Effects of eHealth exercise on paediatric suppurative lung diseases: a systematic review and meta-analysis

Utilising information and communication technologies through eHealth in exercise programmes could support their delivery and improve clinical outcomes in children and adolescents with chronic suppurative lung diseases (CSLDs). This study aimed to systematically investigate the effects of eHealth exercise programmes on clinical outcomes for this population.

Five databases were searched from inception to 12 April 2024. Two researchers independently screened the retrieved results and rated the methodological quality of the included studies using the revised Cochrane Risk of Bias (RoB2) tool for randomised trials and the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool. The quality of evidence was graded using the GRADE approach. A narrative synthesis of findings was performed, and a meta-analysis was conducted to evaluate the effects of eHealth exercise programmes on clinical outcomes that had data from at least two studies.

Seven studies used eHealth exercise programmes through active video games (n=3), videoconferencing (n=3) and a digital spirometer (n=1) lasting from 3 to 12 weeks. Five studies had participants with cystic fibrosis (CF). Results showed a greater improvement in the 6-min walk test following the intervention compared to the control group (pooled estimate mean difference 37.2 m, 95% CI 7.91-66.48 m; p=0.013). Pulmonary function, exercise capacity, balance, peripheral and respiratory muscle strength, and health-related quality of life were also improved. Still, most studies involved a considerable risk of bias.

eHealth exercise programmes can improve clinical outcomes in children and adolescents with CF. Further research is needed for other paediatric populations with CSLDs and also for comparisons with conventional exercise programmes.