Comparative effects of exercise interventions and mindfulness-based interventions for cognitive impairment and quality of life in breast cancer survivors during or after cancer treatment: A systematic review and Bayesian network meta-analysis.

OBJECTIVE: The aim of this network meta-analysis was to compare the improvement effects of various exercise interventions and mindfulness-based interventions to determine the best interventions for the improvement of cognitive impairment.

DESIGN: 7 databases were searched to screen RCTs of exercise interventions and mindfulness-based interventions to improve cognitive impairment. The network meta-analysis was performed using Revman 5.3, R 4.2.1 and ADDIS 1.16.8 software.

RESULTS: 34 RCTs involving 14 interventions were included in the study. In terms of cognitive function, except for mindfulness-based stress reduction, all interventions showed significantly greater improvement in cognitive function compared with conventional therapy. Physical activity and Qigong showed better effect in improving executive function. In terms of improving verbal memory, compensatory cognitive training, neurofeedback training, Qigong and sham Qigong were more effective than other interventions. On performing surface under the cumulative ranking curve analysis, acceptance and commitment therapy, neurofeedback training, Qigong, and mediation had the best effects on cognitive function, quality of life, executive function, and processing speed, respectively.

CONCLUSIONS: Mindfulness-based interventions were found to be more effective than exercise interventions for alleviating cognitive impairment. More robust RCTs focusing on acceptance and commitment therapy for cognitive impairment are required to support the current evidence.