Evidence mapPaperPMID 41721080Full record

SynthesisSports medicine (Auckland, N.Z.)2026

Do Combined Resistance and Aerobic Exercise Programs Cause an Interference Effect in Women with Breast Cancer? A Systematic Review and Network Meta-analysis.

Pedro Lopez, Anderson Rech, Maria Petropoulou, Caroline B Silveira, Talita Molinari, Cindranne Torres Muller, Priscila Casara, Francesco Bettariga, Favil Singh, Régis Radaelli

Abstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in Sports medicine (Auckland, N.Z.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Pedro LopezGrupo de Pesquisa Em Exercício Para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil. pedro.lopezdacruz@resphealth.uwa.edu.au.ORCID http://orcid.org/0000-0002-3897-667X
Anderson RechGrupo de Pesquisa Em Exercício Para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil.
Maria PetropoulouInstitute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
Caroline B SilveiraGrupo de Pesquisa Em Exercício Para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil.
Talita MolinariLaboratório de Pesquisa do Exercício (LAPEX), Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Cindranne Torres MullerGrupo de Pesquisa Em Exercício Para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil.
Priscila CasaraGrupo de Pesquisa Em Exercício Para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil.
Francesco BettarigaSchool of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
Favil SinghSchool of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
Régis RadaelliGrupo de Pesquisa Em Exercício Para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExercise medicine has gained significant recognition owing to its demonstrated benefits throughout the breast cancer treatment continuum. While resistance exercise (RE) promotes improvements in lean mass and muscle strength, aerobic exercise (AE) enhances cardiorespiratory fitness, with several studies investigating both exercise modes in patients with breast cancer. However, because of an effect often referred to as interference effect, it is hypothesised that combining resistance and aerobic exercise (COMB) may compromise gains in lean mass and muscle strength and other outcomes in cancer populations.

objectiveThis study aims to investigate the presence of an interference effect from prescribing COMB compared with RE on fatigue, lean mass, physical function and muscle strength in women with breast cancer. In addition, it examines a range of demographic, clinical and exercise prescription moderators within this population.

methodsWe searched seven databases from inception to January 2024 (PROSPERO CRD42023491118), with an updated search in April 2025. Eligible trials examined the effects of RE, AE and/or COMB in women diagnosed with breast cancer. The primary outcomes for this review were cancer-related fatigue, lean mass, physical function and/or lower-limb muscle strength. A random-effects network meta-analysis was undertaken to examine the effect of different exercise programs and controls, with specific focus on the comparisons between RE and COMB. Differences between RE and COMB above 0.20 standardised mean difference (SMD) were an indicative of a potential interference effect.

resultsWe included a total of 131 articles describing 116 randomised trials (n = 9206). Both RE (SMD - 0.52, 95% CI - 0.83 to - 0.21, p = 0.001) and COMB (SMD - 0.47, 95% CI - 0.65 to - 0.29, p < 0.001) similarly reduced fatigue compared with controls. However, a potential interference effect was observed on fatigue during surgery (SMD - 0.23, 95% CI - 0.58 to 0.12, p = 0.191) and chemotherapy (SMD - 0.22, 95% CI - 0.59 to 0.16, p = 0.257), with RE showing greater benefits than COMB. For physical function, both RE (SMD 0.86, 95% CI 0.41-1.30, p < 0.001) and COMB (SMD 0.90, 95% CI 0.58-1.22, p < 0.001) improved outcomes compared with controls, though RE was superior to COMB in patients receiving hormone therapy (SMD 0.62, 95% CI - 0.56 to 1.81, p = 0.303). Differences between RE and COMB in lean mass (MD 0.18 kg, 95% CI - 0.17-0.53 kg, p = 0.303) and muscle strength (SMD 0.43, 95% CI - 0.01-0.86, p = 0.056) were not significant in the main analyses; however, sensitivity analyses omitting the outliers indicated significant differences favouring RE for lean mass (MD 0.36 kg, 95% CI 0.15-0.57 kg, p < 0.001) and muscle strength (SMD 0.40, 95% CI 0.08-0.71, p = 0.014).

conclusionsOur findings emphasise the importance of personalised exercise medicine targeted to treatment characteristics in women with breast cancer. While COMB may offer benefits across the outcomes investigated, prescribing RE alone may be preferable to minimize potential interference effects on lean mass and muscle strength, regardless of demographic, clinical and exercise prescription characteristics, as well as fatigue and physical function tests, particularly during adjuvant and hormonal therapies.

Indexed as

Breast NeoplasmsExerciseExercise TherapyResistance TrainingBody CompositionFatigueFemaleHumansMuscle Strength

Identifiers

PMID41721080
PMCPMC13388779

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.