Digital and Interactive Health Interventions Minimize the Physical and Psychological Impact of Breast Cancer, Increasing Women’s Quality of Life: A Systematic Review and Meta-Analysis

Abstract

Digital and interactive health interventions (DIHIs), such as virtual-reality-based therapy (VRBT) and smartphone-app-based therapy (SABT), may be useful for reducing the impact of the signs and symptoms of breast cancer (BC) in women. The aim of this meta-analysis was to explore the effect of DIHIs on improving pain, anxiety, depression, quality of life (QoL), and upper extremity (UE) disability-related lymphedema in women with BC. Methods: We searched PubMed Medline, Web of Science, Scopus, CINAHL, Physiotherapy Evidence Database, and SciELO for the period ending February 2022. We included studies that assessed the effect of DIHIs on UE motor disability, pain, anxiety, depression, and QoL in women with BC. The effect size was calculated using Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI). Results: Twenty studies providing data from 1613 women with BC were included. With respect to UE disability, DIHIs increased flexion (SMD, 1.92; 95%CI: −1.16, 2.68), abduction (SMD, 1.66; 95%CI: 0.91, 2.42), external rotation shoulder range of motion (SMD, 1.1; 95%CI: 0.36, 1.85), UE function (SMD, −0.72; 95%CI: −1.31, −0.13), and handgrip strength (SMD, 0.4; 95%CI: 0.21, 0.59). DIHIs reduced pain (SMD, −0.8; 95%CI: −1.31, −0.26), anxiety (SMD, −1.02; 95%CI: −1.71, −0.34), and depression (SMD, −1.57; 95%CI: −3.1, −0.08). Finally, DIHIs increased overall health (SMD, 0.6; 95%CI: 0.31, 0.89). Conclusions: Right at the end of therapy, DIHIs are effective at improving UE function, pain, anxiety, depression, and QoL in women with BC. VRBT has a greater effect than SABT for the assessed outcomes.

Effectiveness of Virtual Reality-Based Early Postoperative Rehabilitation after Total Knee Arthroplasty: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

“…Virtual reality-based early rehabilitation (VRBR) is based on the use of virtual reality devices that allow the patient to be introduced into a virtual environment that feels similar to real-world using a computer, virtual reality glasses, or a game station, allowing interaction with this virtual environment and their objects through your own hands or joystick [20,21]. Virtual reality systems require two characteristics: immersion and presence [22].…”

Managing chronic pain after breast cancer treatments: are web-based interventions the future?

“…This current and previous reviews [35,37] suggest that digital interventions promoting symptom monitoring and support patients to self-manage symptoms have been shown to improve outcomes in cancer patients. Additionally, these interventions can facilitate early detection and intervention by promoting regular monitoring via self-assessment tools and symptom tracking.…”

“…Studies have utilised these interventions to help manage chronic post-treatment symptoms in breast cancer survivors. These include encouraging patients to exercise, adhere to endocrine treatments, and cope with longer term outcomes from adjuvant treatments including anxiety and depression, loss of functionality, lymphoedema and reduced quality of life [32][33][34][35][36].…”

Guided versus non‐guided digital psychological interventions for cancer patients: A systematic review and meta‐analysis of engagement and efficacy

“…The large number of studies ( n = 43) included in this review is another strength, increasing the reliability of the treatment effects identified. In contrast, previous reviews have included around 15–20 studies each 9,14,22,82–84 . The meta‐analysis allowed for a more robust evaluation of efficacy and comparison between guided and non‐guided interventions, thus ensuring generalisability and better guidance of future research and practice.…”