD = 0.46, [0.14, 0.77]). At long-term follow-up, change from baseline MVPA was not statistically significant, while total physical activity showed a moderate effect (SMD = 0.33, [0.18, 0.47]). Physical activity interventions for women with and beyond breast cancer appear effective in the short term. However, long-term effects are inconsistent, especially for intensive activity. Identifying influential factors, including psychological determinants, that promote long-term physical activity would support sustained survivorship outcomes.