Mehnert 2011.

Study characteristics
Methods	Study design: RCT Number randomized: 63; 35 to the exercise group and 28 to the control group Study start and stop dates: not reported Length of intervention: 10 weeks Length of follow‐up: to end of the intervention
Participants	Type cancer: non‐metastatic breast cancer, stages I to III Stage of cancer, n (%): exercise group: Stage I, 17 (56.7%); Stage IIA, 8 (26.7%); Stage IIB, 3 (10.0%); Stage IIIA, 1 (3.3%); Stage IIIB, 1 (3.3%) control group: Stage I, 13 (46.4%); Stage IIA, 7 (25.0%); Stage IIB, 5 (17.9%); Stage IIIA, 3 (10.7%); Stage IIIB, 0 (0%) Time since cancer diagnosis: not reported Time beyond active treatment: at least 4 weeks following chemotherapy, radiation therapy, or both  Inclusion criteria: 18 to 65 years old primary nonmetastatic breast cancer minimum 4 weeks after completion of chemotherapy, radiation therapy, or both Eligibility criterion related to interest or ability to exercise, or both: any disorder that could interfere with ability to perform the physical exercise program Exclusion criteria: severe acute or chronic illness other than cancer (e.g. disorders of the musculoskeletal system) Gender: female Current age, mean (SD) years: exercise group: 53.03 (7.40) years control group: 50.64 (9.44) years Age at cancer diagnosis: not reported Ethnicity/race: not reported Education level, n (%): exercise group: elementary school, 2 (6.9%); junior high school, 17 (58.6%); high school, 2 (6.9%); university degree, 8 (27.6%) control group: elementary school, 4 (14.3%); junior high school, 11 (39.3%); high school, 6 (21.4%); university degree, 7 (25.0%) SES: not reported Employment status, n (%): exercise group: employed, 17 (60.7%); retired, 5 (17.8%); housewife, 4 (14.3%); unemployed, 1 (3.6%); unable to work/sick leave, 1 (3.6%) control group: employed, 14 (50.0%); retired, 3 (10.7%); housewife, 4 (14.3%); unemployed, 6 (21.4%); unable to work/sick leave, 1 (3.6%) Comorbidities: not reported Past exercise history: exercise group: 19/30 (63.3%) engaged in regular sport and fitness activities for a mean (SD) of 2.3 (1.4) training hours per week control group: 10/28 (35.7%) engaged in regular sport and fitness activities for a mean (SD) of 1.7 (0.9) training hours per week On hormone therapy: not reported
Interventions	35 participants assigned to a structured physical training program developed to promote muscular strength and exposure, including: gymnastics, movement games, and relaxation moderate walking and jogging conducted outside Although 35 women were assigned to the exercise intervention, 5 women refused to participate prior to the baseline assessment Type exercise (aerobic/anaerobic): aerobic Intensity of experimental exercise intervention: maximum of 60% VO2 Frequency: twice per week Duration of individual sessions: 90 minutes Duration of exercise program: 10 weeks Total number of exercise sessions: 20 Format: group Facility: indoor sports facility and outdoors Professionally led by trained member of study staff (qualified physical therapist or sport therapist) 28 participants assigned to control group, including: usual care Adherence: not reported Contamination of control group: not reported
Outcomes	No primary outcome was identified. QoL outcomes included: anxiety, measured using HADS depression, measured using HADS cancer‐specific HRQoL, measured using the EORTC QLQ‐C30 subscale generic HRQoL, measured using MOS SF‐36 psychological symptoms, measured using SCL‐90‐R body image, measured using a German version of the BIQ Outcomes were measured at baseline and 10 weeks: Different numbers of participants had data at the 2 time points as follows: Anxiety and depression: exercise group: n = 30 at baseline, n = 30 at 10 weeks control group: n = 28 at baseline, n = 28 at 10 weeks Individual body Image: exercise group: n = 27 at baseline, n = 27 at 10 weeks control group: n = 27 at baseline, n = 27 at 10 weeks Social body image: exercise group: n = 30 at baseline, n = 27 at 10 weeks control group: n = 27 at baseline, n = 27 at 10 weeks Numbers of individuals with data for cancer‐specific HRQoL, generic HRQoL, and psychological symptoms were not reported Subgroup analysis: none reported Adverse events: no cancer recurrences or adverse events reported
Notes	Country: Germany Funding: Friedrich and Louise Homann Foundation, Hamburg, Germany
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	It is unclear how the allocation sequence was generated
Allocation concealment (selection bias)	Low risk	The randomization was adequately concealed through external randomization
Blinding of participants and personnel (performance bias) All outcomes	High risk	Owing to the nature of the intervention, it was not possible to blind the participants; however, it is unclear whether the outcome was influenced by a lack of masking
Blinding of outcome assessment (detection bias) All outcomes	High risk	Study personnel and outcome assessors were not masked or blinded to the study interventions
Incomplete outcome data (attrition bias) All outcomes	High risk	It is unclear how missing data were handled. 5 randomized participants were reported to have "cancelled" participation in the exercise group
Selective reporting (reporting bias)	Low risk	There appears to be no selective reporting of outcomes
Other bias	High risk	The small sample size and participation in physical exercise by women in the study groups can contribute to bias