Abstract 19055: Effectiveness of Mobile Health Applications for Exercise Promotion on Cardiorespiratory Fitness After a Cancer Diagnosis: A Systematic Review and Meta-Analysis

Introduction: Cancer survivors are at higher risk for cardiovascular (CV) related mortality. Smartphone application based (app-based) interventions that promote exercise and physical activity are an increasingly prevalent strategy for health promotion. Yet, whether these mobile health (mHealth) interventions improve CV risk after a cancer diagnosis is unknown.

Methods: Leveraging MEDLINE/PubMed, Scopus, and Clinical Trials.gov, we identified studies through May 1, 2023. Literature searches were conducted on articles meeting study inclusion criteria and with reported cancer diagnoses. Search terms included smartphone , mobile health , mHealth , app , mobile application , exercise , cancer and cardio-oncology . The main outcomes and measures included change in cardiovascular fitness, reflected by 6-minute walk test (6MWT), VO2max, 3-minute step test and systolic blood pressure or any mention of cardiac measures. Effect sizes were calculated as Cohen’s d. Aggregate effect sizes and moderator variables were tested using random effects models.

Results: Overall, from 656 articles, 7 randomized controlled trials (RCTs) with 341 participants were identified. Interventions included mobile apps (n = 6), smartwatches (n = 2), or smartwatch plus an option to also use a web, mobile, or tablet app (n = 1); median age 49.71± 5.9 years; median duration of mHealth use 12 weeks. Across the 7 RCTs, mHealth was associated with improved cardiorespiratory outcomes (Cohen’s d=0.33; 95% CI, 0.07-0.60). Results maintained significance when cholesterol outcomes were added to the other cardiorespiratory outcomes ( d = 0.30; 95% CI = 0.03-0.56). There was no heterogeneity ( Q = 5.86, P >0.05) or publication bias ( P > .05). Among the 4 studies examining the 6MWT, the between groups Δ Cohen’s d was 0.27 (95% CI, -0.21, 0.75).

Conclusions: Smartphone app-based exercise promotion interventions appear to be a viable strategy for improving cardiorespiratory fitness after a cancer diagnosis.