Effectiveness of Real-Time Telerehabilitation Exercise for Cancer Survivors: A Systematic Review and Meta-Analysis

Purpose This study aimed to systematically evaluate the effects of real-time remote exercise rehabilitation on physical and psychological outcomes in cancer survivors. Methods PubMed, EMBASE, and the Cochrane Library were searched through February 2, 2026. Randomized controlled trials and quasi-experimental studies investigating real-time or interactive remote exercise interventions in adult cancer survivors were included. Outcomes were classified as physical (physical function, fatigue, and pain) and psychological (depression, anxiety, and quality of life [QoL]). A random-effects meta-analysis was performed using standardized mean differences (SMDs) with 95% confidence intervals (CIs). Results Twelve studies involving 1,509 participants were included in the systematic review, and seven were included in the meta-analysis. The overall pooled effect on physical outcomes was not significant (SMD = -0.05, 95% CI -0.38 to 0.29, p = 0.79; I² = 76.6%), although pain was significantly reduced in subgroup analysis (SMD = -0.53, 95% CI -0.85 to -0.20, p = 0.001). For psychological outcomes, the pooled overall effect approached significance (SMD = -0.28, 95% CI -0.57 to 0.01, p = 0.06; I² = 77%). Subgroup analyses showed significant improvements in depression (SMD = -0.67, 95% CI -1.02 to -0.31, p = 0.0002), anxiety (SMD = -0.57, 95% CI -0.93 to -0.22, p = 0.002), and QoL (SMD = 0.37, 95% CI 0.13 to 0.60, p = 0.003). Conclusion Real-time remote exercise rehabilitation may provide meaningful supportive care benefits for cancer survivors, particularly in pain reduction and psychological recovery. These findings support its potential as a symptom-focused, clinically applicable intervention in cancer survivorship care.