Meta-analysis of home-based exercise for colorectal cancer reports reduced anxiety and fatigue with low certainty evidence

BackgroundColorectal cancer (CRC) patients usually experience a range of distressing symptoms such as anxiety, depression, and cancer-related fatigue, which undermine their quality of life. Home-based exercise is considered a complementary intervention with significant potential for managing these symptoms. This study aimed to determine the effects of home-based exercise on anxiety, depression, cancer-related fatigue, and quality of life in CRC patients.MethodsA comprehensive search was conducted in PubMed, Web of Science, Scopus, Embase, Cochrane Library, CINAHL, CNKI, WanFang, VIP, and CBM, from their inception to February 2026. Randomized controlled trials investigating the effect of home-based exercise on anxiety, depression, cancer-related fatigue, and quality of life among CRC patients were included. The risk bias of the included trials was assessed using the Cochrane Risk of Bias tool 2.0 (ROB 2.0), and the certainty of the evidence for each outcome was subsequently graded according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. For quantitative synthesis, a random-effects model was used for all meta-analyses.ResultsA total of 12 randomized controlled trials involving 802 CRC patients were included. The pooled analyses demonstrated that home-based exercise significantly reduced anxiety (SMD = -1.26, 95% CI: -2.24 to -0.29, low certainty evidence), and cancer-related fatigue (SMD = -0.66, 95% CI: -1.14 to -0.18, low certainty evidence), as well as improved quality of life (SMD = 0.64, 95% CI: 0.18 to 1.10, low certainty evidence) compared to usual care. In contrast, no statistically significant effect was observed on depression levels in this population (SMD = -0.76, 95% CI: -1.81 to 0.30, very low certainty evidence).ConclusionsOur findings demonstrated that home-based exercise may serve as a complementary therapy to reduce anxiety and cancer-related fatigue in CRC patients while improving their quality of life. However, it did not exhibit positive effects in reducing their depression levels. Given the substantial heterogeneity of results and the low certainty of evidence, future studies should focus on improving study design, with particular emphasis on the use of validated and multidimensional outcome measures, to establish a more robust evidence base.