Abstract
BACKGROUND: Cancer's rising incidence and growing survivor population underscore the need for strategies to enhance health and quality of life. Outdoor physical activity (PA) settings may provide unique benefits, yet evidence in this context is scarce. This systematic review aims to evaluate the impact of outdoor PA and exercise interventions on the health and well-being of cancer survivors. METHODS: A systematic search was conducted in PubMed, Web of Science, and PsycINFO databases from their inception until April 23, 2024. Studies included randomized controlled trials (RCTs) and non-RCTs involving outdoor PA or exercise interventions for cancer survivors. The search strategy adhered to PRISMA guidelines, and the quality of studies was assessed using the PEDro scale. RESULTS: Twelve studies involving 712 cancer survivors were included, comprising 7 RCTs and 5 non-RCTs. Four studies compared outdoor exercise to indoor exercise instead of a usual care control group, and one used a crossover design. The interventions varied in frequency, intensity, time, and type, with Nordic walking and walking being the most common. Key findings indicated significant improvements in mental health, PA levels, muscular fitness, body composition, and exercise motivation. However, the impact on vital signs and sleep quality was inconclusive due to the limited number of studies and variability in interventions. CONCLUSIONS: Outdoor PA, including structured exercise interventions, substantially benefits cancer survivors, particularly in enhancing mental health and physical fitness. Despite the promising findings, further research is needed to explore long-term effects, the benefits for different cancer types and age groups, and the underlying mechanisms of these interventions. Health practitioners should consider incorporating outdoor activities into cancer rehabilitation programs. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024545392.