The intervention mechanisms of square dance exercise participation on loneliness and social alienation in elderly cancer patients: A systematic review

Abstract

Loneliness and social alienation are key psychosocial challenges in the integrated care of elderly cancer patients, significantly affecting their quality of life and treatment outcomes. This systematic review integrates two decades of interdisciplinary research and uses bibliometric analysis to elucidate the multidimensional mechanisms behind square dance exercise (SDE) as an effective nonpharmacological intervention. Empirical research shows that the mechanism of action of SDE involves three synergistic pathways: rebuilding social support networks, regulating neuroendocrine responses, and achieving behavioral cognitive reconstruction through group action synchronization. Studies have confirmed that moderating factors such as cultural-community embeddedness, collective action coordination, and disease stage adaptability have a significant impact on the intervention effect. The proposed "exerciseneuroplasticity-social synergy" (ENSS) framework emphasizes that combining open community spaces with culturally familiar movement patterns can effectively reduce implementation barriers in resource-limited settings. The inherent accessibility, low cost, and lifestyle embeddedness of SDE establish a scalable model for psycho-oncology rehabilitation in the aging population. Future study should focus on developing intervention protocols that are adapted to different cultures and optimized for dose-response, as well as establishing dynamic assessment models using neurobehavioral biomarkers to promote a paradigm shift from empirical approaches to precision personalized interventions. This eco-centric intervention paradigm, based on community-engaged behavioral neuroscience, provides a transformative, interdisciplinary research approach to alleviate psychosocial distress in elderly cancer patients.