Educational applications of aerobic exercise in psycho-oncology: Teaching mind–body resilience through movement

  • Jin Xu Kyungnam University, 7 Kyungnamdaehak-ro, Masanhappo-gu, Changwon-si, Gyeongsangnam-do 51276, South Korea
  • Wenjing Guo Kyungnam University, 7 Kyungnamdaehak-ro, Masanhappo-gu, Changwon-si, Gyeongsangnam-do 51276, South Korea
  • Jianmin Dai * Kyungnam University, 7 Kyungnamdaehak-ro, Masanhappo-gu, Changwon-si, Gyeongsangnam-do 51276, South Korea
Article ID: 5564
42 Views
Keywords: aerobic exercise; psycho-oncology; resilience; mind–body education; cancer survivorship; embodied learning

Abstract

Cancer represents not only a biomedical condition but also a profound psychological and existential experience that challenges patients’ sense of agency and well-being. Within psycho-oncology, aerobic exercise has emerged as a powerful mind–body intervention that extends beyond physical rehabilitation to serve as an educational medium for cultivating resilience. This narrative review synthesizes theoretical, empirical, and pedagogical evidence to explore how structured aerobic activity can teach self-regulation, emotional awareness, and adaptive coping in cancer care. Drawing on biopsychosocial and neuropsychobiological models, the review demonstrates that rhythmic aerobic movement enhances mood, cognition, and physiological coherence while fostering reflective learning through embodied experience. Integrating these effects into psycho-oncological education transforms exercise into a cyclical process of physiological activation, emotional insight, reflection, and personal transformation. Implementing such movement-based pedagogy requires interdisciplinary collaboration, culturally sensitive adaptation, and reflective facilitation, yet it holds significant promise for both patients and healthcare professionals. Ultimately, teaching resilience through movement unites therapy and education, embodying the biopsychosocial principles of psycho-oncology and redefining recovery as a dynamic, experiential process through which individuals learn to move with awareness, strength, and purpose toward holistic well-being.

Published
2025-12-12
How to Cite
Xu, J., Guo, W., & Dai, J. (2025). Educational applications of aerobic exercise in psycho-oncology: Teaching mind–body resilience through movement. Psycho-Oncologie, 19(4), 5564. https://doi.org/10.18282/po5564
Section
Review

References

1. Meoded MD, Tănase M, Mehedințu C, Cirimbei C. Psycho-oncology in breast cancer: Supporting women through distress, treatment, and recovery—Three arguments—Rapid narrative review. Medicina. 2025; 61(6): 1008. doi: 10.3390/medicina61061008

2. Rosberger Z, Perez S, Bloom J, et al. The missing piece: Cancer prevention within psycho‐oncology—A commentary. Psycho-Oncology. 2015; 24(10): 1330-1337. doi: 10.1002/pon.3916

3. Ilgen J, Renovanz M, Stengel A, et al. Resilience as a factor influencing psychological distress experience in patients with neuro-oncological disease. Current Oncology. 2022; 29(12): 9875-9883. doi: 10.3390/curroncol29120776

4. Ludolph P, Kunzler AM, Stoffers-Winterling J, et al. Interventions to promote resilience in cancer patients. Deutsches Ärzteblatt International. 2019; 116: 865-872. doi: 10.3238/arztebl.2019.0865

5. Yu K, Yin B, Zhu Y, et al. Efficacy of a digital postoperative rehabilitation intervention in patients with primary liver cancer: Randomized controlled trial. JMIR mHealth and uHealth. 2025; 13: e59228. doi: 10.2196/59228

6. Hall CC, Cook J, Maddocks M, et al. Combined exercise and nutritional rehabilitation in outpatients with incurable cancer: A systematic review. Supportive Care in Cancer. 2019; 27(7): 2371-2384. doi: 10.1007/s00520-019-04749-6

7. Qi Y, Wang M, Xue Y, et al. Feasibility of an exercise-nutrition-psychology integrated rehabilitation model based on mobile health and virtual reality for cancer patients: A single-center, single-arm, prospective phase II study. BMC Palliative Care. 2024; 23(1): 155. doi: 10.1186/s12904-024-01487-3

8. Gilchrist SC, Barac A, Ades PA, et al. Cardio-oncology rehabilitation to manage cardiovascular outcomes in cancer patients and survivors: A scientific statement from the American Heart Association. Circulation. 2019; 139(21). doi: 10.1161/CIR.0000000000000679

9. Bennett AE, O’Neill L, Connolly D, et al. Patient experiences of a physiotherapy-led multidisciplinary rehabilitative intervention after successful treatment for oesophago-gastric cancer. Supportive Care in Cancer. 2018; 26(8): 2615-2623. doi: 10.1007/s00520-018-4112-6

10. O’Neill L, Guinan E, Doyle SL, et al. Rehabilitation strategies following esophageal cancer (the ReStOre trial): A feasibility study. Diseases of the Esophagus. 2017; 30(5): 1-8. doi: 10.1093/dote/dow012

11. Sabani N, Hardaker G, Sabki A, Salleh S. Understandings of Islamic pedagogy for personalised learning. The International Journal of Information and Learning Technology. 2016; 33(2): 78-90. doi: 10.1108/IJILT-01-2016-0003

12. Garrett F. Engaged pedagogy through role‐play in a Buddhist studies classroom. Teaching Theology & Religion. 2018; 21(4): 336-344. doi: 10.1111/teth.12462

13. Nguyen DJ, Larson JB. Don’t forget about the body: Exploring the curricular possibilities of embodied pedagogy. Innovative Higher Education. 2015; 40(4): 331-344. doi: 10.1007/s10755-015-9319-6

14. Senf B, Fettel J, Demmerle C, Maiwurm P. Physicians’ attitudes towards psycho‐oncology, perceived barriers, and psychosocial competencies: Indicators of successful implementation of adjunctive psycho‐oncological care? Psycho-Oncology. 2019; 28(2): 415-422. doi: 10.1002/pon.4962

15. Brown JC, Huedo-Medina TB, Pescatello LS, et al. The efficacy of exercise in reducing depressive symptoms among cancer survivors: A meta-analysis. PLoS One. 2012; 7(1): e30955. doi: 10.1371/journal.pone.0030955

16. Zheng D, Marbut AR, Zhang J, O’Keefe LC. The contribution of psychological resilience and job meaningfulness to well-being of working cancer survivors. Workplace Health & Safety. 2022; 70(10): 468-478. doi: 10.1177/21650799221085466

17. Ağaç M, Üzar-Özçetin YS. Psychological resilience, metacognitions, and fear of recurrence among cancer survivors and family caregivers. Cancer Nursing. 2022; 45(2): E454-E462. doi: 10.1097/NCC.0000000000000973

18. Fernandes JB, Domingos J, Almeida AS, et al. Enablers, barriers and strategies to build resilience among cancer survivors: A qualitative study protocol. Frontiers in Psychology. 2023; 14. doi: 10.3389/fpsyg.2023.1049403

19. Clark V, Brown RF, Gada U, Kamen CS. Resilience related to anxiety, self-esteem, and internalized lesbian, gay, bisexual, and/or transgender negativity: A stepwise regression model among lesbian, gay, bisexual, transgender, queer, and/or another gender and/or sexually expansive identity cancer survivors. Translational Issues in Psychological Science. 2025; 11(1): 107-118. doi: 10.1037/tps0000451

20. Park JH, Lee JS, Ko YH, Kim YH. Physical activity of Korean cancer survivors is associated with age and sex. The Korean Journal of Internal Medicine. 2021; 36(Suppl 1): S225-S234. doi: 10.3904/kjim.2019.240

21. Javellana M, Hlubocky FJ, Somasegar S, et al. Resilience in the face of pandemic: The impact of COVID-19 on the psychologic morbidity and health-related quality of life among women with ovarian cancer. JCO Oncology Practice. 2022; 18(6): e948-e957. doi: 10.1200/OP.21.00514

22. Lim J, Shon E, Paek M, Daly B. The dyadic effects of coping and resilience on psychological distress for cancer survivor couples. Supportive Care in Cancer. 2014; 22(12): 3209-3217. doi: 10.1007/s00520-014-2334-9

23. Papathanasiou IV, Kelepouris K, Valari C, et al. Depression, anxiety and stress among patients with hematological malignancies and the association with quality of life: A cross-sectional study. Medicine and Pharmacy Reports. 2020; 93(1): 62-68. doi: 10.15386/mpr-1502

24. Üzar-Özçetin YS, Kovanci MS. “For Years I lived in a Cage. Now the Cage Is Open and I Am Just Learning to Fly.” Perspectives of cancer survivors on psychological resilience. Cancer Nursing. 2022; 45(4): 297-305. doi: 10.1097/NCC.0000000000001039

25. Kim M, Sok S. Factors influencing resilience among breast cancer survivors: Implications for evidence‐based practice. Worldviews on Evidence-Based Nursing. 2024; 21(1): 87-95. doi: 10.1111/wvn.12678

26. Tarasenko Y, Chen C, Schoenberg N. Self‐reported physical activity levels of older cancer survivors: Results from the 2014 national health interview survey. Journal of the American Geriatrics Society. 2017; 65(2): e39-e44. doi: 10.1111/jgs.14589

27. Jones LW, Courneya KS. Exercise counseling and programming preferences of cancer survivors. Cancer Practice. 2002; 10(4): 208-215. doi: 10.1046/j.1523-5394.2002.104003.x

28. Sprod LK, Hsieh CC, Hayward R, Schneider CM. Three versus six months of exercise training in breast cancer survivors. Breast Cancer Research and Treatment. 2010; 121(2): 413-419. doi: 10.1007/s10549-010-0913-0

29. Smith-Turchyn J, Allen L, Dart J, et al. Characterizing the exercise behaviour, preferences, barriers, and facilitators of cancer survivors in a rural Canadian community: A cross-sectional survey. Current Oncology. 2021;28(4): 3172-3187. doi: 10.3390/curroncol28040276

30. Dams L, Van der Gucht E, Devoogdt N, et al. Effect of pain neuroscience education after breast cancer surgery on pain, physical, and emotional functioning: A double-blinded randomized controlled trial (EduCan trial). Pain. 2023; 164(7): 1489-1501. doi: 10.1097/j.pain.0000000000002838

31. Wick K, Leeger-Aschmann CS, Monn ND, et al. Interventions to promote fundamental movement skills in childcare and kindergarten: A systematic review and meta-analysis. Sports Medicine. 2017; 47(10): 2045-2068. doi: 10.1007/s40279-017-0723-1

32. Ernstmann N, Enders A, Halbach S, et al. Psycho-oncology care in breast cancer centres: A nationwide survey. BMJ Supportive & Palliative Care. 2020; 10(4): e36. doi: 10.1136/bmjspcare-2018-001704

33. Lee BO, Choi WJ, Sung NY, et al. Incidence and risk factors for psychiatric comorbidity among people newly diagnosed with cancer based on Korean national registry data. Psycho-oncology. 2015; 24(12): 1808-1814. doi: 10.1002/pon.3865

34. Kang JI, Sung NY, Park SJ, et al. The epidemiology of psychiatric disorders among women with breast cancer in South Korea: Analysis of national registry data. Psycho-oncology. 2014; 23(1): 35-39. doi: 10.1002/pon.3369

35. Hui D, Kim SH, Kwon JH, et al. Access to palliative care among patients treated at a comprehensive cancer center. The Oncologist. 2012; 17(12): 1574-1580. doi: 10.1634/theoncologist.2012-0192

36. Singer S, Dieng S, Wesselmann S. Psycho‐oncological care in certified cancer centres—A nationwide analysis in Germany. Psycho-oncology. 2013; 22(6): 1435-1437. doi: 10.1002/pon.3145

37. Hammon DE, Pearsall K, Smith NM, et al. Eutectic mixture of lidocaine and prilocaine decreases movement and propofol requirements for pediatric lumbar puncture during deep sedation: A randomized, placebo-controlled, double blind trial. Journal of Pediatric Hematology/Oncology. 2022; 44(1): e213-e216. doi: 10.1097/MPH.0000000000002169

38. Zhu H, Chen S, Xie P, et al. Quality of reporting in oncology randomized controlled trials. Cancer Control. 2018; 25(1). doi: 10.1177/1073274818781309

39. Fernández-Rodríguez EJ, González-Sánchez J, Puente-González AS, et al. Specific autonomy recovery programme in a comprehensive rehabilitation on functionality and respiratory parameters in oncological patients with dyspnoea. Study protocol. BMC Nursing. 2021; 20(1): 120. doi: 10.1186/s12912-021-00633-z

40. Bakitas M, Lyons KD, Hegel MT, et al. Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: The Project ENABLE II randomized controlled trial. JAMA. 2009; 302(7): 741-749. doi: 10.1001/jama.2009.1198

41. Chuck KW, Hoang T, Kim J. Patterns of oncological clinical trials in African countries: A scoping review. Journal of Cancer Prevention. 2025; 30(3): 154-165. doi: 10.15430/JCP.25.021

42. McClelland S. Accuracy of medical oncology prognosis for metastatic cancer patients evaluated for enrollment onto an ongoing randomized clinical trial. American Journal of Clinical Oncology. 2024; 47(10): 496-497. doi: 10.1097/COC.0000000000001122

43. Windisch P, Dennstädt F, Koechli C, et al. A pipeline for the automatic identification of randomized controlled oncology trials and assignment of tumor entities using natural language processing. Oncology. 2024. doi: 10.1101/2024.07.01.24309767

44. Margevicius S, Daly B, Schluchter M, et al. Randomized trial of a web-based nurse education intervention to increase discussion of clinical trials. Contemporary Clinical Trials Communications. 2021; 22: 100789. doi: 10.1016/j.conctc.2021.100789

45. Carmona-Gonzalez CA, Cunha MT, Menjak IB. Bridging research gaps in geriatric oncology: Unraveling the potential of pragmatic clinical trials. Current Opinion in Supportive and Palliative Care. 2024; 18(1): 3-8. doi: 10.1097/SPC.0000000000000688

46. Olivier T, Haslam A, Prasad V. Reporting of physicians’ or investigators’ choice of treatment in oncology randomized clinical trials. JAMA Netw Open. 2022; 5(1): e2144770. doi: 10.1001/jamanetworkopen.2021.44770

47. Antoni MH. Psychosocial intervention effects on adaptation, disease course and biobehavioral processes in cancer. Brain, Behavior, and Immunity. 2013; 30: S88-S98. doi: 10.1016/j.bbi.2012.05.009

48. Jacobsen PB. Clinical practice guidelines for the psychosocial care of cancer survivors: Current status and future prospects. Cancer. 2009; 115(S18): 4419-4429. doi: 10.1002/cncr.24589

49. Baziliansky S, Cohen M. Emotion regulation and psychological distress in cancer survivors: A systematic review and meta‐analysis. Stress and Health. 2021; 37(1): 3-18. doi: 10.1002/smi.2972

50. Namjoshi S. The crucial role of psychosocial research for patients and caregivers: A narrative review of pediatric psycho-oncology research in India. Psycho-Oncology Research in Pediatric Cancer in India. 2024; 45(3): 202-209. doi: 10.1055/s-0044-1786967

51. Conley CC, Bishop BT, Andersen BL. Emotions and emotion regulation in breast cancer survivorship. Healthcare. 2016; 4(3): 56. doi: 10.3390/healthcare4030056

52. Mock V, St. Ours C, Hall S, et al. Using a conceptual model in nursing research—Mitigating fatigue in cancer patients. Journal of Advanced Nursing. 2007; 58(5): 503-512. doi: 10.1111/j.1365-2648.2007.04293.x

53. Turner J. The changing landscape of cancer care—The impact of psychosocial clinical practice guidelines. Psycho-Oncology. 2015; 24(4): 365-370. doi: 10.1002/pon.3803

54. Miller M, Vachon E, Kwekkeboom K. Cancer-related symptom frameworks using a biopsychosocial-spiritual perspective: A scoping review. Western Journal of Nursing Research. 2023; 45(10): 963-973. doi: 10.1177/01939459231193698

55. Pradeu T, Daignan‐Fornier B, Ewald A, et al. Reuniting philosophy and science to advance cancer research. Biological Reviews. 2023; 98(5): 1668-1686. doi: 10.1111/brv.12971

56. Aburizik A, Raque TL, Spitz N, et al. Responding to distress in cancer care: Increasing access to psycho oncology services through integrated collaborative care. Psycho-Oncology. 2023; 32(11): 1675-1683. doi: 10.1002/pon.6217

57. John JM, Haug V, Thiel A. Physical activity behavior from a transdisciplinary biopsychosocial perspective: A scoping review. Sports Medicine - Open. 2020; 6(1): 49. doi: 10.1186/s40798-020-00279-2

58. Meggiolaro E, De Padova S, Ruffilli F, et al. From distress screening to uptake: An Italian multicenter study of cancer patients. Cancers. 2021; 13(15): 3761. doi: 10.3390/cancers13153761

59. Dilworth S, Higgins I, Parker V, et al. Patient and health professional’s perceived barriers to the delivery of psychosocial care to adults with cancer: A systematic review. Psycho-oncology. 2014; 23(6): 601-612. doi: 10.1002/pon.3474

60. Lawson McLean AC, Lawson McLean A, Ernst T, et al. Benchmarking palliative care practices in neurooncology: A German perspective. Journal of Neuro-Oncology. 2024; 168(2): 333-343. doi: 10.1007/s11060-024-04674-7

61. Grassi L, Watson M. Psychosocial care in cancer: An overview of psychosocial programmes and national cancer plans of countries within the International Federation of Psycho‐Oncology Societies. Psycho-oncology. 2012; 21(10): 1027-1033. doi: 10.1002/pon.3154

62. Anuk D, Özkan M, Kizir A, Özkan S. The characteristics and risk factors for common psychiatric disorders in patients with cancer seeking help for mental health. BMC Psychiatry. 2019; 19(1): 269. doi: 10.1186/s12888-019-2251-z

63. Brebach R, Sharpe L, Costa DSJ, et al. Psychological intervention targeting distress for cancer patients: A meta‐analytic study investigating uptake and adherence. Psycho-oncology. 2016; 25(8): 882-890. doi: 10.1002/pon.4099

64. Brédart A, Didier F, Robertson C, et al. Psychological distress in cancer patients attending the European Institute of Oncology in Milan. Oncology. 1999; 57(4): 297-302. doi: 10.1159/000012064

65. Tada Y, Matsubara M, Kawada S, et al. Psychiatric disorders in cancer patients at a university hospital in Japan: Descriptive analysis of 765 psychiatric referrals. Japanese Journal of Clinical Oncology. 2012; 42(3): 183-188. doi: 10.1093/jjco/hyr200

66. Kadan‐Lottick NS, Vanderwerker LC, Block SD, et al. Psychiatric disorders and mental health service use in patients with advanced cancer. Cancer. 2005; 104(12): 2872-2881. doi: 10.1002/cncr.21532

67. Mirzaie K, Burns-Gebhart A, Meyerheim M, et al. Emotion regulation flexibility and electronic patient-reported outcomes: A framework for understanding symptoms and affect dynamics in pediatric psycho-oncology. Cancers. 2022; 14(16): 3874. doi: 10.3390/cancers14163874

68. Donovan KA, Grassi L, Deshields TL, et al. Advancing the science of distress screening and management in cancer care. Epidemiology and Psychiatric Sciences. 2020; 29: e85. doi: 10.1017/S2045796019000799

69. Kusch M, Labouvie H, Schiewer V, et al. Integrated, cross-sectoral psycho-oncology (isPO): A new form of care for newly diagnosed cancer patients in Germany. BMC Health Services Research. 2022; 22(1): 543. doi: 10.1186/s12913-022-07782-0

70. Sibarani LP, Setijadi AR, Apriningsih H, et al. Effects of aerobic exercise on the six minutes walking test and quality of life in EGFR mutation non-small cell lung cancer patients. Jurnal Respirologi Indonesia. 2025; 45(2): 93-99. doi: 10.36497/jri.v45i2.613

71. Courneya KS, Sellar CM, Stevinson C, et al. Randomized controlled trial of the effects of aerobic exercise on physical functioning and quality of life in lymphoma patients. Journal of Clinical Oncology. 2009; 27(27): 4605-4612. doi: 10.1200/JCO.2008.20.0634

72. Niederer D, Vogt L, Thiel C, et al. Exercise effects on HRV in cancer patients. International Journal of Sports and Medicine. 2012; 34(01): 68-73. doi: 10.1055/s-0032-1314816

73. Niederer D, Vogt L, Gonzalez-Rivera J, et al. Heart rate recovery and aerobic endurance capacity in cancer survivors: Interdependence and exercise-induced improvements. Supportive Care in Cancer. 2015; 23(12): 3513-3520. doi: 10.1007/s00520-015-2719-4

74. Aydin M, Kose E, Odabas I, et al. The effect of exercise on life quality and depression levels of breast cancer patients. Asian Pacific Journal of Cancer Prevention. 2021; 22(3): 725-732. doi: 10.31557/APJCP.2021.22.3.725

75. Mehnert A, Veers S, Howaldt D, et al. Effects of a physical exercise rehabilitation group program on anxiety, depression, body image, and health-related quality of life among breast cancer patients. Onkologie. 2011; 34(5): 248-253. doi: 10.1159/000327813

76. Kulchycki M, Halder HR, Askin N, et al. Aerobic physical activity and depression among patients with cancer. JAMA Netw Open. 2024; 7(10): e2437964. doi: 10.1001/jamanetworkopen.2024.37964

77. Grote S, Ricci JM, Dehom S, et al. Heart rate variability and cardiovascular adaptations among cancer-survivors following a 26-week exercise intervention. Integrative Cancer Therapies. 2020; 19. doi: 10.1177/1534735420969816

78. Kloter E, Barrueto K, Klein SD, et al. Heart rate variability as a prognostic factor for cancer survival—A systematic review. Frontiers in Physiology. 2018; 9. doi: 10.3389/fphys.2018.00623

79. Zhu G, Zhang X, Wang Y, et al. Effects of exercise intervention in breast cancer survivors: A meta-analysis of 33 randomized controlled trails. OncoTargets and Therapy. 2016; 2016: 2153-5168. doi: 10.2147/OTT.S97864

80. Musanti R, Murley B. Community-based exercise programs for cancer survivors. Clinical Journal of Oncology Nursing. 2016; 20(6): S25-S30. doi: 10.1188/16.CJON.S2.25-30

81. Alberton CL, Andrade LS, Xavier BEB, et al. Land- and water-based aerobic exercise program on health-related outcomes in breast cancer survivors (WaterMama): Study protocol for a randomized clinical trial. Trials. 2024; 25(1): 536. doi: 10.1186/s13063-024-08389-y

82. Batalik L, Winnige P, Dosbaba F, et al. Home-based aerobic and resistance exercise interventions in cancer patients and survivors: A systematic review. Cancers. 2021; 13(8): 1915. doi: 10.3390/cancers13081915

83. Campbell KL, Winters-Stone KM, Wiskemann J, et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Medicine & Science in Sports & Exercise. 2019; 51(11): 2375-2390. doi: 10.1249/MSS.0000000000002116