Mobile health and supervised rehabilitation versus mobile health alone in breast cancer survivors: Randomized controlled trial - 20/07/20
, Carolina Fernández-Lao a, b, c, d, Irene Cantarero-Villanueva a, b, c, d, Isabel B. López-Barajas e, Manuel Arroyo-Morales a, b, c, d
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Highlights |
• | The use of the BENECA mHealth app alone can improve quality of life of breast cancer survivors. |
• | The proposed integral strategy combining the BENECA app and rehabilitation doubles or even triples the effect size. |
• | Rehabilitation techniques should be personalized to each patient. |
• | The proposed strategy leads to a clinically reliable improvement in QoL and active range of motion. |
Abstract |
Background |
Survival rates in cancer are increasing exponentially, with a corresponding increase/influence in disability-adjusted life-years. Efforts should be made to explore the optimal balance between unsupervised/distance-based and supervised/onsite approaches to cancer care.
Objective |
This study aimed to compare the clinical efficacy of the BENECA mobile Health (mHealth) lifestyle application combined with a supervised rehabilitation program (BENECA and supervised rehabilitation) versus the BENECA mHealth lifestyle application alone on quality of life (QoL) and functional outcomes of breast cancer survivors.
Methods |
This randomized controlled trial included 80 survivors of breast cancer diagnosed at stage I–IIIA, who completed adjuvant therapy and were overweight or obese at diagnosis. Participants were randomly allocated (ratio 1:1, 3 waves) to BENECA mHealth and rehabilitation for 2months (n=40) or BENECA mHealth and usual care (BENECA mHealth alone; n=40). Participants completed a questionnaire at baseline (T1), 8-weeks post-intervention (T2) and 6-month follow-up (T3). The primary outcome was QoL assessed with the EORT QLQ-C30. Secondary outcomes included upper-limb functionality and body composition. Statistical (between-group analyses of covariance) and clinical effects were analyzed by intention to treat.
Results |
Both groups showed improved outcomes, but global QoL was significantly better with BENECA mHealth and rehabilitation than BENECA mHealth alone (mean difference, 12.76; 95% confidence interval 4.85; 20.67; P=0.004), with a moderate-to-large effect size (d=72). The proportion of participants reporting reliable clinical improvement on global QoL at T2 was higher with BENECA mHealth and rehabilitation than BENECA mHealth alone (57.5% vs 26.3%, P=0.008). Improvement in subjective and objective upper-limb functionality was also higher with BENECA mHealth and rehabilitation.
Conclusions |
The BENECA mHealth lifestyle application with a supervised rehabilitation program had a statistically and clinically significant effect on QoL and upper-limb functionality in breast cancer survivors and is a unique and important promising new approach.
Le texte complet de cet article est disponible en PDF.Keywords : Breast cancer, Integral strategy, Rehabilitation, mHealth, Occupational therapy
Plan
Vol 63 - N° 4
P. 316-324 - juillet 2020 Retour au numéro
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