JMIR Publications

ABSTRACT

Background:

Physical activity (PA) is a primary health-promoting factor in pediatric oncology, yet fewer than 50% of patients meet recommended guidelines. Technology-based interventions, such as augmented reality (AR) exergames and wearable devices, offer a non-invasive way to monitor and promote PA during treatment.

Objective:

The aim of this formative study was to evaluate the feasibility of implementing an augmented reality–based physical activity intervention in a pediatric oncology ward and to identify key barriers affecting engagement, adherence, and physical activity monitoring.

Methods:

We employed a case-crossover pilot design at the Children's Clinical University Hospital (CCUH) in Latvia. Patients aged 10–18 years were monitored using Fitbit devices to establish a 3–4 day baseline, followed by a 3–4 day active intervention phase using an AR-based mobile application.

Results:

Nine patients met the inclusion criteria, 4 dropped out due to technical incompatibility (AR-unsupported smartphones, n=3), refusal to wear the device (n=1), and device loss (n=1). Five participants who remained showed low median engagement, with in-game activity reaching a median of 125.5 steps across all days and 22.8 active minutes. The largest success was with the case that faced strict isolation, with intervention contributing to 32.5% of total physical activity during the time period.

Conclusions:

This formative evaluation indicates that while digital tools are acceptable in principle, engagement during acute treatment was limited due to clinical, motivational, and technical factors. The findings highlight important considerations for designing future interventions, particularly the need for stronger motivational elements and solutions that support use across both hospital and home environments.