Introduction:
The aim of the study was to examine the impact of different exercise interventions on anxiety and depression in breast cancer patients through 1-year outpatient rehabilitation.

Methods:
Overall, 138 breast cancer patients were assessed for eligibility. After excluding 14 women, 124 patients were randomly allocated to water exercise interventions (group A, n = 50), Pilates exercise interventions (group B, n = 44), and yoga exercise interventions (group C, n = 30). Finally, 115 patients completed relevant interventions and were analysed. The participants reported anxiety and depression using the Hospital Anxiety and Depression Scale at baseline and after 6 and 12 months of the interventions.

Results:
After 12 months, a decrease in anxiety and depression was observed by 5.64 (p < 0.001) and 4.09 (p < 0.001) points in group A, by 5.75 (p < 0.001) and 4.60 (p < 0.001) points in group B, and by 4.07 (p < 0.001) and 3.14 (p < 0.001) points in group C, respectively. Group A showed significantly better results than group C in anxiety (by 1.54 points; p < 0.01) and depression (by 1.40 points; p < 0.05). Group B obtained significantly better results than group C in anxiety (by 1.61 points; p < 0.01) and depression (by 1.81 points; p < 0.01).

Conclusions:
Practising a water exercise program resulted in a better decrease of anxiety and depression levels compared with Pilates and yoga interventions.