The Combined Effect of Mindfulness and Physical Activity on Stress: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

backgroundInterventions combining mindfulness and physical activity are increasingly used for stress management, but their average efficacy and incremental benefit over either component alone remain uncertain.

objectiveThis study aimed to evaluate combined mindfulness-physical activity interventions for stress or stress-related outcomes relative to passive or general control conditions, mindfulness alone, and physical activity alone, and to explore potential sources of heterogeneity.

methodsFollowing PRISMA 2020, eight electronic databases were searched through November 2025. Two reviewers independently screened records. Data extraction and the initial risk-of-bias assessment were performed by the first author and checked in full by a second reviewer. Risk of bias was assessed using RoB 1.0. Certainty of evidence was assessed using the GRADE approach. Hedges'

resultsFourteen randomised controlled trials involving 872 randomised participants were included in the systematic review, and 13 contributed to quantitative synthesis. Compared with passive or general control conditions, combined interventions produced a statistically significant average effect favouring the combined intervention (

conclusionsCombined mindfulness and physical activity interventions may reduce stress or stress-related psychological outcomes relative to passive or general controls. The current evidence is insufficient to determine whether they provide additional benefit over well-delivered single-component interventions. Substantial heterogeneity and the small number of active-comparator trials warrant cautious interpretation.