A Web-Based Exercise System (e-CuidateChemo) to Counter the Side Effects of Chemotherapy in Patients With Breast Cancer: Randomized Controlled Trial

Abstract

Background Breast cancer patients have to face a high-risk state during chemotherapy, which involves deterioration of their health including extensive physical deterioration. Face-to-face physical exercise programs have presented low adherence rates during medical treatment, and telehealth systems could improve these adherence rates. Objective This study aimed to evaluate the effectiveness of a Web-based exercise program (e-CuidateChemo) to mitigate the side effects of chemotherapy on the physical being, anthropometric aspects, and body composition. Methods A total of 68 patients diagnosed with breast cancer, who were undergoing chemotherapy, were enrolled. The patients were categorized into two groups: e-CuidateChemo (n=34) and controls (n=34). The e-CuidateChemo group participated in an adapted 8-week tailored exercise program through a Web-based system. A blinded, trained researcher assessed functional capacity, strength, anthropometric parameters, and body composition. The intervention effects were tested using analysis of covariance and Cohen d tests. Results Functional capacity improved significantly in the e-CuidateChemo group compared to the control group (6-minute walk test: 62.07 [SD 130.09] m versus –26.34 [SD 82.21] m; 6-minute walk test % distance predicted: 10.81% [SD 22.69%] m versus –4.60% [SD 14.58%]; between-group effect: P =.015 for both). The intervention group also showed significantly improved secondary outcomes such as between-group effects for abdominal (24.93 [SD 26.83] s vs –18.59 [SD 38.69] s), back (12.45 [SD 10.20] kg vs 1.39 [10.72] kg), and lower body (–2.82 [SD 3.75] s vs 1.26 [SD 2.84] s) strength; all P <.001 compared to the control group. Conclusions This paper showed that a Web-based exercise program was effective in reversing the detriment in functional capacity and strength due to chemotherapy. Trial Registration ClinicalTrials.gov NCT02350582; https://clinicaltrials.gov/ct2/show/NCT02350582

Six-Minute Walk Distance in Breast Cancer Survivors—A Systematic Review with Meta-Analysis

“…After reading the full text, 20 papers were excluded because they did not meet the inclusion criteria (e.g., no report of 6MWD, report of 6MWD from a mixed group of cancer patients without specific 6MWD for breast cancer, etc.). A total of 21 papers were included in the quantitative synthesis [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]. Among these papers were 9 randomized controlled trials (RCT), 8 prospective cohort studies and 4 cross-sectional studies.…”

“…In most (15/21) of the studies, 6MWT was used as part of a comprehensive physical assessment of BCS [ 31 , 32 , 33 , 35 , 36 , 37 , 39 , 40 , 43 , 45 , 46 , 48 , 49 , 50 , 51 ] to evaluate the CRF-related effectiveness of the exercise intervention ( Table 1 ). In the Ortiz study [ 41 ] mentioned above, the authors also reported significant combined effects of weekly exercise volume (expressed in minutes of moderate and vigorous physical activity with additional walking) reported by the International Physical Activity Questionnaire and 6MWD, whereas in another study examining 40 BCS aged 20-60 years, they did not report such an effect [ 44 ].…”

Effects of Tele-Rehabilitation Compared with Home-Based in-Person Rehabilitation for Older Adult’s Function after Hip Fracture

“…Home rehabilitation is an important option post-hospital discharge for hip fracture [5], and given the advances in information and communication technologies (ICT) [6], tele-rehabilitation (tele-rehab) ("the provision of rehabilitation services at a distance") is another possible delivery mode. There are many studies highlighting the benefits of tele-rehabilitation in other clinical areas, such as post joint arthroplasty [7,8], cancer [9], stroke [10], and/or heart conditions [11]. Conversely, there is a gap in evidence and practice for tele-rehabilitation for older adults with hip fracture [12].…”

From Patient Engagement to Precision Oncology: Leveraging Informatics to Advance Cancer Care

“…Currently, it is still challenging to bring together disparate data streams generated by patients from technologies such as smartphones, social media platforms, wearable activity trackers, and Internet of Things (IoT) devices such as smart home sensors. However, multiple studies have begun to demonstrate the value of employing digital health technologies to improve cancer prevention and care 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 .…”

“…For example, apps and web-based interventions have been used to support exercise 5 and in digital outreach efforts focused on cancer screening 6 . In a web-based exercise intervention to mitigate the effects of chemotherapy, breast cancer patients demonstrated improvements on the six-minute walk test, and abdominal, back, lower body strength compared to the control group over the eight-week study 5 . One study demonstrated that Google search and Facebook advertisements could be used to promote cancer screening 6 .…”