Home-based exercise rehabilitation in cancer improved fitness and quality of life, with high heterogeneity

A systematic review and meta-analysis of nine randomised controlled trials, covering 632 adults with cancer, tested home-based exercise interventions that incorporate cardiac rehabilitation principles Meta-analysis (Winnige et al., PMID 42811812). Home delivery improved cardiorespiratory fitness (standardised mean difference 0.42, 95% confidence interval 0.09–0.75; I² 62%) and health-related quality of life (standardised mean difference 0.63, 0.05–1.22; I² 84%). Adherence exceeded 75% in most of the studies that reported it, and dropout was 15.2%.

Heterogeneity is the main qualification. It was high for both outcomes and particularly for quality of life, where the confidence interval’s lower bound sits close to no effect, so the pooled figure is an average across programmes that differed. Adverse-event reporting was inconsistent across the trials, and findings on strength and fatigue were mixed. The review therefore supports a modest benefit and good adherence, not a precise effect size, and it cannot settle safety.

The population matters as much as the numbers. These are adults with cancer, not older people living with frailty, so the review does not show that home-based exercise improves function for frail older adults. Read against the published pattern on sarcopenia and exercise delivery, which rests on a network meta-analysis in sarcopenia, it does not widen that pattern’s reach: it concerns a different population and different outcomes, and the heterogeneity here is high.

What the review does support is home delivery as an access option where travelling to a facility limits attendance, with fitness and quality-of-life gains and good adherence in the trials pooled. Whether those gains translate into time spent well for older people with frailty is not tested.