Ehlers[36] | 2020 | USA | 22 (2348) | Aerobic exercise Resistance exercise Yoga Qi gong | Routine methods of care No exercise | RoB | FACIT-F; BFI; MFI; FAQ; PFS | Exercise intervention improved CRF in breast cancer patients after chemotherapy, but the effect was small to moderate. | Yes |
Shen[37] | 2020 | China | 8 (782) | Exercise | Routine methods of care Relaxation control | RoB | FACIT-F; BFI; FAQ | CRF, pain, and depression were significantly reduced by exercise interventions for breast cancer patients undergoing radiotherapy. | Yes |
Lee[38] | 2018 | Korea | 8 (826) | Exercise | Routine methods of care No exercise | Quality assessment of controlled intervention studies | MFI; RPFS | Aerobic exercise, resistance training, and a combination of exercises produced beneficial effects on CRF, and the effect of high-intensity exercise was better than that of low- or moderate-intensity exercise. | Yes |
Singh[39] | 2018 | Australia | 31 (2878) | Aerobic exercise Resistance exercise Strength exercise Pilates | Routine methods of care | RoB | FACIT-F; PFS; SCFS-6; POMS-F; BFI; MFI; FAQ | Most of the breast cancer patients safely participated in the exercise interventions at moderate- or high-intensity, which improved their CRF. | Yes |
Lipsett[40] | 2017 | Ireland | 9 (755) | Resistance exercise Strength exercise Yoga | Routine methods of care | PEDro | FAQ; FACIT-F; PFS; BFI | Exercise may be beneficial for CRF management in breast cancer patients undergoing radiotherapy. Supervised exercise intervention was more effective in alleviating CRF than unsupervised exercise. | Yes |
Juvet[41] | 2017 | Norway | 17 (1812) | Aerobic exercise Resistance exercise | Routine methods of care | NOKC | FACIT-F; PFS; SCFS-6; POMS-F; MFI; PFI | Breast cancer patients’ CRF was reduced by regular exercise, which had a positive effect, but the effect was not significant. | Yes |
Zhu[23] | 2016 | China | 12 (1574) | Aerobic exercise Resistance exercise Yoga | Routine methods of care No exercise Supportive therapy | RoB | FACIT-F; MFI; VO2 Peak | The effect of exercise on the improvement of CRF in breast cancer patients was not significant. | Yes |
McNeely[42] | 2006 | Canada | 5 (230) | Exercise | Routine methods of care | Homemade Standard | FACIT-F; PFS | Exercise improved CRF in breast cancer patients. | Yes |
Gu[43] | 2012 | China | 9 (988) | Aerobic exercise Gymnastics | Routine methods of care | RoB | FACIT-F; FS; POMS-F; LAS-F | There was a significant difference of CRF in breast cancer patients between the exercise intervention groups and the control groups. | Yes |
Vannorsdall[24] | 2020 | USA | 11 (1654) | Exercise | Routine methods of care | RoB | PFS; CFS; MFI; FAQ; MFI | The exercise interventions had a remarkable effect on CRF in breast cancer patients during and after treatment. | Yes |
van Vulpen[44] | 2016 | The Nether-lands | 5 (707) | Exercise | Routine methods of care | RoB | FAQ; MFI | Physical exercise had the greatest effect on reducing body fatigue, as the importance of auxiliary exercise was emphasized. | Yes |
Ramírez-Vélez[45] | 2021 | Republic of Lithuania | 39 (4150) | Aerobic exercise Resistance exercise | Routine methods of care | PEDro | FACIT-F; BFI; MFI | Exercise had a moderate positive effect on CRF in breast cancer patients. Each session of tai chi lasted > 40 minutes, and the intervention duration was ≤ 6 weeks, which had a good relief effect on CRF. | Yes |
Liu[46] | 2021 | China | 17 (1133) | Tai chi Yoga Strength exercise Pilates | Routine methods of care Health education | RoB | BFI; EORTC-QLQ-C30; FACIT-F; CFS; FSI; PFS-R | Mind-body exercise improved CRF in breast cancer patients. | Yes |
Lin[47] | 2021 | Taiwan, China | 9 (581) | Aerobic Yoga | Routine methods of care | JBI-MAStARI | PFS; FSI; PFS-R; FACIT-F; SCFS | Breast cancer patients benefitted from exercise, including reduced fatigue. In addition, supervised exercise by a nurse or family member had a stronger effect on CRF in breast cancer patients. | Yes |
Duijts[48] | 2011 | The Nether-lands | 11 (1000) | Resistance exercise Yoga | Routine methods of care Health education | None | FACIT-F; MFI; FS; LAS-F; PFS; POMS-F; FSS | CRF was reduced by physical exercise, but the overall effect warrants further investigation. | Yes |
Liu[49] | 2017 | China | 4 (674) | Exercise | Routine methods of care Walking | None | FACIT-F | CRF in breast cancer patients was reduced by home-based physical exercise, which should be recommended. | Yes |
Zheng[50] | 2021 | China | 5 (436) | Yoga | Routine methods of care | RoB | CFS | Fatigue in breast cancer patients was reduced by exercise, such as yoga and qi gong. | Yes |
Wu[51] | 2018 | China | 3 (400) | Yoga | Routine methods of care | RoB | FACIT-F; CFS | For breast cancer patients, CRF was reduced by yoga, but more large, high-quality studies are needed. | Yes |
Zhang[52] | 2015 | China | 9 (623) | Yoga | Routine methods of care Health education No exercise | RoB | FACIT-F; FSI | Yoga was positively significant in alleviating CRF in patients with breast cancer. | Yes |
O’Neill[53] | 2020 | China | 24 (1379) | Yoga | Routine methods of care Health education No exercise | RoB | FACIT-F; FSI; BFI; EORTC-QLQ-C30 | Based on the available evidence, yoga reduced CRF in breast cancer patients, with effects comparable to those of aerobic exercise. | Yes |
Dong[54] | 2019 | China | 17 (2273) | Yoga | Routine methods of care | RoB | BFI; FSS; CFS; EORTC-QLQ-C30; FACIT-F; MFI; MFSI-SF | The breast cancer patients’ physical fatigue was alleviated by yoga, which had a moderate effect on cognitive fatigue and a relatively small effect on mental fatigue. | Yes |
Hsueh[55] | 2021 | Taiwan, China | 14 (882) | Yoga | Routine methods of care Health education | RoB 2.0 | BFI; FACIT-F; MFI; MFSI-SF | CRF in breast cancer patients can be lessened by yoga without serious adverse events, and yoga was strongly recommended as a supportive therapy for CRF post-treatment. | Yes |
Xu[56] | 2020 | China | 15 (1650) | Aerobic exercise (walking, dancing, swimming, etc.) | Routine methods of care | RoB | RPFS; PFS; POMS-F; FACIT-F | Aerobic exercise had an effect on CRF in breast cancer patients, but the mechanism was not fully understood. | Yes |
Hu[57] | 2009 | China | 6 (494) | Aerobic | Routine methods of care No exercise | RoB | FACIT-F; PFS | Rehabilitation exercise was initially shown to be effective in alleviating CRF in breast cancer patients undergoing chemotherapy/radiotherapy. | Yes |
Yang[58] | 2019 | China | 12 (1232) | Aerobic exercise (jogging, cycling, swimming, etc.) | Routine methods of care No exercise | RoB | PFS; BFI; MFI; FSS; FSI; FACIT-F | CRF was relieved by aerobic exercise. However, aerobic exercise was difficult to achieve in the double-blind clinical intervention, and thus the Hawthorne effect may have occurred, affecting the authenticity of the results. | Yes |
Zhang[59] | 2012 | China | 9 (593) | Aerobic exercise | Routine methods of care | Jadad Scores | PFS; SCFS-6; FACIT-F; MFI | Aerobic exercise had an influence on CRF, with degree related to the duration of the exercise intervention. | Yes |
Zou[60] | 2014 | China | 12 (1104) | Aerobic exercise | Routine methods of care | NOS | FACIT-F; PFS | Aerobic exercise effectively improved CRF caused by chemotherapy in breast cancer patients. | Yes |
Luo[61] | 2020 | China | 3 (160) | Tai chi | Routine methods of care Supportive therapy | RoB | FACIT-F | Tai chi quan exercise had positive effects on CRF remission, but more rigorous approaches and low risk-of-bias RCTs should be provided to support more reliable evidence. | Yes |
Liu[62] | 2019 | New Zealand | 2 (337) | Tai chi | Routine methods of care | PEDro | FACIT-F; FSI | Due to the small number of included studies, it was impossible to verify the effect of tai chi in breast cancer patients with CRF. | Yes |