The Effectiveness of Wearable Electronic Device System-Supported Physical Activity Programs for Cancer Survivors:...

As cancer is increasingly regarded as a chronic disease, it is essential to support cancer survivors' self-management and enhance their quality of life (QoL). Although a physically active lifestyle can help alleviate symptom burden, improve QoL, and even benefit survival among cancer survivors, many remain physically inactive. Wearable electronic device systems (WEDSs) have become increasingly integrated into daily life and may offer a potential solution to promote physical activity (PA) and improve QoL in this population. However, existing findings remain modest and inconclusive.

This meta-analysis aims to evaluate (1) the effects of WEDS-supported PA programs on improving PA, sedentary behavior, BMI, and QoL in cancer survivors; and (2) the effects of various types of these interventions.

A comprehensive literature search was conducted across PubMed, Embase, Web of Science, CENTRAL, and MEDLINE from database inception through July 31, 2024. Two authors independently screened the articles, extracted the data, and evaluated the methodological quality of the included studies using the Cochrane Risk-of-Bias tool 2. Data synthesis was performed using R Studio. The effects of the interventions were determined by calculating standard mean differences (SMDs) and 95% CIs, while heterogeneity was assessed using I² statistics and P values. Subgroup analysis was conducted to assess whether the effects differed by the formats of the partnering tools and the duration of the intervention. Sensitivity analysis was performed using the one-study-out method to evaluate the robustness of the results, and the Egger test was conducted to assess small study effects. Statistical significance for the overall effect was considered when the 2-tailed P value was less than .05.

A total of 46 randomized controlled trials, involving 3727 patients, were included in this meta-analysis. The results indicated that WEDS-supported PA programs significantly improved objectively measured moderate-to-vigorous-intensity physical activity (MVPA; SMD 0.66, 95% CI 0.47-0.86, P<.001, I2=69%), subjectively reported PA (SMD 0.5, 95% CI 0.23-0.77, P<.001, I2=79%), steps per day (SMD 0.5, 95% CI 0.23-0.77, P=.009, I2=79%), and QoL (SMD 0.19, 95% CI 0.08-0.31, P<.001, I2=33%) among cancer survivors. Subgroup analysis revealed that interventions incorporating multipartnering tools (no fewer than 2 formats) were effective in improving subjectively reported PA, steps per day, and QoL. Long-term interventions (≥12 weeks) improved objectively measured MVPA, subjectively reported PA, steps per day, and QoL. Interventions tailored to specific cancer types significantly improved steps per day (SMD 0.59, 95% CI 0.1-1.08, P=.008, I2=83%) and QoL (SMD 0.14, 95% CI 0.04-0.23, P=.006, I2=0%).

We observed that WEDS-supported PA programs are effective in improving the level of PA (both objectively and subjectively), steps per day, and QoL among cancer survivors, but showed no significant effects on sedentary behavior or BMI. In the future, the use of multipartnering tools, appropriate intervention duration, and tailored PA programs should be carefully considered when developing WEDS-supported PA interventions. Further promotion and refinement of WEDS-supported PA programs are warranted.