Exercise App Shows Feasibility, Reduces Fatigue in Pediatric Cancer Patients

A nurse-integrated mobile health application, HOPEMOVE, was feasible, acceptable, and safe as a structured exercise intervention for adolescents with cancer, with 80% of participants meeting predefined adherence criteria and significant improvements observed across all fatigue subdomains, according to pilot study findings (NCT07274358) presented at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting.

Overall fatigue scores improved significantly from a mean of 100.06 (± 22.28) at baseline to 139.26 (± 18.89) post-intervention (P < .001; Z = –3.408), reflecting meaningful reductions in treatment-related physical and cognitive burden across the 8-week program. Usability scores rated by clinical experts using the Mobile Application Usability Scale were high at 6.55 (± 0.49), and participant satisfaction measured by visual analog scale was equally strong at 6.66 (± 0.48). All 15 enrolled adolescents completed the study without withdrawals or technical issues, and no adverse events were reported.

“This app was designed so thoughtfully for us. I enjoyed using it,” one participant noted. Another said it made them feel “more active and motivated, even on days I felt tired,” while a third commented that “the exercises were easy to follow, and I felt safe doing them.”

Improvements in fatigue were observed across all 4 subdomains of the Fatigue Scale for Pediatric Oncology Patients: general problems, sleep problems, cognitive problems, and problems related to treatment. General problems scores rose from a mean of 60.45 (± 13.87) to 83.93 (± 10.95; P < .001; Z = –3.408); problems scores improved from 19.33 (± 4.60) to 26.20 (± 4.19; P = .001; Z = –3.205); cognitive problems scores increased from 12.46 (± 2.94) to 17.40 (± 2.69; P = .002; Z = –3.045); and problems related to treatment improved from 7.80 (± 3.05) to 11.73 (± 2.21; P = .005; Z = –2.823). In all subdomain comparisons, higher post-intervention scores indicated reduced fatigue burden.

“This study demonstrated that HopeMove is a feasible, acceptable, and safe mobile health intervention for supporting structured exercise participation among adolescents with cancer,” presenting study author Rejin Kebudi, MD, of Istanbul University, Oncology Institute and American Hospital-Koc University, Pediatric Hematology-Oncology, and coauthors, wrote. “The findings indicate that a clinician-supported, video-guided exercise program can be integrated into pediatric oncology supportive care without increasing clinical workload.”

The single-center pilot study was conducted at a Pediatric Hematology and Oncology clinic at a university hospital between September and November 2025, enrolling 15 patients aged 13 to 18 years with stable cancer diagnoses. The mean patient age was 15.06 years (± 2.05). The most common diagnoses were osteosarcoma (26.6%), Ewing sarcoma (13.3%), and nasopharyngeal carcinoma (13.3%), with the remainder comprising other solid and hematologic malignancies. Approximately 53.3% of patients were undergoing radiotherapy, 33.4% chemotherapy, and 13.3% combined chemo-radiotherapy.

HOPEMOVE was developed through multidisciplinary collaboration between nursing researchers and engineers across 2 phases. Phase 1 encompassed app development and pre-evaluation, including a usability assessment by 10 clinical experts and feedback on ease of use gathered from hospitalized adolescents. Phase 2 consisted of the 8-week pilot implementation, in which participants completed a minimum of three 45-minute video-guided exercise sessions per week. A nurse-integrated clinician dashboard enabled remote monitoring of adherence and secure messaging between clinicians and patients. The app's design, which allowed participation based on daily condition, was a key factor for sustaining engagement during treatment.

Future directions include larger multicenter randomized controlled trials, integration of objective activity monitoring such as wearables, expansion to additional age groups and cancer diagnoses, evaluation of anxiety and sleep quality outcomes, and cost-effectiveness analyses. The team also plans to explore personalization, gamification, and adaptive feedback features within the app, as well as potential integration into standard nurse-led supportive care models.

References

Berktaş Y, Kebudi R, Zülfikar OB, et al. HOPEMOVE: Feasibility and acceptability of a mobile exercise app for pediatric patients undergoing cancer treatment. J Clin Oncol. 2026;44(suppl 16):285. doi:10.1200/JCO.2026.44.16_suppl.10034