Telemedicine Applications for Cancer Rehabilitation: A Scoping Review

JMIR Cancer. 2024 Jul 30. doi: 10.2196/56969. Online ahead of print.

ABSTRACT

BACKGROUND: Cancer is a significant public health issue worldwide. Treatments such as surgery, chemotherapy, and radiation therapy often cause psychological and physiological side effects, affecting patients' ability to function and their quality of life. Physical activity is crucial to cancer rehabilitation, improving physical function and quality of life and reducing cancer-related fatigue. However, many patients face barriers to accessing cancer rehabilitation due to socioeconomic factors, transportation issues, and time constraints. Telerehabilitation can potentially overcome these barriers by delivering rehabilitation remotely.

OBJECTIVE: To identify how telemedicine is used for the rehabilitation of patients with cancer.

METHODS: This scoping review followed recognized frameworks. We conducted an electronic literature search on PubMed for studies published between January 2015 and May 2023. Inclusion criteria were studies reporting physical therapy telerehabilitation interventions for cancer patients, including randomized and non-randomized controlled trials, feasibility studies, and usability studies. Twenty-one studies met the criteria and were included in the final review.

RESULTS: Our search yielded 37 articles, with 21 included in the final review. Randomized Controlled Trials comprised 47.6% (10/21) of the studies, with feasibility studies at 33.3% (7/21) and usability studies at 19.0% (4/21). Sample sizes were typically 50 or fewer participants in 57.1% (12/21) of the reports. Participants were generally aged 65 or younger (81.0%, 17/21), with a balanced gender distribution. Organ-specific cancers were the focus of 66.7% (14/21) of the articles, while 28.6% (6/21) included post-treatment patients. Web-based systems were the most used technology (61.9%, 13/21), followed by phone call/SMS-based systems (42.9%, 9/21) and mobile applications (23.8%, 5/21). Exercise programs were mainly home-based (90.5%, 19/21) and included aerobic (90.5%, 19/21), resistance (61.9%, 13/21), and flexibility training (33.3%, 7/21). Outcomes included improvements in functional capacity, cognitive functioning, and quality of life (47.6%, 10/21); reductions in pain and hospital length of stay; and enhancements in fatigue, physical and emotional well-being, and anxiety. Positive effects on feasibility (14.3%, 3/21), acceptability (38.1%, 8/21), and cost-effectiveness (9.5%, 2/21) were also noted. Functional outcomes were frequently assessed (71.4%, 19/21) with tools like the 6-Minute Walk Test and grip strength tests.

CONCLUSIONS: Telerehabilitation for cancer patients is beneficial and feasible, with diverse approaches in study design, technologies, exercises, and outcomes. Future research should focus on developing standardized methodologies, incorporating objective measures, and exploring emerging technologies like virtual reality, wearable or non-contact sensors, and artificial intelligence to optimize telerehabilitation interventions. Addressing these areas can enhance clinical practice and improve outcomes for remote rehabilitation patients.

PMID:39079103 | DOI:10.2196/56969