How Digital Technologies Support Children with Cancer, According to RSU Researchers

Long-term hospital treatment for many children means not only fighting the illness itself but also coping with a lack of physical activity. Researchers in Latvia are looking for ways to make this daily life more engaging by using a digital, game-based approach that helps children with cancer stay more active and, in the long run, improve their quality of life.

According to the World Health Organization, approximately 400,000 children aged 0 to 19 are diagnosed with cancer worldwide each year. The most common types are leukemias, brain tumors, lymphomas, and various connective tissue tumors^[1]In Latvia, malignant tumors are detected in an average of 60–70 children annually^[2].

In most developed countries, more than 80% of children are cured, but both the disease and its treatment have long-term effects on health and quality of life^[1]. 

Children with oncological diseases also belong to a high-risk group for developing other health conditions, such as increased rates of obesity and cardiovascular diseases.^[3].

The Department of Rehabilitation at the Faculty of Health and Sport Sciences, Rīga Stradiņš University (RSU), has launched a research project* in which researchers, in collaboration with clinical specialists from the Children's Clinical University Hospital (CCUH), investigate the physical activity habits of children with oncological diseases and explore the potential of digital solutions to improve these habits. The team uses a digital game-based approach in the hospital setting to provide young oncology patients with child-friendly ways to stay active during the prolonged periods they must spend in the hospital, in a manner appropriate to their health condition. The project has already attracted international interest for further research collaborations.

Why do children with cancer move less?

Oncological diseases and their treatment cause a range of side effects—nausea, loss of appetite, weight loss, mood swings, and chronic fatigue[4]. Chemotherapy can also lead to anemia and a decline in muscle function.^[5]. Various factors, including psychological ones, play a significant role: children often experience fear or insecurity about their bodies after starting treatment. Additionally, the hospital environment is not always conducive to physical activity—spaces are often limited, and there is a lack of suitable opportunities for play or exercise.

Another important factor is the low immunity following chemotherapy, which often means prolonged stays in their hospital room without contact with other peers or opportunities to leave the hospital premises.

Under these circumstances, children tend to choose calmer activities, such as watching television or using mobile devices^[5],^[6].

Parental and family support is also an important aspect. If parents fear that physical activity might harm their child during treatment, they often unintentionally limit the child’s movements. Lack of space, decreased motivation, fear of causing harm, and uncertainty about their own abilities significantly hinder children from being active^[5],^[7]. As a result, children with cancer are less active than their peers, especially in older age groups or among children with higher body weight^[8]. 

The Importance of Physical Activity

Research shows that children who maintain physical activity during treatment are more likely and quicker to return to their usual activities and school life than those who are less active. This affects not only their physical health but also their emotional well-being and social integration.

Regular physical activity reduces the side effects of cancer therapy, particularly fatigue^[9]. They improve muscle strength, bone health, and quality of life^[9][10].

In addition, physical activity reduces the risk of developing chronic diseases, such as diabetes, cardiovascular diseases, or obesity^[11]. 

International guidelines recommend that children be active for at least one hour a day. For primary school students, the suggested targets are: 13,000–15,000 steps per day for boys, 11,000–12,000 steps per day for girls, and for adolescents, an average of 10,000–11,700 steps per day^[12]. However, less than 50% of children with oncological diseases meet these recommendations[6], which makes appropriate physical activity an essential component of treatment and rehabilitation for children with cancer. Patients also require targeted support to engage in safe physical activities, helping them move more, maintain motivation, and ultimately improve their long-term quality of life.

Opportunities for Assessing Physical Activity

To ensure that physical activity truly provides the aforementioned benefits, it is essential to understand whether a child’s activity level is sufficient and appropriate for their individual capabilities. The latest modern solutions suggest combining various data sources, including acceleration sensors (accelerometers), heart rate monitors, and digital diaries, which allow for a more comprehensive understanding of a child’s activity habits. For example, physical activity levels are measured using objective methods—such as acceleration sensors and pedometers—as well as subjective methods, such as questionnaires and self-assessment scales^[13]. 

Such a multidimensional approach is especially important for oncology patients, whose types of activities are influenced by both physical and emotional factors.

It is also important to note that children often rate their own activity levels higher than what acceleration sensors indicate.^[14], therefore, the most effective results are achieved by combining both objective and subjective methods.

The results of a Danish study show that hospitalized children and adolescents were inactive for up to 22 hours a day on average, spending most of their time sitting or lying in bed, with an average step count of only about 2,300 per day. These findings clearly demonstrate the importance of introducing digital and motivational solutions to reduce sedentary behavior and promote physical activity even in hospital settings.^[15]. 

Digital technologies as a tool

Digital technologies open up new possibilities for motivating children and monitoring their activities. Virtual reality, mobile applications, and digital health solutions allow children to be physically active in an interactive and engaging way^[15][16]. Research shows that applications incorporating gamification elements promote children’s physical activity and ensure longer-term engagement^[15][17]. They offer interactive challenges, encourage active and independent participation, and provide feedback.^[17][18]. 

Virtual reality can be motivating and tailored to individual needs. Mobile health (mHealth) solutions—mobile and wireless technologies—and wearable devices also offer the ability to monitor physical activity levels and systematically incorporate physical activity into daily life. This helps children become more independent and develop healthy habits, positively influencing their everyday routines^[17][18]. 

Nowadays, almost all children know how to use a smartphone, which makes these solutions easily accessible and understandable.

These technologies offer scalable, flexible, and patient-tailored solutions that could enhance children’s participation in physical activities and promote the development of healthy habits in the long term^[19]. 

Digital tools are particularly important because they can provide personalized support, real-time feedback, and long-term motivation for patients with chronic conditions. Since traditional interventions are often fragmented and difficult to implement in daily care, digital technologies offer scalable and flexible solutions capable of reaching a wider patient population.^[20]. 

Our studies in Latvia

The team of researchers from RSU, in collaboration with BKUS, has launched the study "Monitoring Physical Activity Habits of Pediatric Oncology Patients Using a Digital Approach with Augmented Reality Interactive Game Elements" to understand the physical activity habits of children with oncological conditions and to test the potential of digital solutions to improve these habits^[21]. 

Existing studies on digital solutions for promoting physical activity in pediatric oncology patients have been summarized in a literature review, which clearly shows how under-researched yet promising this field is [20]. Within the framework of the study, an augmented reality interactive approach is being tested, using game-based elements to motivate children to be active even in a hospital environment. The data obtained will be used to develop an appropriate physical activity monitoring tool for patients with oncological conditions.

In the Latvian project, particular attention is also given to psychological aspects—children are provided opportunities to engage in activities that bring joy and foster positive emotions.

This is important because emotional well-being is closely linked to levels of physical activity. The project involves both researchers and clinical specialists and aims to test solutions in a hospital setting to provide child-friendly and sustainable support for movement. It is anticipated that in the future, this project could serve as a foundation for international collaboration and data exchange with other European countries.

Conclusions and future outlook

Physical activity is an essential component of treatment and rehabilitation for children with oncological conditions. Digital technologies—mobile applications, virtual reality, and wearable devices—offer new opportunities to promote such activity. Our study in Latvia will supplement the limited international evidence base and help implement modern, child-friendly approaches in practice. The goal is to make physical activity a natural and enjoyable part of daily life for children with oncological conditions, improving their health and quality of life in the long term.

Project "Internal RSU and External RSU with LSPA Consolidation", No. 5.2.1.1.i.0/2/24/I/CFLA/005. Researcher Grant "Monitoring Physical Activity Habits of Pediatric Oncology Patients Using a Digital Approach with Augmented Reality Interactive Game Elements" (Project/Contract No.: RSU/LSPA-PA-2024/1-0002).

Source: Public Broadcasting of Latvia | LSM.

References

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