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

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.