Efficacy and Safety of an mHealth App and Wearable Device in Physical Performance for Patients With Hepatocellular Carcinoma: Development and Usability Study

Abstract

Background Exercise is predicted to have a positive effect among hepatocellular carcinoma (HCC) patients. However, these patients are hesitant to start and build up an exercise program for one major reason: the vague fear of developing hepatic decompensation, a potentially fatal condition that can lead to death. Integrating mobile health (mHealth) with individualized exercise programs could be a possible option for promoting physical capacity among HCC patients. Objective The aim of this study was to evaluate the efficacy and safety of rehabilitation exercises, which have been individually prescribed via an mHealth app, on physical fitness, body composition, biochemical profile, and quality of life among HCC patients. Methods A total of 37 HCC patients were enrolled in a 12-week course with an mHealth app program targeted to HCC patients. The wearable wristband device Neofit (Partron Co) was provided to participants, and recorded daily physical data, such as the number of steps, calorie expenditure, exercise time, and heart rate. Each participant was given an individualized rehabilitation exercise program that was prescribed and adjusted at the 6-week midintervention period based on the assessment results. At baseline, 6-week, and 12-week sessions, participants’ physical fitness levels (ie, 6-minute walk test, grip strength test, and 30-second chair stand test) were measured. Physical activity levels, as measured by the International Physical Activity Questionnaire-Short Form (IPAQ-SF); body composition (ie, body mass index, body fat percentage, and muscle mass); biochemical profiles; and quality of life, as measured by the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire C30, were assessed at baseline and at the end point. At the 6-week midpoint, exercise intensity was individually adjusted. Results Of the 37 patients, 31 (84%) completed the 12-week intervention. Grip strength improved significantly after 12 weeks of the intervention. The 30-second chair stand test and the 6-minute walk test showed significant improvement from 0 to 6 weeks, from 0 to 12 weeks, and from 6 to 12 weeks. Muscle mass and the IPAQ-SF score increased significantly after 12 weeks of the intervention without biochemical deterioration. Conclusions Following 12 weeks of mHealth care, including an individually prescribed rehabilitation exercise program, we saw significant improvements in physical fitness, body composition, and physical activity without any complication or biochemical deterioration among compensated HCC patients who had completed therapy.

Remote Assessment of Functional Mobility and Strength in Older Cancer Survivors: Protocol for a Validity and Reliability Study

“…Additionally, few if any of these studies have been tested in rural areas, which often have less reliable high-speed internet necessary for quality video transmission. Similarly, home-based rehabilitation interventions delivered via technology typically have involved an in-person assessment of physical performance, either through home visits by a member of the study team [ 37 , 38 ] or by requiring participants to travel to the research center for data collection [ 39 , 40 ].…”

mHealth Interventions to Address Physical Activity and Sedentary Behavior in Cancer Survivors: A Systematic Review

“…Of the 31 included studies, 14 were conducted in the United States [ 10 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ], five in Australia [ 38 , 53 , 54 , 55 , 56 ], four in Republic of Korea [ 57 , 58 , 59 , 60 ], two each in Canada [ 61 , 62 ] and France [ 63 , 64 ], and one each in The Netherlands [ 65 ], Germany [ 66 ], Spain [ 67 ], and United Kingdom [ 68 ]. All studies were conducted between 2015 and 2020.…”

“…All studies were conducted between 2015 and 2020. Sixteen of the included studies were RCT [ 38 , 40 , 42 , 44 , 46 , 47 , 48 , 49 , 51 , 52 , 53 , 56 , 61 , 64 , 65 , 69 ], whereas 12 studies employed a pre-post [ 41 , 43 , 45 , 50 , 54 , 55 , 59 , 60 , 62 , 63 , 67 , 68 ], and three studies applied a quasi-experimental design [ 57 , 58 , 66 ]. The study duration ranged from two weeks [ 55 ] to six months [ 41 , 45 , 46 , 48 , 51 , 54 , 63 ].…”

“…Several studies focused on two cancer types, such as colorectal cancer with gynecologic cancer survivors [ 56 ], breast cancer with colorectal cancer survivors [ 42 ] and breast cancer with endometrial cancer survivors [ 50 ]. The remaining studies were conducted among survivors of brain tumors [ 45 ], endometrial cancer [ 48 ], pediatric cancer [ 66 ], and hepatocellular carcinoma [ 60 ].…”

Innovation in Precision Cardio-Oncology During the Coronavirus Pandemic and Into a Post-pandemic World

“…Many of these technologies are also being explored for various scenarios in cardiology (44)(45)(46)(47)(48)(49)(50)(51), and have great clinical utility for cardio-oncology and COVID-19. Remote monitoring from wearable biosensors and mHealth is being investigated to improve outcomes in heart rhythm and heart failure and other cardiovascular conditions (44,(46)(47)(48)(49)(50), and may have utility for COVID-19 (19,(52)(53)(54)(55)(56)(57)(58) and Cardio-Oncology (59)(60)(61). Voice apps and voice analysis have shown promise in cardiology for heart failure, ischemic heart disease, pulmonary hypertension, and other forms of cardiovascular disease (45,(62)(63)(64), as well as cardio-oncology (65), and have been considered for COVID-19.…”