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Vasconcelos C, Sousa P. Effects of Combined Interventions of Physical Activity and Diet in Childhood Cancer Survivors: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:853. [PMID: 39062301 PMCID: PMC11275232 DOI: 10.3390/children11070853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/06/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024]
Abstract
Physical activity and diet have complementary benefits for attenuating adverse health effects that childhood cancer survivors experience after the end of treatment. This review aimed to explore the impact of combined physical activity and diet interventions on the health status of childhood cancer survivors. A thorough review of the literature was carried out using the Cochrane Library, PubMed, Scielo, LILACS and Web of Science databases for studies published until June 2024. Studies concerning survivors of childhood cancer of any type engaged exclusively in combined diet/physical activity interventions were included in this review. Three manuscripts met the inclusion criteria. The results indicated that combined physical activity plus diet interventions showed beneficial impacts for the intestinal microbiome, percentage of calories from sweet foods, daily consumption of sugary beverages, reduction in sedentary activity, and mood (1 out of 1 study for each of the presented outcomes). Although more rigorous studies are needed, these findings showed promising results regarding the impact of interventions involving both physical activity and diet on childhood cancer survivors.
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Affiliation(s)
- Carlos Vasconcelos
- Higher School of Education of Viseu, Ci&DEI, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal
| | - Patrícia Sousa
- Higher School of Education of Viseu, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal;
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2
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Wagner MJ, Jeewa A, Pidborochynski T, Lemaire‐Paquette S, Khoury M, Cunningham C, Dhillon S, Laroussi NA, Vaujois L, Dallaire F, Schantz D, Armstrong K, Mawad W, Bradley TJ, Conway J. Exploring Health-Related Quality of Life in Children With Hypertrophic Cardiomyopathy and Relationship to Physical Activity. J Am Heart Assoc 2024; 13:e033968. [PMID: 38879453 PMCID: PMC11255765 DOI: 10.1161/jaha.123.033968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/15/2024] [Indexed: 06/19/2024]
Abstract
BACKGROUND Hypertrophic cardiomyopathy is a burdensome condition that inflicts both physical and psychological impairment on those with the disease, negatively impacting health-related quality of life (HRQoL). Given the abundance of evidence suggesting a role of physical activity (PA) in modulating HRQoL in healthy populations of children, we sought to determine the relationship between HRQoL and PA in children diagnosed with hypertrophic cardiomyopathy. METHODS AND RESULTS A multicenter prospective observational cohort study was conducted, with patients with hypertrophic cardiomyopathy aged 10 to 19 years being provided a wrist-worn activity tracker (Fitbit Charge HR) to wear for 14 days. Patients self-reported on Pediatric Quality of Life 4.0 quality of life inventory items, which were associated with PA metrics following covariate adjustment using linear regression. A total of 56 participants were recruited to the study. The median age at enrollment was 15.5 years (interquartile range, 13.8-16.8), and 16 out of 56 (29%) of the cohort were girls. The cohort reported decreased metrics of physical, psychosocial, and total summary scores compared with health reference populations, with scores comparable with that of published populations with chronic disease. Increased physical HRQoL scores were significantly associated with increased daily steps taken, distance traveled, and flights of stairs climbed. CONCLUSIONS These results show that impaired PA correlates with reduced HRQoL in children with hypertrophic cardiomyopathy, suggesting PA may partially mediate HRQoL in this population.
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Affiliation(s)
| | - Aamir Jeewa
- Department of Pediatrics, Division of CardiologyThe Hospital for Sick ChildrenTorontoONCanada
| | | | | | - Michael Khoury
- Department of PediatricsUniversity of AlbertaEdmontonABCanada
- Division of Pediatric CardiologyStollery Children’s HospitalEdmontonABCanada
| | - Chentel Cunningham
- Division of Pediatric CardiologyStollery Children’s HospitalEdmontonABCanada
| | - Santokh Dhillon
- Department of Pediatrics, Division of CardiologyIWK Health CentreHalifaxNSCanada
| | - Nassiba Alami Laroussi
- Division of Pediatric CardiologySainte‐Justine University Hospital Center, University of MontrealMontrealQCCanada
| | - Laurence Vaujois
- Department of Pediatric CardiologyCentre Hospitalier Universitaire Quebec‐LavalQuebec CityQCCanada
| | - Frederic Dallaire
- Division of Pediatric CardiologyUniversité de SherbrookeSherbrookeQCCanada
| | - Daryl Schantz
- Department of PediatricsVariety Children’s Heart CentreWinnipegMBCanada
| | - Kathryn Armstrong
- Department of PediatricsBritish Columbia Children’s HospitalVancouverBCCanada
| | - Wadi Mawad
- Department of PediatricsMontreal Children’s HospitalMontrealQCCanada
| | - Timothy J. Bradley
- Division of Pediatric CardiologyJim Pattison Children’s HospitalSaskatoonSKCanada
| | - Jennifer Conway
- Department of PediatricsUniversity of AlbertaEdmontonABCanada
- Division of Pediatric CardiologyStollery Children’s HospitalEdmontonABCanada
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3
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Rueegg CS, Zürcher SJ, Schindera C, Jung R, Deng WH, Bänteli I, Schaeff J, Hebestreit H, von der Weid NX, Kriemler S. Effect of a 1-year physical activity intervention on cardiovascular health in long-term childhood cancer survivors-a randomised controlled trial (SURfit). Br J Cancer 2023; 129:1284-1297. [PMID: 37653075 PMCID: PMC10575964 DOI: 10.1038/s41416-023-02410-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND This randomised controlled trial (RCT) assessed the effect of a 1-year, partially supervised, physical activity (PA) intervention on a cardiovascular disease (CVD) risk score in adult survivors of childhood cancer. METHODS We included childhood cancer survivors ≥16 y at enrolment, <16 y at diagnosis and ≥5 y in remission. The intervention group was asked to perform an additional ≥2.5 h of intense physical activity/week, controls continued exercise as usual; assessments were performed at baseline, 6 months (T6) and 12 months (T12). The primary endpoint was change in a CVD risk score (average z-score of waist circumference, blood pressure, fasting glucose, inverted high-density lipoprotein cholesterol, triglycerides, and inverted cardiorespiratory fitness) from baseline to T12. We performed intention-to-treat (ITT, primary) and 3 per protocol analyses. RESULTS We randomised 151 survivors (44% females, 30.4 ± 8.6 years). We found a significant and robust reduction of the CVD risk score in the intervention compared to the control group at T6 and T12 across all analyses; with a difference in the reduction of the CVD risk z-score of -0.18 (95% confidence interval -0.29 to -0.06, P = 0.003) at T12 in favour of the intervention group (ITT analysis). CONCLUSIONS This RCT showed that a long-term PA intervention can reduce CVD risk in long-term survivors of childhood cancer. TRIAL REGISTRATION Clinicaltrials.gov: NCT02730767.
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Grants
- Swiss Cancer League (KLS-3175-02-2013), the “Stiftung für krebskranke Kinder, Regio Basiliensis”, “Gedächtnis-Stiftung Susy Rückert zur Krebsbekämpfung”, “Taecker-Stiftung für Krebsforschung”, “Stiftung Henriette & Hans-Rudolf Dubach-Bucher”, “Stiftung zur Krebsbekämpfung”, “Stiftung Krebs-Hilfe Zürich”, “Fondation Recherche sur le Cancer de l'Enfant (FORCE)”, and Fond’Action contre le Cancer. CSR has received funding from the European Union Seventh Framework Programme (FP7-PEOPLE-2013-COFUND) under grant agreement n°609020-Scientia Fellows. WHD is paid by a research grant from the South-Eastern Norway Regional Health Authority (grant number 2019039, to CSR).
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Affiliation(s)
- Corina S Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.
| | - Simeon J Zürcher
- Center for Psychiatric Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD) and University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Christina Schindera
- Department of Pediatric Hematology and Oncology, University Children's Hospital Basel (UKBB) and University of Basel, Basel, Switzerland
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Ruedi Jung
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Wei H Deng
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Iris Bänteli
- Department of Psychosomatic Medicine, University Hospital and University of Basel, Basel, Switzerland
| | - Jonathan Schaeff
- Pediatric Department, University Hospital Augsburg, Augsburg, Germany
| | - Helge Hebestreit
- Pediatric Department, University Hospital, Julius-Maximilians University, Würzburg, Germany
| | - Nicolas X von der Weid
- Department of Pediatric Hematology and Oncology, University Children's Hospital Basel (UKBB) and University of Basel, Basel, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Carniel CF, Rosin BM, de Souza BC, Raimundo RD. Pediatric oncohematological exercise program in hospital: clinical trial study protocol. Future Oncol 2023; 19:1385-1395. [PMID: 37497690 DOI: 10.2217/fon-2023-0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
Leukemias are the most common types of hematological cancers in children, and negatively impact functional capacity. There is evidence in the literature that therapeutic exercises can have a positive impact on functions. The aim of this study is to evaluate functional capacity, muscle strength, fatigue and quality of life through the application of a protocol of therapeutic exercises during pediatric leukemia hospitalization. Children will be allocated into two groups: one will carry out a protocol of therapeutic exercises, while the other will undergo conventional respiratory physiotherapy. The protocol is approved by the ethics and research committee of the host institution (No. 5.439.594). Results will be disseminated through peer-reviewed journal articles and conferences. Clinical trial registration: RBR-8sxnfyd (https://ensaiosclinicos.gov.br).
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Affiliation(s)
- Cintia Freire Carniel
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, 09060-590, Brazil
| | - Beatriz M Rosin
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, 09060-590, Brazil
| | - Bruna Cunha de Souza
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, 09060-590, Brazil
| | - Rodrigo Daminello Raimundo
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, 09060-590, Brazil
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Gilbert R, Bates CR, Khetawat D, Dreyer Gillette ML, Moore R. Risk and Resilient Functioning of Families of Children with Cancer during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5208. [PMID: 36982118 PMCID: PMC10048924 DOI: 10.3390/ijerph20065208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
Previous literature highlights the impact of COVID-19 on family functioning. Less is known about the impact of the pandemic on families of pediatric cancer patients. In order to determine universal and unique risk and resilience factors of these families during the pandemic, a qualitative analysis was conducted on families currently receiving cancer treatment at a Midwestern hospital. Results of the data analysis depict ways in which these families have been impacted by and have adapted to COVID-19. These findings suggest that families of pediatric cancer patients have unique experiences in the context of COVID-19, in addition to universal experiences outlined in previous literature.
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Affiliation(s)
- Renee Gilbert
- Clinical Child Psychology Program, Dole Human Development Center, University of Kansas, Lawrence, KS 66044, USA
| | - Carolyn R. Bates
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 64114, USA
- University of Kansas Cancer Center, 4001 Rainbow Blvd, Kansas City, KS 64114, USA
| | - Devanshi Khetawat
- Clinical Child Psychology Program, Dole Human Development Center, University of Kansas, Lawrence, KS 66044, USA
| | | | - Rachel Moore
- Department of Pediatrics, Children’s Mercy Kansas City, 2401 Gillham Rd, Kansas City, MO 64108, USA
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Rapti C, Dinas PC, Chryssanthopoulos C, Mila A, Philippou A. Effects of Exercise and Physical Activity Levels on Childhood Cancer: An Umbrella Review. Healthcare (Basel) 2023; 11:healthcare11060820. [PMID: 36981477 PMCID: PMC10048410 DOI: 10.3390/healthcare11060820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 03/14/2023] Open
Abstract
Patients and survivors of childhood cancer experience adverse effects related to the disease and its treatment. These adverse effects are associated with both physiological and psychological health. Exercise helps manage the side effects and improve the health outcomes. The objective of this umbrella review is to search the current literature in the context of exercise and physical activity as complementary interventions on pediatric cancer and to provide comprehensive information about the derived health outcomes. A literature search was conducted on the Cochrane, PubMed, and Embase databases for systematic reviews published up to January 2023. Moreover, a hand search of reference lists was performed. We included participants under 19 years of age at diagnosis of any type of childhood cancer, without restriction on the type or phase of treatment, who participated in exercise interventions. The results showed a beneficial impact on fatigue, muscle strength, aerobic capacity, activity and participation levels, psychosocial health, cardiovascular/cardiorespiratory fitness, physical function, bone mineral density, and brain volume and structure, with limited and not serious adverse effects. These findings documented that exercise interventions had a positive effect on many physiological and psychological health outcomes in pediatric cancer patients and survivors.
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Affiliation(s)
- Christina Rapti
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Petros C. Dinas
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Costas Chryssanthopoulos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Alexandra Mila
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Anastassios Philippou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
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Wu WW, Shiu CS, Tang CC, Jou ST, Chen HL. The Moderated Mediating Effects of Nutrition and Physical Activity Between Fatigue and Quality of Life in Childhood Cancer Survivors. Asian Nurs Res (Korean Soc Nurs Sci) 2023; 17:23-29. [PMID: 36592888 DOI: 10.1016/j.anr.2022.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/20/2022] [Accepted: 12/26/2022] [Indexed: 01/01/2023] Open
Abstract
PURPOSE The aim of this study was to investigate the associations between nutrition, physical activity, fatigue, and quality of life (QoL) among childhood cancer survivors. The specific purpose was to examine whether nutrition mediated and physical activity moderated the relationship between fatigue and QoL in this population. METHODS A pooled sample of 120 childhood cancer survivors was recruited at pediatric oncology wards and ambulatory settings between August 2020 and May 2021. We collected data on participants' demographic characteristics, fatigue, nutritional status, physical activity, and QoL. We then adapted Hayes Process Macro to examine the mediating and moderating effects of nutrition and physical activity on the relationship between fatigue and QoL. RESULTS In models adjusted for age and sex, (1) the simple mediation analysis identified the mediating effect of nutrition on the relationship between fatigue and QoL; and (2) the mediation and moderation analysis identified that the direct effect of nutrition between fatigue and QoL was significant when adding (a) physical activity and (b) fatigue × physical activity. There were significantly decreasing trends in physical activity at 1 standard deviation below the mean and at the mean, but not at 1 standard deviation above the mean. CONCLUSIONS Our findings demonstrate that nutrition mediated and physical activity moderated the relationship between fatigue and QoL. This highlights an opportunity to enhance QoL among childhood cancer survivors through healthy lifestyle interventions. To ensure that future interventions address children's needs and promote the greatest impact, such interventions should include nutrition and physical activity components that involve nurses, pediatric oncology physicians, nutritionists, and physical therapists.
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Affiliation(s)
- Wei-Wen Wu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
| | - Cheng-Shi Shiu
- Department of Social Work, National Taiwan University, Taipei, Taiwan
| | - Chia-Chun Tang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Shiann-Tang Jou
- Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan; Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Huey-Ling Chen
- Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan; Department and Graduate Institute of Medical Education and Bioethics, College of Medicine, National Taiwan University, Taipei, Taiwan
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8
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Petersen NN, Larsen HB, Pouplier A, Schmidt‐Andersen P, Thorsteinsson T, Schmiegelow K, Fridh MK. Childhood cancer survivors' and their parents' experiences with participation in a physical and social intervention during cancer treatment: A RESPECT study. J Adv Nurs 2022; 78:3806-3816. [PMID: 35942568 PMCID: PMC9804908 DOI: 10.1111/jan.15381] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/21/2022] [Accepted: 07/09/2022] [Indexed: 01/09/2023]
Abstract
AIMS This study explores experiences of childhood cancer survivors and their parents with a combined physical and social activity intervention during treatment, including how the survivors and their parents perceive physical activity post-treatment. DESIGN A process evaluation using semi-structured interviews. METHODS Using a criterion-sampling strategy, 18 Danish childhood cancer survivors (aged 11-18 years) and their parents were interviewed from September 2019 through May 2020. Data analysis used an inductive thematic approach focused on meaning. RESULTS Three themes emerged: (1) being physically active during hospitalization; (2) peers as motivators and (3) physical activity post-treatment. During hospitalization, daily motivation to do physical activity was dependent on the daily well-being, that is, presence of the side effects from the child's treatment. Healthy classmates provided distraction, reduced loneliness and promoted normality for those hospitalized. For most of the survivors, their healthy peers provided motivation for being physically active during treatment. When surplus energy was lacking, some survivors preferred doing physical activity alone with a professional. Those who were physically active in the hospital sustained being physically active post-treatment while their parents continued seeking advice about appropriate activity levels. CONCLUSION Childhood cancer survivors and their parents benefited from the intervention which also provided guidance to remaining physically active post-treatment. This was particularly true for the participants with leukaemia. IMPACT Healthcare professionals should support children with cancer to be physically active during hospitalization. Including social and physical components in their care plan and being aware of individual preferences is pivotal to improving the survivors' level of physical and social well-being during and post-treatment. PATIENT OR PUBLIC CONTRIBUTION The participants were involved in designing the interview guides to ensure that the interview guides were understandable for the participants to provide rich descriptions of their experiences with a physical and social activity intervention during hospitalization.
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Affiliation(s)
- Natasha Nybro Petersen
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
| | - Hanne Bækgaard Larsen
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark,Faculty of Health SciencesUniversity of Copenhagen and The Pediatric Clinic, Juliane Marie Centre, University Hospital (Rigshospitalet)CopenhagenDenmark
| | - Anna Pouplier
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
| | - Peter Schmidt‐Andersen
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
| | - Troels Thorsteinsson
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark,Faculty of Health SciencesUniversity of Copenhagen and The Pediatric Clinic, Juliane Marie Centre, University Hospital (Rigshospitalet)CopenhagenDenmark
| | - Martin Kaj Fridh
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
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Effect of virtual reality-based exercise intervention on sleep quality in children with acute lymphoblastic leukemia and healthy siblings: A randomized controlled trial. Palliat Support Care 2022; 20:455-461. [PMID: 35289266 DOI: 10.1017/s1478951522000268] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Sleep is one of the important measurements of the quality of life for children especially suffering from a chronic illness such as cancer. Our aim was to determine the changes in sleep quality and to investigate the effect of virtual reality-based exercise (VRBE) approaches on sleep in patients with acute lymphoblastic leukemia (ALL) off treatment. METHOD The participants (ALL and healthy siblings) were evaluated for sleep quality with polysomnography and "Children's Sleep Habit Questionnaire" before and after 12 weeks. The study randomized into two groups: an exercise group who received VRBE in two days in a week, 45 min of each session for 12 weeks and an control group who were managed with supportive measures. The VRBE comprised of aerobic exercise in four different games by Nintendo Wii Fit Plus®. RESULTS This randomized controlled trial was carried out on 38 participants. Before intervention, ALL patients (n = 24) and healthy siblings (n = 14) had similar sleep quality in terms of polysomnography and Children's Sleep Habit Questionnaire findings. After intervention, total time asleep (p = 0.023), respiratory disturbance index of hypopnea (p = 0.005), apnea/hypopnea index (p = 0.008), and number of apnea (p = 0.028) statistically significant improved. SIGNIFICANCE OF RESULTS Patients with ALL off treatment had similar values of sleep quality with healthy siblings. Novel types of exercises like VRBE have positive effects on sleep disorders in children with ALL and also healthy siblings. Future studies are needed comparing the different types of interventions.
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Schmidt-Andersen P, Fridh MK, Müller KG, Anna Pouplier, Hjalgrim LL, Faigenbaum AD, Schmiegelow K, Hasle H, Lykkedegn S, Zhang H, Christensen J, Larsen HB. Integrative Neuromuscular Training in Adolescents and Children Treated for Cancer (INTERACT): Study Protocol for a Multicenter, Two-Arm Parallel-Group Randomized Controlled Superiority Trial. Front Pediatr 2022; 10:833850. [PMID: 35359909 PMCID: PMC8964065 DOI: 10.3389/fped.2022.833850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/14/2022] [Indexed: 12/19/2022] Open
Abstract
Background Improved survival rates for children and adolescents diagnosed with cancer call for novel strategies for reducing short- and long-term treatment-related side effects. These include the physical and metabolic sequelae that are exacerbated by sedentary behavior and treatment-induced toxicities. We aim to investigate the effect of an integrative neuromuscular training intervention during the first 6 months of anti-cancer treatment primarily on muscle strength, and secondarily on exercise capacity, physical function, markers of metabolic syndrome, dysmetabolism, and health-related quality of life during and after ended treatment. Methods One hundred and twenty-seven children and adolescents, newly diagnosed with malignant and benign neoplasia, aged 6-17 years, and treated with chemotherapy or radiation will be randomized to either the intervention or the control arm of the study. The intervention group will, in addition to usual care, be offered a combination of 6 months of supervised physical exercise (integrative neuromuscular training) and home-based exercise. The active control group will, in addition to usual care, receive information along an unsupervised written home-based training program. All participants, including parents, will receive information about the importance of physical exercise during the course of cancer treatment, at the start of treatment, and in 5 monthly sessions. The primary outcome is measured in terms of isometric quadriceps muscle strength. Secondary outcomes include muscle strength and endurance, markers of metabolic syndrome and dysmetabolism, exercise capacity, physical function and activity, days of hospitalization, and health-related quality of life. Assessment will be conducted at treatment initiation (baseline), at 3 and 6 months after inclusion, and 1 month and 1 year after ended treatment. The primary endpoint for lower-body muscle strength is at 6 months after treatment initiation. The effects of the intervention will be evaluated through a constrained linear mixed model. Discussion This national randomized controlled study has the potential to provide new knowledge concerning the short- and long-term effects of a novel, inclusive approach for youth exercise programming (integrative neuromuscular exercise) in children and adolescents during anti-cancer treatment. Using a pragmatic, low-cost, and time-efficient training design, this intervention can be easily adapted to both hospital and home settings. Clinical Trial Registration ClinicalTrials.gov (NCT04706676), first released January 5, 2021.
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Affiliation(s)
- Peter Schmidt-Andersen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Occupational and Physiotherapy, Center of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin Kaj Fridh
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Klaus Gottlob Müller
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anna Pouplier
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lisa Lyngsie Hjalgrim
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Avery D. Faigenbaum
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, United States
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Hasle
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Sine Lykkedegn
- Department of Pediatric Hematology and Oncology, H.C. Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - He Zhang
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational and Physiotherapy, Center of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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11
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Gaser D, Peters C, Oberhoffer-Fritz R, Götte M, Feuchtinger T, Schmid I, Haller B, von Luettichau I, Kesting S. Effects of strength exercise interventions on activities of daily living, motor performance, and physical activity in children and adolescents with leukemia or non-Hodgkin lymphoma: Results from the randomized controlled ActiveADL Study. Front Pediatr 2022; 10:982996. [PMID: 36425395 PMCID: PMC9679409 DOI: 10.3389/fped.2022.982996] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Pediatric patients with cancer experience impairments in muscle strength and physical activity (PA) that may reduce autonomy during hospitalization. To determine the effects of strength exercise interventions on the accomplishment of activities of daily living (ADLs), motor performance, and PA in children with leukemia or non-Hodgkin lymphoma, we randomly allocated patients (4-18 years) immediately after diagnosis into two exercise groups. METHODS The intervention group (IG; n = 21) received a specific strength training combined with a standard care exercise program, whereas the control group (CG; n = 20) was provided standard care exercise program without any targeted muscle strengthening. After the baseline visit, participants were followed-up three times until intensive treatment cessation. We assessed physical function limitations using the Activities Scale for Kids© (ASK) and Functional ADL Screen. Secondary outcomes were PA levels using accelerometer and motor performance as measured by MOON-test (motor performance in pediatric oncology-test). RESULTS In both groups, ADL accomplishment had significantly increased (p < 0.05). However, no significant between-group differences for ASK outcome were noted. Motor performance was reduced in all motor abilities. CONCLUSIONS Both exercise interventions were effective to maintain ADLs and motor performance during intensive treatment. In comparison, regular strength exercise interventions in the course of therapy tended to be more beneficial with regards to muscular explosive and endurance strength.
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Affiliation(s)
- Dominik Gaser
- Kinderklinik München Schwabing, Department of Pediatrics and Children's Cancer Research Centre, TUM School of Medicine, Technical University of Munich, Munich, Germany.,Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.,Pediatric Oncology Network, KIONET Bavaria, Erlangen, Germany
| | - Christiane Peters
- Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Renate Oberhoffer-Fritz
- Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Miriam Götte
- Clinic of Pediatrics III, Department of Hematology and Oncology, West German Cancer Centre Essen, University Hospital, Essen, Germany
| | - Tobias Feuchtinger
- Pediatric Oncology Network, KIONET Bavaria, Erlangen, Germany.,Dr. von Hauner Children's Hospital, Pediatric Hematology and Oncology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Irene Schmid
- Pediatric Oncology Network, KIONET Bavaria, Erlangen, Germany.,Dr. von Hauner Children's Hospital, Pediatric Hematology and Oncology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Bernhard Haller
- Institute of AI and Informatics in Medicine, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Irene von Luettichau
- Kinderklinik München Schwabing, Department of Pediatrics and Children's Cancer Research Centre, TUM School of Medicine, Technical University of Munich, Munich, Germany.,Pediatric Oncology Network, KIONET Bavaria, Erlangen, Germany
| | - Sabine Kesting
- Kinderklinik München Schwabing, Department of Pediatrics and Children's Cancer Research Centre, TUM School of Medicine, Technical University of Munich, Munich, Germany.,Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.,Pediatric Oncology Network, KIONET Bavaria, Erlangen, Germany
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12
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Ospina PA, McComb A, Pritchard-Wiart LE, Eisenstat DD, McNeely ML. Physical therapy interventions, other than general physical exercise interventions, in children and adolescents before, during and following treatment for cancer. Cochrane Database Syst Rev 2021; 8:CD012924. [PMID: 34343340 PMCID: PMC8407387 DOI: 10.1002/14651858.cd012924.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Children and adolescents diagnosed with cancer are at high risk of experiencing severe side effects from cancer treatment, many of which are amenable to physical therapy. These side effects can negatively impact a child's quality of life and ability to participate in daily activities (e.g. play and attendance at school). Researchers have evaluated physical therapy interventions in children with cancer and childhood cancer survivors. However, factors such as small sample sizes, varying intervention protocols and differences in cancer types among trials make it difficult to draw conclusions about efficacy. OBJECTIVES The primary aim of this review was to evaluate the efficacy of physical therapy interventions - with a specific focus on symptom relief and compensation of therapy-related side effects - on the quality of life of children and adolescents diagnosed with cancer. Participants must be between the ages of 0 and 19 years at the time of the physical therapy intervention study. The intervention may occur prior to, during or following cancer treatment. The intervention must be compared to a control group of children receiving standard care, no physical therapy intervention or a comparison intervention. We have excluded general physical exercise studies where the primary aim was to improve physical fitness through aerobic, anaerobic, resistance exercise or combined physical exercise training regimens (i.e. combined aerobic and resistance exercise regimens). We have also intended to record the occurrence of any adverse effects resulting from physical therapy interventions. The secondary aims were to evaluate the efficacy of physical therapy on impairments of pain, peripheral neuropathy, balance, gait, functional abilities and mobility, motor function and performance, range of motion, strength and fatigue. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, PEDro, ongoing trial registries, conference proceedings and the reference lists of relevant studies and reviews in March 2020. We also contacted oncology rehabilitation researchers working in paediatrics in March 2020 to identify additional studies. SELECTION CRITERIA The review included randomised controlled trials (RCTs), cross-over trials, and controlled clinical trials (CCTs) that compared the effects of physical therapy interventions to a control group, and involved children and adolescents diagnosed with cancer between the ages of 0 and 19 years at the time of the intervention. We excluded studies examining general physical exercise interventions where the primary aim was to improve physical fitness through aerobic exercise, resistance exercise or combined physical exercise training regimens (i.e. combined aerobic and resistance exercise regimens). DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We found no RCTs, cross-over trials or CCTs comparing the effects of physical therapy interventions with a focus on symptom relief and compensation of therapy-related side effects for children and adolescents between the ages of 0 and 19 years. AUTHORS' CONCLUSIONS Results demonstrate that the evidence to date is inadequate to inform clinical practice. Recommendations for future research include the need for large-scale, high-quality designs that examine: (1) paediatric populations with same cancer types; (2) similar intervention protocols; (3) long-term outcomes; (4) physical therapy interventions (e.g. electrophysical modalities and sensory interventions); and (5) outcomes commonly impaired in children with cancer (e.g. peripheral neuropathy and gait deficits).
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Affiliation(s)
- Paula A Ospina
- Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Alyssa McComb
- Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | | | | | - Margaret L McNeely
- Department of Physical Therapy/ Department of Oncology, University of Alberta, Edmonton, Canada
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Dimitri P, Joshi K, Jones N. Moving more: physical activity and its positive effects on long term conditions in children and young people. Arch Dis Child 2020; 105:1035-1040. [PMID: 32198161 DOI: 10.1136/archdischild-2019-318017] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 11/04/2022]
Abstract
While the benefits of regular participation in physical activity in children and young people are clear, misconceptions have developed about the possible negative effects and potential complications of exercise on long-term conditions such as epilepsy, asthma and diabetes. Over the last decade evidence has emerged supporting the positive impact that physical activity has on long-term conditions. Previous concerns were raised about the risks of hypoglycaemia in children with type 1 diabetes mellitus (T1DM) thus limiting participation in sports. Importantly, physical activity improves the metabolic profile, bone mineral density, cardiorespiratory fitness and insulin sensitivity while lowering mortality risk in children with T1DM. Children with asthma were prevented from doing exercise due to concerns about precipitating an acute asthmatic episode. To the contrary, physical activity interventions have consistently shown an increase in cardiovascular fitness, physical capacity, asthma-free days and quality of life in childhood asthmatics. Children with epilepsy are often excluded from sports due to concerns relating to increased seizure frequency, yet evidence suggests that this is not the case. The evidence supporting physical activity in childhood survivors of cancer is growing but still primarily confined to patients with acute lymphoblastic leukaemia. Participation in sports and physical activity also reduces mental health problems developing in adolescence. While further research is required to investigate benefits of physical activity on specific aspects of long-term conditions in children, in general this group should be advised to increase participation in sports and exercise as a means of improving long-term physical and mental health.
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Affiliation(s)
- Paul Dimitri
- Paediatric Endocrinology, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Kush Joshi
- Faculty of Sports and Exercise Medicine, Oxford University Hospitals NHS Trust, Oxford, Oxfordshire, UK
| | - Natasha Jones
- Faculty of Sports and Exercise Medicine, Oxford University Hospitals NHS Trust, Oxford, Oxfordshire, UK
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14
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Santos SDS, Moussalle LD, Heinzmann-Filho JP. EFFECTS OF PHYSICAL EXERCISE DURING HOSPITALIZATION IN CHILDREN AND ADOLESCENTS WITH CANCER: A SYSTEMATIC REVIEW. ACTA ACUST UNITED AC 2020; 39:e2019313. [PMID: 33027320 PMCID: PMC7537404 DOI: 10.1590/1984-0462/2021/39/2019313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 01/19/2020] [Indexed: 04/08/2023]
Abstract
Objective: To identify the effects of exercise programs during hospitalization on
children and adolescents with cancer. Data source: This is a systematic review, carried out in PubMed/ Medical Literature
Analysis and Retrieval System Online (MEDLINE), Latin American and Caribbean
Health Sciences Literature (LILACS), Scientific Electronic Library Online
(SciELO), Latin American and Caribbean Center on Health Sciences Information
(BIREME), and Physiotherapy Evidence Database (PEDro). We selected studies
that included children and adolescents diagnosed with cancer (solid or
hematologic) and submitted to exercise protocols during hospitalization.
Studies involving patients with other pathologies or with a medical
contraindication for exercise were excluded. We used the following search
strategy: Neoplasm OR Leukemia OR Cancer OR Tumor OR Medical Oncology AND
Hospitalization OR Inpatient Care Units OR Intrahospital AND Exercise. The
methodological quality of the studies was analyzed by the PEDro scale. Data synthesis: Among the 626 articles found, only 9 fulfilled the inclusion criteria,
obtaining a regular methodological quality. The samples had 172
participants, aged 4 to 18 years. Only 6 studies presented both intervention
group and control group. The intervention group received strength, aerobic,
and muscle stretching exercises, and games, among others. The control group
received the standard treatment. The studies varied regarding time,
frequency, intensity, and type of exercise. Most studies showed an increase
in muscle strength (4/5), followed by an improvement in physical fitness
(2/3) and functional capacity (2/4). No adverse events were reported during
the interventions. The methodological quality was considered regular. Conclusions: The findings suggest that. during hospitalization of children and
adolescents with cancer, exercise improves muscle strength, physical
fitness, and functionality.
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15
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The impact of cancer on theory of planned behavior measures and physical activity levels during the first weeks following cancer diagnosis in children. Support Care Cancer 2020; 29:823-831. [PMID: 32495031 DOI: 10.1007/s00520-020-05541-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The theory of planned behavior (TPB) is used to document children's health behaviors linked to their physical activity. The TPB model and its components have been applied to comprehend the adoption of physical activity along informational and motivational parameters. Thus, this exploratory study aims to assess the evolution of children's physical activity levels (MVLPA) during the first weeks of their cancer, in addition to documenting the evolution of the TPB measures, self-reported fitness, and self-esteem in the physical domain to better understand children's physical activity behavior. METHODS A total of 16 children (8 boys and 8 girls) with cancer answered psychosocial questionnaires at the diagnosis of cancer (time 1) and at 6 to 8 weeks (time 2) to assess the TPB measures, self-reported fitness, self-esteem in the physical domain, and their daily physical activities. RESULTS A significant decrease of 41.2 min/days of daily MVLPA was observed between the time at cancer diagnosis (50.5 ± 32.8 min/days) and 6 to 8 weeks after the first interview (9.3 ± 9.1 min/days). We found that the time after the diagnosis of cancer negatively impacted children's TPB measures (mean in attitude, injunctive norms, identity, facilitating factors, self-confidence, and intention) and MVLPA levels. The TPB model explains 40% of the variance in MVLPA by the injunctive norms during the first weeks following cancer diagnosis in children. CONCLUSION The findings of this study highlight the negative impacts of cancer on children's TPB measures, self-reported fitness, and self-esteem in the physical domain and self-reported MVLPA levels over 4 to 6 weeks following the diagnosis. These findings help to better understand the effect of cancer diagnosis on children's physical activity behavior.
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16
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Keiser T, Gaser D, Peters C, Oberhoffer-Fritz R, Kesting S, von Luettichau I. Short-Term Consequences of Pediatric Anti-cancer Treatment Regarding Blood Pressure, Motor Performance, Physical Activity and Reintegration Into Sports Structures. Front Pediatr 2020; 8:463. [PMID: 32850561 PMCID: PMC7431623 DOI: 10.3389/fped.2020.00463] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/02/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Cardiovascular diseases in childhood cancer survivors are known late sequelae following treatment. Arterial stiffness, pulse wave velocity (PWV) and central systolic blood pressure (cSBP) are potential predictors to assess the status of cardiovascular health. Frequent inpatient stays and reduced physical activity (PA) during treatment can lead to noticeable impairments regarding motor skills and physical performance. The present study examined parameters of cardiovascular health, motor performance and the status of integration into sports structures shortly after cessation of treatment. Methods: A cross-sectional, monocentric study was conducted from April to June 2019. Participants (6-18 yrs, mixed cancer entities) during maintenance therapy and follow-up care were recruited. Peripheral and central systolic/diastolic blood pressure (pSBP, pDBP, cSBP) and PWV were assessed using the Mobil-O-Graph®. The MOON test (MOtor performance in pediatric ONcology) was used to scale motor performance. PA levels and status of integration into sports structures were assessed with a questionnaire referring to the KiGGS study. All measured data were compared to published reference values. Results: Forty participants (11.3 ± 3.8 years, 50% female) were recruited 1.6 ± 1.8 years post-treatment. PSBP (z-score: 0.87 ± 0.67, p = 0.003), pDBP (0.83 ± 1.94, p = 0.033) and cSBP (≥8 years: 0.60 ± 1.29, p = 0.011) were significantly increased compared to reference values. PWV was also elevated, but not significantly. Motor performance was reduced in almost all motor abilities. Thirty-six percent of the examined group did not participate in physical education at school to the full extent. Only 17% reported 1 hour of daily moderate-to-vigorous PA as recommended for children and adolescents by the World Health Organization. Half of the participants were active sports club members before treatment, but one third did not resume their former membership. Conclusion: Increased cardiovascular parameters and impaired motor performance shortly after cessation of treatment, physical inactivity, and low rates of integration into regular sports programs highlight the support needed. Young cancer patients should receive early support in coping with physical limitations preferably soon after diagnosis. Motor deficits could be reduced by applying targeted interventions. Furthermore, a regular sports therapy program during in- and outpatient care could increase engagement in PA to possibly counteract risk factors and improve cardiovascular health.
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Affiliation(s)
- Tina Keiser
- Department of Sports Medicine and Exercise, Justus-Liebig University Gießen, Gießen, Germany
| | - Dominik Gaser
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany.,Department of Pediatrics and Children's Cancer Research Center, Kinderklinik München Schwabing, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Christiane Peters
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Renate Oberhoffer-Fritz
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Sabine Kesting
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany.,Department of Pediatrics and Children's Cancer Research Center, Kinderklinik München Schwabing, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Irene von Luettichau
- Department of Pediatrics and Children's Cancer Research Center, Kinderklinik München Schwabing, TUM School of Medicine, Technical University of Munich, Munich, Germany
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17
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Shank J, Chamorro-Viña C, Guilcher GMT, Langelier DM, Schulte F, Culos-Reed SN. Evaluation Tools for Physical Activity Programs for Childhood Cancer: A Scoping Review. J Pediatr Oncol Nurs 2019; 37:163-179. [PMID: 31847707 DOI: 10.1177/1043454219891987] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Research on the benefits of physical activity (PA) in childhood cancer has been translated into a handful of community-based programs. However, to foster further translation, an understanding of how to evaluate participant outcomes would be beneficial to provide feedback to participants and stimulate future research. Such a review would provide a summary of acceptable tools for work in this area. The purpose of this scoping review was to identify the evaluation tools that have been used in PA/exercise studies or programs for childhood cancer. This review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies included in the review used physical and psychosocial evaluation tools within PA and exercise programs or research for childhood cancer. In addition, studies with measures of health behavior such as PA levels and activities of daily living were included. Tools that assessed physical fitness and physical performance were excluded. Information on the types of evaluation tools used, mean age of participants, and type of cancer was extracted. Psychometric properties of each evaluation tool are reported. The most commonly assessed patient outcomes were motor performance, fatigue, well-being, functional mobility, and quality of life. Less commonly reported patient outcomes were hope, self-efficacy, and self-perception. None of the evaluation tools reported in the PA/exercise and pediatric oncology literature assess physical literacy. This review was the first step in a knowledge translation process, identifying evaluation tools that have been used in PA/exercise programs in childhood cancer survivors, that will guide the development and evaluation of current and future community-based programs.
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Affiliation(s)
- Jena Shank
- University of Calgary, Calgary, Alberta, Canada
| | - Carolina Chamorro-Viña
- University of Calgary, Calgary, Alberta, Canada.,Kids Cancer Care Foundation of Alberta, Calgary, Alberta, Canada
| | - Gregory M T Guilcher
- University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital, Calgary, Alberta, Canada
| | | | | | - S Nicole Culos-Reed
- University of Calgary, Calgary, Alberta, Canada.,Alberta Health Services, Calgary, Alberta, Canada
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18
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Esbenshade AJ, Ness KK. Dietary and Exercise Interventions for Pediatric Oncology Patients: The Way Forward. J Natl Cancer Inst Monogr 2019; 2019:157-162. [PMID: 31532528 DOI: 10.1093/jncimonographs/lgz021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/30/2019] [Accepted: 07/01/2019] [Indexed: 12/29/2022] Open
Abstract
Abstract
This review focuses on diet and exercise interventions that have been conducted in pediatric cancer and pediatric stem cell transplant patients. It examines the different reasons for conducting lifestyle interventions with attention to the different outcome measurements and feasibility of these measures with an argument toward a need for standardization to move the field forward.
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Affiliation(s)
- Adam J Esbenshade
- Vanderbilt-Ingram Cancer Center, Nashville, TN (AJE)
- Monroe Carell Jr. Children’s Hospital at Vanderbilt Division of Pediatric Hematology-Oncology, Nashville, TN (AJE)
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN (KKN)
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19
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Physical Activity and Quality of Life of Healthy Children and Patients with Hematological Cancers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152776. [PMID: 31382561 PMCID: PMC6696059 DOI: 10.3390/ijerph16152776] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/13/2019] [Accepted: 08/01/2019] [Indexed: 01/23/2023]
Abstract
The aim was to assess the level of physical activity and the quality of life of children undergoing cancer treatment, during and after the completion of the treatment. Eighty-eight children aged 11–15 were enrolled. Three groups of children were assessed, i.e., children undergoing cancer treatment (n = 30), children after cancer treatment (n = 28), and healthy children (n = 30). The level of physical activity in children was assessed using the questions from the Health Behavior in School-Aged Children (HBSC) questionnaire. The assessment of children’s quality of life was conducted using the KIDSCREEN-10 Index. The chi-square test was used to assess the statistical significance of the differences in the results between the study groups in the case of both HBSC and KIDSCREEN-10 questionnaires. Children undergoing cancer treatment did not perform any physical activity of at least 60 min (in total) per day, during the week. Therefore, they did not meet the recommendations related to the appropriate level of daily physical activity (Moderate-to-Vigorous Physical Activity; MVPA). Children after cancer treatment and healthy children significantly more frequently undertook physical activity. The quality of life of children with cancer is significantly lower and different from the quality of life of healthy children.
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20
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Loeffen EA, Kremer LC, van de Wetering MD, Mulder RL, Font‐Gonzalez A, Dupuis LL, Campbell F, Tissing WJ. Reducing pain in children with cancer: Methodology for the development of a clinical practice guideline. Pediatr Blood Cancer 2019; 66:e27698. [PMID: 30848078 PMCID: PMC9286396 DOI: 10.1002/pbc.27698] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/21/2019] [Accepted: 02/24/2019] [Indexed: 12/12/2022]
Abstract
Although pain is one of the most prevalent and bothersome symptoms children with cancer experience, evidence-based guidance regarding assessment and management is lacking. With 44 international, multidisciplinary healthcare professionals and nine patient representatives, we aimed to develop a clinical practice guideline (following GRADE methodology), addressing assessment and pharmacological, psychological, and physical management of tumor-, treatment-, and procedure-related pain in children with cancer. In this paper, we present our thorough methodology for this development, including the challenges we faced and how we approached these. This lays the foundation for our clinical practice guideline, for which there is a high clinical demand.
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Affiliation(s)
- Erik A.H. Loeffen
- University of GroningenUniversity Medical Center GroningenBeatrix Children's HospitalDepartment of Pediatric Oncology/HematologyGroningenthe Netherlands
| | - Leontien C.M. Kremer
- Princess Máxima Center for Pediatric OncologyUtrechtthe Netherlands,Department of Pediatric OncologyEmma Children's HospitalAcademic Medical CenterAmsterdamthe Netherlands
| | | | - Renée L. Mulder
- Princess Máxima Center for Pediatric OncologyUtrechtthe Netherlands,Department of Pediatric OncologyEmma Children's HospitalAcademic Medical CenterAmsterdamthe Netherlands
| | - Anna Font‐Gonzalez
- Princess Máxima Center for Pediatric OncologyUtrechtthe Netherlands,Department of Pediatric OncologyEmma Children's HospitalAcademic Medical CenterAmsterdamthe Netherlands
| | - Lee L. Dupuis
- Department of Pharmacy and Research InstituteThe Hospital for Sick ChildrenTorontoONCanada,Leslie Dan Faculty of PharmacyUniversity of TorontoTorontoONCanada
| | - Fiona Campbell
- Department of Anesthesia and Pain MedicineThe Hospital for Sick ChildrenUniversity of TorontoTorontoONCanada
| | - Wim J.E. Tissing
- University of GroningenUniversity Medical Center GroningenBeatrix Children's HospitalDepartment of Pediatric Oncology/HematologyGroningenthe Netherlands,Princess Máxima Center for Pediatric OncologyUtrechtthe Netherlands
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Hobusch GM, Cernakova M, Puchner SE, Kolb A, Panotopoulos J, Windhager R. Sports activity after soft tissue sarcoma of the lower extremity. Disabil Rehabil 2019; 42:14-19. [DOI: 10.1080/09638288.2018.1520929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Gerhard M. Hobusch
- Department of Orthopaedic Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Miroslava Cernakova
- Department of Orthopaedic Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Stephan E. Puchner
- Department of Orthopaedic Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Alexander Kolb
- Department of Orthopaedic Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Joannis Panotopoulos
- Department of Orthopaedic Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Reinhard Windhager
- Department of Orthopaedic Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
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22
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Su HL, Wu LM, Chiou SS, Lin PC, Liao YM. Assessment of the effects of walking as an exercise intervention for children and adolescents with cancer: A feasibility study. Eur J Oncol Nurs 2018; 37:29-34. [PMID: 30473048 DOI: 10.1016/j.ejon.2018.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/01/2018] [Accepted: 10/19/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE To examine the effects of walking exercise on exercise tolerance, fatigue, sleep quality, and quality of life (QOL) for children and adolescents with cancer. METHODS A 6-week walking exercise regimen was implemented in pediatric hematological and oncological wards and in clinics of a medical center in Taiwan. A 6-min walk test (6MWT), fatigue, sleep quality, and QOL were measured at baseline and for six subsequent weeks. RESULTS Adherence to the walking exercise regimen was achieved by 72-89% of the participants in this study. Significant improvements in exercise tolerance were observed after two weeks and they continued through week 6 (F = 17.07, p < 0.001). Both cognitive fatigue and general fatigue were significantly improved after six weeks of walking exercise (t = 2.41, p = 0.02; t = 2.76, p = 0.01), while sub-scores for sleep/rest fatigue did not improve. No significant impact on sleep quality or QOL was observed. CONCLUSIONS Walking exercise is a feasible and tolerable intervention that should be considered for children and adolescents with cancer. Here, a 6-week walking exercise regimen increased exercise tolerance and improved fatigue. We recommend that walking exercise should be promoted during hospitalization and at home to alleviate fatigue.
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Affiliation(s)
- Hsiu-Lan Su
- Department of Nursing, Kaohsiung Medical University Hospital, and School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Li-Min Wu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Shyh-Shin Chiou
- Division of Hematology and Oncology Department of Pediatrics, Kaohsiung Medical University Hospital, Department of Pediatrics, College of Medicine, Kaohsiung Medical University, Taiwan.
| | - Pei-Chin Lin
- Division of Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Department of Pediatrics, College of Medicine, Kaohsiung Medical University, Taiwan.
| | - Yu-Mei Liao
- Division of Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Taiwan.
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Howell CR, Krull KR, Partin RE, Kadan-Lottick NS, Robison LL, Hudson MM, Ness KK. Randomized web-based physical activity intervention in adolescent survivors of childhood cancer. Pediatr Blood Cancer 2018; 65:e27216. [PMID: 29722481 PMCID: PMC6019155 DOI: 10.1002/pbc.27216] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 03/20/2018] [Accepted: 04/09/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Healthy lifestyle choices, including participation in regular physical activity, may improve health outcomes in survivors of childhood cancer. We aimed to evaluate the efficacy of a web-delivered physical activity intervention among adolescent survivors to increase moderate to vigorous physical activity (MVPA) and improve fitness and neurocognitive and health-related quality of life (HRQoL) over 24 weeks. PROCEDURE This randomized controlled trial was conducted among survivors (aged ≥11 to <15 years) treated at a single institution. Participants were randomized to either a physical activity intervention delivered over the internet or a control group. The intervention group received educational materials, an activity monitor, and access to an interactive website designed to motivate increased physical activity via rewards; the control group received an activity monitor and educational materials. Physical activity, fitness, and neurocognitive and HRQoL outcomes were assessed at baseline and at 24 weeks. Mean changes were compared between groups using paired t-tests. RESULTS Of the 97 survivors enrolled, 78 completed the study; the mean age was 12.7 (standard deviation 1.1), 80% were White, and 55.1% were female. Fifty-three survivors were assigned to the intervention and 25 to the control group. While survivors in the intervention group increased, and those in the control group decreased (4.7 ± 119.9 vs. -24.3 ± 89.7 min) weekly MVPA, this difference was not significant (P = 0.30). However, hand grip strength, number of sit-ups and pushups, neurocognitive function, and HRQoL outcomes improved in the intervention, but not in the control group. CONCLUSIONS An interactive, rewards-based intervention designed to increase MVPA is feasible in adolescent survivors of childhood cancer.
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Affiliation(s)
- Carrie R. Howell
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Kevin R. Krull
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee,Department of Psychology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Robyn E. Partin
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Nina S. Kadan-Lottick
- Department of Yale University School of Medicine and Smilow Cancer Center, New Haven, Connecticut
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Melissa M. Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee,Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Kirsten K. Ness
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
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Satapathy S, Kaushal T, Bakhshi S, Chadda RK. Non-pharmacological Interventions for Pediatric Cancer Patients: A Comparative Review and Emerging Needs in India. Indian Pediatr 2018. [DOI: 10.1007/s13312-018-1323-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Rodriguez-Romo L, Olaya Vargas A, Gupta S, Shalkow-Klincovstein J, Vega-Vega L, Reyes-Lopez A, Cicero-Oneto C, Mejia-Arangure J, Gonzalez-Ramella O, Pineiro-Retif R, Lopez-Facundo A, de los Angeles Del Campo-Martinez M, Tejocote I, Brennan K, Booth CM. Delivery of Pediatric Cancer Care in Mexico: A National Survey. J Glob Oncol 2018; 4:1-12. [PMID: 30084750 PMCID: PMC6223522 DOI: 10.1200/jgo.17.00238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Limited data describe the delivery of pediatric cancer care in Mexico. We report a nationwide survey of pediatric cancer units. Methods An electronic survey was distributed to 74 pediatric cancer units in Mexico to describe case volumes; organization of care; and availability of medical/surgical specialists, supportive care, complex therapies, and diagnostic services. Centers were classified as low (< 30 new patients/year), medium (30 to 59/year) and high (≥ 60/year). Results Sixty-two centers completed the survey (response rate, 84%). The median annual new case volume per center was 50 (interquartile range [IQR], 23 to 81). Thirty-four percent (n = 21), 26% (n = 16), and 40% (n = 25) of units were low-, medium-, and high-volume centers, respectively. Treatment units reported a median of two pediatric oncologists (IQR, 2) and one pediatric hematologist (IQR, 1 to 2). Availability of medical and surgical subspecialists varied by center size, with substantially more specialist support at higher-volume centers ( P < .01). Multidisciplinary tumor boards are available at 29% (six of 21), 56% (nine of 16), and 76% (19 of 25) of low- to high-volume centers, respectively ( P = .005). Radiation and palliative care services are available at 42% (n = 26) and 63% (n = 36) of all centers, which did not vary by center volume. Educational support for hospitalized children and school reintegration programs are available at 56% (n = 36) and 58% (n = 36) of centers, respectively. One third (38% [n = 23]) of centers reported that at least one half of patients were lost to follow-up during the transition from pediatric to adult programs. Conclusion A large variation exists in annual case volumes across Mexican pediatric cancer centers. Additional efforts to increase access to multidisciplinary, supportive, and palliative care across all pediatric cancer units in Mexico are required.
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Affiliation(s)
- Laura Rodriguez-Romo
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Alberto Olaya Vargas
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Sumit Gupta
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Jaime Shalkow-Klincovstein
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Lourdes Vega-Vega
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Alfonso Reyes-Lopez
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Carlo Cicero-Oneto
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Juan Mejia-Arangure
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Oscar Gonzalez-Ramella
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Rafael Pineiro-Retif
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Aracely Lopez-Facundo
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Maria de los Angeles Del Campo-Martinez
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Isidoro Tejocote
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Kelly Brennan
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
| | - Christopher M. Booth
- Laura Rodriguez-Romo, Queen’s University; Kelly Brennan and Christopher M. Booth, Queen’s University Cancer Research Institute, Kingston; Sumit Gupta, The Hospital for Sick Children, Toronto, Ontario, Canada; Laura Rodriguez and Rafael Pineiro-Retif, Hospital Universitario de la Universidad Autónoma de Nuevo León, Nuevo León; Alberto Olaya Vargas and Jaime Shalkow-Klincovstein, Instituto Nacional de Pediatria; Alfonso Reyes-Lopez and Carlo Cicero-Oneto, Hospital Infantil de México; Juan Mejia-Arangure, Centro Médico Nacional Siglo XXI; Maria de los Angeles Del Campo-Martinez, Centro Médico Nacional La Raza, Mexico City; Lourdes Vega-Vega, Hospital Infantil Teletón de Oncología, Querétaro; Oscar Gonzalez-Ramella, Hospital Civil de Guadalajara, Guadalajara; Aracely Lopez-Facundo, Universidad Autónoma del Estado de México, México; and Isidoro Tejocote, Hospital para el Nino del Instituto Materno Infantil, México, México, Toluca, Mexico
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Effect of inpatient rehabilitation on activities of daily living in pediatric cancer patients in Japan. Int J Rehabil Res 2018; 41:146-151. [DOI: 10.1097/mrr.0000000000000280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Götte M, Kesting SV, Gerss J, Rosenbaum D, Boos J. Feasibility and effects of a home-based intervention using activity trackers on achievement of individual goals, quality of life and motor performance in patients with paediatric cancer. BMJ Open Sport Exerc Med 2018; 4:e000322. [PMID: 29765699 PMCID: PMC5950644 DOI: 10.1136/bmjsem-2017-000322] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Supervised exercise interventions during inpatient care are feasible. The objective was to evaluate the usability of activity trackers and centralised monitoring to conduct a home-based exercise intervention during cancer treatment. The primary endpoint and confirmatory analysis was achievement of individual goals for daily steps, compared (A) in the intervention group (IG) over time and (B) between the IG and control group (CG). Secondary endpoints included achievement of goals for active minutes and effects on motor performance and health-related quality of life (hrQoL). METHODS Forty patients treated for paediatric cancer (14.7±3.9 years) were included. The IG received a 6-8 week intervention during acute treatment (T1) and a 2-week intervention in transition to aftercare (T2). The CG only received the intervention at T2. Baseline tests to assess motor performance and physical activity were conducted prior to every intervention. RESULTS In the primary confirmatory analysis, the IG significantly improved achievement of individual step goals (p=0.04) whereas group analyses did not reveal significant differences. Achievement of active minutes remained low (p=0.23). IG scored higher in hrQoL than CG (p<0.01) and percentage of children scoring below normative value in strength tests was higher in CG. Of all participants, 94% rated the intervention as meaningful and 80% as motivational. CONCLUSIONS Results of this study indicate that this intervention for home stays with centralised supervision is feasible and leads to increased achievement of individual step goals. Despite the positive effects on hrQoL, further strategies are needed to increase positive effects on motor performance.
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Affiliation(s)
- Miriam Götte
- Department of Pediatric Hematology/Oncology, Center for Child and Adolescent Medicine, University Hospital Essen, Essen, Germany
- Department for Pediatric Hematology and Oncology, University Hospital Münster, Münster, Germany
| | - Sabine Verena Kesting
- Department for Pediatric Hematology and Oncology, University Hospital Münster, Münster, Germany
- Department of Sport and Health Science, Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Comprehensive Cancer Center Munich, Kinderklinik München Schwabing, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Joachim Gerss
- Institute of Biostatistics and Clinical Research, University Hospital Münster, Münster, Germany
| | - Dieter Rosenbaum
- Institute of Experimental Musculoskeletal Medicine, University Hospital Münster, Münster, Germany
| | - Joachim Boos
- Department for Pediatric Hematology and Oncology, University Hospital Münster, Münster, Germany
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Rustler V, Hagerty M, Daeggelmann J, Marjerrison S, Bloch W, Baumann FT. Exercise interventions for patients with pediatric cancer during inpatient acute care: A systematic review of literature. Pediatr Blood Cancer 2017; 64. [PMID: 28423225 DOI: 10.1002/pbc.26567] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 02/25/2017] [Accepted: 03/03/2017] [Indexed: 02/05/2023]
Abstract
Physical inactivity has been shown to exacerbate negative side effects experienced by pediatric patients undergoing cancer therapy. Exercise interventions are being created in response. This review summarizes current exercise intervention data in the inpatient pediatric oncology setting. Two independent reviewers collected literature from three databases, and analyzed data following the PRISMA statement for systematic reviews and meta-analyses. Ten studies were included, representing 204 patients. Good adherence, positive trends in health status, and no adverse events were noted. Common strategies included individual, supervised, combination training with adaptability to meet fluctuating patient abilities. We recommend that general physical activity programming be offered to pediatric oncology inpatients.
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Affiliation(s)
- Vanessa Rustler
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany
| | - Meaghan Hagerty
- Faculty of Health Sciences, Global Health, McMaster University, Hamilton, Canada
| | - Julia Daeggelmann
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany
| | - Stacey Marjerrison
- Department of Hematology and Oncology, McMaster Children's Hospital, McMaster University, Hamilton, Canada
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany
| | - Freerk T Baumann
- Department 1 of Internal Medicine, Center for Integrated Oncology Cologne/Bonn, University Hospital Cologne, Germany
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Johnston K, Deliva R, Evans C. Mobilization patterns of children on a hematology/oncology inpatient ward. Pediatr Blood Cancer 2017; 64. [PMID: 28409889 DOI: 10.1002/pbc.26552] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 02/23/2017] [Accepted: 02/24/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND Children being treated for cancer are admitted to the hospital for treatment of their disease or complications of therapy. Periods of bed rest during hospitalization can cause impairments detrimental to children with cancer who endure many side effects of therapy. Little is known about how these children mobilize while admitted to the hospital. The purpose of this study was to examine how children admitted to a hematology/oncology ward are mobilizing and analyze factors associated with delayed or infrequent mobility. PROCEDURE A retrospective chart review was conducted on 228 charts with data recorded on documented mobilization and referrals to physiotherapy. Primary outcome was related to mobility including timing, frequency, type, and nature of mobilization. RESULTS Almost half of children (43%) mobilized between 3 and 5 days per week, with median time to first mobilization being 2 days (interquartile range 1-3). Caregivers assisted with mobilization 91% of the time. Children isolated to their room and those reporting fever had a statistically significant decrease in the percent of admission days involving mobilization (mean difference 15 and 8%, respectively) than those not isolated and without fever. Children who were isolated also mobilized 1 day later (P = 0.016) than children who were not isolated. Percentage of time in isolation was positively correlated with timing (P = 0.04) and negatively correlated with frequency of mobilization (P < 0.001). CONCLUSION Most children admitted to the hospital for treatment of oncologic or hematologic conditions were noted to mobilize early, but frequency of mobilization could be improved. Periods of time in isolation appear to negatively affect mobilization.
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Affiliation(s)
- Krista Johnston
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.,Department of Rehabilitation, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Robin Deliva
- Department of Rehabilitation, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Cathy Evans
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
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Improving Functional Mobility in Children and Adolescents Undergoing Treatment for Non-Central Nervous System Cancers: A Systematic Review. PM R 2017; 9:S385-S397. [DOI: 10.1016/j.pmrj.2017.05.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/19/2017] [Accepted: 05/21/2017] [Indexed: 11/18/2022]
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What Sport Activity Levels Are Achieved in Patients After Resection and Endoprosthetic Reconstruction for a Proximal Femur Bone Sarcoma? Clin Orthop Relat Res 2017; 475:817-826. [PMID: 27020426 PMCID: PMC5289166 DOI: 10.1007/s11999-016-4790-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Limited information is available about sports activities of survivors after resection and reconstruction of primary malignant bone tumors with megaprostheses. Because patients often ask what activities are possible after treatment, objective knowledge about sports activities is needed to help assess the risks of sports participation and to help guide patients' expectations. QUESTIONS/PURPOSES The aims of this study were to evaluate (1) what proportion of patients with proximal-femoral megaprostheses placed as part of tumor reconstructions can perform sports; (2) what activity levels they achieved; and (3) whether sports activity levels are associated with an increased likelihood of revision. METHODS This retrospective study considered all 27 living patients in our institutional tumor registry with enduring proximal-femoral reconstructions performed more than 5 years ago who were between the ages of 11 and 49 years at the time of the reconstruction; seven were lost to followup and one was excluded because of paraplegia as a result of a car accident and another because of senile dementia; another two were excluded from statistics because of growing prostheses and skeletal immaturity at the time of followup, leaving 16 (11 male, five female) for analysis. Their mean age was 26 ± 12 years (range, 11-49 years) at surgery, and the mean followup was 18 ± 7 years (range, 5-27 years). Types of sports, frequency per week, duration of each sports session as well as the UCLA and modified Weighted Activity Score were assessed retrospectively by an independent assessor a median of 18 years (range, 5.3-27 years) after surgery. RESULTS Patients recalled that preoperatively 14 were practicing sports 5 (± 4) hours/week. At followup, 11 of the patients were practicing one or more sports activities 2 (± 3) hours/week on a regular basis. The preoperative UCLA and modified Weighted Activity Score levels of 9 and 6 fell to levels of 6 (p = 0.005) and 3 (p = 0.025), respectively, at followup. With the numbers of patients available for study, we could not determine that prosthetic failures were associated with sport activity levels. CONCLUSIONS Patients who survive primary malignant bone tumors in the proximal femur reconstructed by megaprostheses are able to perform some sports activities. The estimates of activity levels made in this study probably are best-case estimates, given that some patients were lost to followup; patients unaccounted for might not be doing as well as those represented here. Also, the degree to which sports participation influences implant durability remains, for the most part, unanswered; studies with more patients and longer followup will be needed to determine to what degree prosthesis survivorship relates to sporting activity levels. Most patients perform low-impact sports and at a lower level than they had preoperatively. Because this is a preliminary study of a select group of patients, further information is necessary to weight the benefits of higher sports activity levels against potential risks. If this can be confirmed in a larger number of patients, the information may guide surgeons in their discussion with patients preoperatively and give them some objective assessment of what to expect regarding sports activities. LEVEL OF EVIDENCE Level IV, therapeutic study.
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Taylor MF, Pooley JA. Sarcoma survivors’ perspectives on their body image and functional quality of life post-resection/limb salvage surgery. Eur J Cancer Care (Engl) 2017; 26. [DOI: 10.1111/ecc.12667] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 01/09/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Myra F. Taylor
- School of Medical and Health Sciences; Edith Cowan University; Joondalup WA Australia
| | - Julie A. Pooley
- School of Psychology; Edith Cowan University; Joondalup WA Australia
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Le A, Mitchell HR, Zheng DJ, Rotatori J, Fahey JT, Ness KK, Kadan-Lottick NS. A home-based physical activity intervention using activity trackers in survivors of childhood cancer: A pilot study. Pediatr Blood Cancer 2017; 64:387-394. [PMID: 27615711 DOI: 10.1002/pbc.26235] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 07/29/2016] [Accepted: 08/02/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Over 70% of childhood cancer survivors develop late complications from therapy, many of which can be mitigated by physical activity. Survivors engage in exercise at similar or lower rates than their sedentary healthy peers. We piloted a novel home-based exercise intervention with a motivational activity tracker. We evaluated (i) feasibility, (ii) impact on activity levels and physical fitness, and (iii) barriers, preferences, and beliefs regarding physical activity. METHODS Childhood cancer survivors currently 15 years or older and not meeting the Centers for Disease Control and Prevention physical activity guidelines were enrolled and instructed to wear the Fitbit One, a 4.8 cm × 1.8 cm motivational activity tracker, daily for 6 months. Baseline and follow-up evaluations included self-report surveys, an Actigraph accelerometer for 7 days, and a VO2 maximum test by cardiac stress test. RESULTS Nineteen participants were enrolled (13.4% participation rate) with a mean age of 24.3 ± 5.8 years (range 15-35). Four participants withdrew with a 79% retention rate. Participants wore the Fitbit an average of 19.0 ± 4.7 days per month during months 1-3 and 15.0 ± 7.9 days per month during months 4-6. Total weekly moderate to vigorous physical activity increased from 265.6 ± 117.0 to 301.4 ± 135.4 min and VO2 maximum increased from 25.7 ± 7.7 to 27.2 ± 7.4 ml/kg/min. These changes were not statistically significant (P = 0.47 and 0.30, respectively). Survey responses indicated no change in barriers, preferences, and beliefs regarding physical activity. CONCLUSIONS This pilot study of a motivational activity tracker demonstrated feasibility as measured by participant retention, receptivity, and belief of utility. Future studies with a large sample size are needed to demonstrate the efficacy and sustainability of this intervention.
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Affiliation(s)
- Alyssa Le
- Department of Pediatric Hematology/Oncology, Yale School of Medicine, New Haven, Connecticut
| | - Hannah-Rose Mitchell
- Department of Pediatric Hematology/Oncology, Yale School of Medicine, New Haven, Connecticut
| | - Daniel J Zheng
- Department of Pediatric Hematology/Oncology, Yale School of Medicine, New Haven, Connecticut
| | - Jaime Rotatori
- Department of Pediatric Hematology/Oncology, Yale School of Medicine, New Haven, Connecticut
| | - John T Fahey
- Department of Pediatric Cardiology, Yale School of Medicine, New Haven, Connecticut
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Nina S Kadan-Lottick
- Department of Pediatric Hematology/Oncology, Yale School of Medicine, New Haven, Connecticut.,Yale Cancer Center, New Haven, Connecticut
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Lam KKW, Ho Cheung William L, Ho KYE, Chung OKJ, Chan CFG. Factors contributing to the low physical activity level for Hong Kong Chinese children hospitalised with cancer: an exploratory study. J Clin Nurs 2016; 26:190-201. [DOI: 10.1111/jocn.13495] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Ka Yan Eva Ho
- School of Nursing; The University of Hong Kong; Hong Kong China
| | | | - Chi Fung Godfrey Chan
- Department of Paediatrics and Adolescent Medicine; LKS Faculty of Medicine; Queen Mary Hospital; The University of Hong Kong; Hong Kong China
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Ducassou S, Genelini F, Rochard C, Pérel Y. L’activité physique en cancérologie pédiatrique en pratique. ONCOLOGIE 2016. [DOI: 10.1007/s10269-016-2669-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Grimshaw SL, Taylor NF, Shields N. The Feasibility of Physical Activity Interventions During the Intense Treatment Phase for Children and Adolescents with Cancer: A Systematic Review. Pediatr Blood Cancer 2016; 63:1586-93. [PMID: 27186955 DOI: 10.1002/pbc.26010] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/11/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND Physical activity may have benefits for children undergoing intense treatment for cancer, but such programmes are challenging to implement. This systematic review aimed to investigate the feasibly of physical activity interventions during intense cancer treatment for children and adolescents. PROCEDURE A systematic search of seven electronic databases (Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, Public/Publisher MEDLINE, Psychological Information Database, Sportsdiscuss, Excerpta Medica Database, Allied and Complementary Medicine Database) from 2005 to August 2015 was completed. The risk of bias was assessed using the Downs and Black Checklist and The Critical Review Form-Qualitative Studies. Results were summarised descriptively across eight domains of feasibility: acceptability, demand, implementation, adaptation, practicality, integration, expansion and limited efficiency testing (including effectiveness). RESULTS Eleven quantitative studies and one qualitative study were identified for inclusion. Physical activity interventions were typically supervised, individualised programmes that prescribed a variety of activity types for hospital inpatients. There was evidence that physical activity interventions during the intense phase of cancer treatment were acceptable to parents and children, safe and successfully implemented. A trend of positive effects across all aspects of functioning was noted. Data were unavailable documenting feasibility for the domains of integration, adaptation and expansion. CONCLUSION There is preliminary evidence that physical activity interventions are feasible, in that they are acceptable, safe and potentially beneficial for children with cancer but more work needs to be done to understand the most effective ways to implement these types of programmes.
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Affiliation(s)
- Sarah L Grimshaw
- School of Allied Health, La Trobe University, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia
| | - Nicholas F Taylor
- School of Allied Health, La Trobe University, Melbourne, Australia.,Allied Health Research Office, Eastern Health, Melbourne, Australia
| | - Nora Shields
- School of Allied Health, La Trobe University, Melbourne, Australia.,Department of Allied Health, Northern Health, Melbourne, Australia
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Müller C, Krauth KA, Gerß J, Rosenbaum D. Physical activity and health-related quality of life in pediatric cancer patients following a 4-week inpatient rehabilitation program. SUPPORTIVE CARE IN CANCER : OFFICIAL JOURNAL OF THE MULTINATIONAL ASSOCIATION OF SUPPORTIVE CARE IN CANCER 2016. [PMID: 27056572 DOI: 10.1007/s00520-016-3198-y.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE Chronic health conditions and impaired quality of life are commonly experienced in childhood cancer survivors. While rehabilitation clinics support patients in coping with the disease, studies evaluating an inpatient rehabilitation program on promoting physical activity (PA) and health-related quality of life (HRQoL) are missing. METHODS A 4-week inpatient rehabilitation program was prospectively evaluated. One hundred fifty patients with leukemia or lymphoma (N = 86), brain tumors (N = 38), and sarcomas (N = 26) were enrolled on average 17 months after cessation of acute medical treatment. PA amount and cadence (indicating the intensity of walking activity) using the StepWatch™ 3 Activity Monitor and HRQoL global and physical well-being scores using the KINDL(®) questionnaire were assessed before, immediately after, and 6 and 12 months following the program and analyzed using multiple linear mixed models. RESULTS Significant effects on PA were only found at 12-month follow-up for amount and cadence variables (all p < 0.05). While leukemia and lymphoma patients revealed the highest PA level throughout the study, rehabilitation effects were more pronounced for cadence variables in brain tumor and sarcoma patients. The rehabilitation program had immediate (t = 4.56, p < 0.001) and sustainable effects on HRQoL global scores (6-month follow-up, t = 4.08, p < 0.001; 12-month follow-up, t = 3.13, p < 0.006). CONCLUSIONS Immediate and sustainable increases in HRQoL indicate that a 4-week rehabilitation program is beneficial for improving psychosocial well-being, while the significant increase in PA levels could be related to general recovery as well. The lack of a control group hampers the evaluation of the rehabilitation program on promoting PA levels in pediatric cancer patients.
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Affiliation(s)
- Carsten Müller
- Institute of Sports Science, Work Unit Human Performance and Training in Sports, University of Münster, Horstmarer Landweg 62b, 48149, Münster, Germany. .,Institute of Experimental Musculoskeletal Medicine, Movement Analysis Laboratory, University Hospital Münster, Domagkstr. 3, 48149, Münster, Germany.
| | | | - Joachim Gerß
- Institute of Biostatistics and Clinical Research, University of Münster, Schmeddingstr. 56, 48149, Münster, Germany
| | - Dieter Rosenbaum
- Institute of Experimental Musculoskeletal Medicine, Movement Analysis Laboratory, University Hospital Münster, Domagkstr. 3, 48149, Münster, Germany
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Müller C, Krauth KA, Gerß J, Rosenbaum D. Physical activity and health-related quality of life in pediatric cancer patients following a 4-week inpatient rehabilitation program. Support Care Cancer 2016; 24:3793-802. [PMID: 27056572 DOI: 10.1007/s00520-016-3198-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 03/28/2016] [Indexed: 01/14/2023]
Abstract
PURPOSE Chronic health conditions and impaired quality of life are commonly experienced in childhood cancer survivors. While rehabilitation clinics support patients in coping with the disease, studies evaluating an inpatient rehabilitation program on promoting physical activity (PA) and health-related quality of life (HRQoL) are missing. METHODS A 4-week inpatient rehabilitation program was prospectively evaluated. One hundred fifty patients with leukemia or lymphoma (N = 86), brain tumors (N = 38), and sarcomas (N = 26) were enrolled on average 17 months after cessation of acute medical treatment. PA amount and cadence (indicating the intensity of walking activity) using the StepWatch™ 3 Activity Monitor and HRQoL global and physical well-being scores using the KINDL(®) questionnaire were assessed before, immediately after, and 6 and 12 months following the program and analyzed using multiple linear mixed models. RESULTS Significant effects on PA were only found at 12-month follow-up for amount and cadence variables (all p < 0.05). While leukemia and lymphoma patients revealed the highest PA level throughout the study, rehabilitation effects were more pronounced for cadence variables in brain tumor and sarcoma patients. The rehabilitation program had immediate (t = 4.56, p < 0.001) and sustainable effects on HRQoL global scores (6-month follow-up, t = 4.08, p < 0.001; 12-month follow-up, t = 3.13, p < 0.006). CONCLUSIONS Immediate and sustainable increases in HRQoL indicate that a 4-week rehabilitation program is beneficial for improving psychosocial well-being, while the significant increase in PA levels could be related to general recovery as well. The lack of a control group hampers the evaluation of the rehabilitation program on promoting PA levels in pediatric cancer patients.
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Affiliation(s)
- Carsten Müller
- Institute of Sports Science, Work Unit Human Performance and Training in Sports, University of Münster, Horstmarer Landweg 62b, 48149, Münster, Germany. .,Institute of Experimental Musculoskeletal Medicine, Movement Analysis Laboratory, University Hospital Münster, Domagkstr. 3, 48149, Münster, Germany.
| | | | - Joachim Gerß
- Institute of Biostatistics and Clinical Research, University of Münster, Schmeddingstr. 56, 48149, Münster, Germany
| | - Dieter Rosenbaum
- Institute of Experimental Musculoskeletal Medicine, Movement Analysis Laboratory, University Hospital Münster, Domagkstr. 3, 48149, Münster, Germany
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Lam KK, Li WH, Chiu S, Chan GC. The impact of cancer and its treatment on physical activity levels and quality of life among young Hong Kong Chinese cancer patients. Eur J Oncol Nurs 2016; 21:83-9. [DOI: 10.1016/j.ejon.2016.01.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 09/11/2015] [Accepted: 01/28/2016] [Indexed: 11/26/2022]
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Braam KI, van der Torre P, Takken T, Veening MA, van Dulmen‐den Broeder E, Kaspers GJL. Physical exercise training interventions for children and young adults during and after treatment for childhood cancer. Cochrane Database Syst Rev 2016; 3:CD008796. [PMID: 27030386 PMCID: PMC6464400 DOI: 10.1002/14651858.cd008796.pub3] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND A decreased physical fitness has been reported in patients and survivors of childhood cancer. This is influenced by the negative effects of the disease and the treatment of childhood cancer. Exercise training for adult cancer patients has frequently been reported to improve physical fitness. In recent years, literature on this subject has also become available for children and young adults with cancer, both during and after treatment. This is an update of the original review that was performed in 2011. OBJECTIVES To evaluate the effect of a physical exercise training intervention on the physical fitness (i.e. aerobic capacity, muscle strength, or functional performance) of children with cancer within the first five years from their diagnosis (performed either during or after cancer treatment), compared to a control group of children with cancer who did not receive an exercise intervention.To determine whether physical exercise within the first five years of diagnosis has an effect on fatigue, anxiety, depression, self efficacy, and HRQoL and to determine whether there are any adverse effects of the intervention. SEARCH METHODS We searched the electronic databases of Cochrane Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, and PEDro; ongoing trial registries and conference proceedings on 6 September 2011 and 11 November 2014. In addition, we performed a handsearch of reference lists. SELECTION CRITERIA The review included randomized controlled trials (RCTs) and clinical controlled trials (CCTs) that compared the effects of physical exercise training with no training, in people who were within the first five years of their diagnosis of childhood cancer. DATA COLLECTION AND ANALYSIS Two review authors independently identified studies meeting the inclusion criteria, performed the data extraction, and assessed the risk of bias using standardized forms. Study quality was rated by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) criteria. MAIN RESULTS Apart from the five studies in the original review, this update included one additional RCT. In total, the analysis included 171 participants, all during treatment for childhood acute lymphoblastic leukaemia (ALL).The duration of the training sessions ranged from 15 to 60 minutes per session. Both the type of intervention and intervention period varied in all the included studies. However, the control group always received usual care.All studies had methodological limitations, such as small numbers of participants, unclear randomization methods, and single-blind study designs in case of one RCT and all results were of moderate to very low quality (GRADE).Cardiorespiratory fitness was evaluated by the 9-minute run-walk test, timed up-and-down stairs test, the timed up-and-go time test, and the 20-m shuttle run test. Data of the 9-minute run-walk test and the timed up-and-down stairs test could be pooled. The combined 9-minute run-walk test results showed significant differences between the intervention and the control groups, in favour of the intervention group (standardized mean difference (SMD) 0.69; 95% confidence interval (CI) 0.02 to 1.35). Pooled data from the timed up-and-down stairs test showed no significant differences in cardiorespiratory fitness (SMD -0.54; 95% CI -1.77 to 0.70). However, there was considerable heterogeneity (I(2) = 84%) between the two studies on this outcome. The other two single-study outcomes, 20-m shuttle run test and the timed up-and-go test, also showed positive results for cardiorespiratory fitness in favour of the intervention group.Only one study assessed the effect of exercise on bone mineral density (total body), showing a statistically significant positive intervention effect (SMD 1.07; 95% CI 0.48 to 1.66). The pooled data on body mass index showed no statistically significant end-score difference between the intervention and control group (SMD 0.59; 95% CI -0.23 to 1.41).Three studies assessed flexibility. Two studies assessed ankle dorsiflexion. One study assessed active ankle dorsiflexion, while the other assessed passive ankle dorsiflexion. There were no statistically significant differences between the intervention and control group with the active ankle dorsiflexion test; however, in favour of the intervention group, they were found for passive ankle dorsiflexion (SMD 0.69; 95% CI 0.12 to 1.25). The third study assessed body flexibility using the sit-and-reach distance test, but identified no statistically significant difference between the intervention and control group.Three studies assessed muscle strength (knee, ankle, back and leg, and inspiratory muscle strength). Only the back and leg strength combination score showed statistically significant differences on the muscle strength end-score between the intervention and control group (SMD 1.41; 95% CI 0.71 to 2.11).Apart from one sub-scale of the cancer scale (Worries; P value = 0.03), none of the health-related quality of life scales showed a significant difference between both study groups on the end-score. For the other outcomes of fatigue, level of daily activity, and adverse events (all assessed in one study), there were no statistically significant differences between the intervention and control group.None of the included studies evaluated activity energy expenditure, time spent on exercise, anxiety and depression, or self efficacy as an outcome. AUTHORS' CONCLUSIONS The effects of physical exercise training interventions for childhood cancer participants are not yet convincing. Possible reasons are the small numbers of participants and insufficient study designs, but it can also be that this type of intervention is not as effective as in adult cancer patients. However, the first results show some positive effects on physical fitness in the intervention group compared to the control group. There were positive intervention effects for body composition, flexibility, cardiorespiratory fitness, muscle strength, and health-related quality of life (cancer-related items). These were measured by some assessment methods, but not all. However, the quality of the evidence was low and these positive effects were not found for the other assessed outcomes, such as fatigue, level of daily activity, and adverse events. There is a need for more studies with comparable aims and interventions, using a higher number of participants that also include diagnoses other than ALL.
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Affiliation(s)
- Katja I Braam
- VU University Medical CenterDepartment of Pediatrics, Division of Oncology/HematologyPO Box 7057Room 6 D 120AmsterdamNetherlands1007 MB
| | - Patrick van der Torre
- Wilhelmina Children's Hospital, University Medical Center UtrechtChild Development and Exercise CenterPO Box 85090UtrechtNetherlands3508 AB
| | - Tim Takken
- Wilhelmina Children's Hospital, University Medical Center UtrechtChild Development and Exercise CenterPO Box 85090UtrechtNetherlands3508 AB
| | - Margreet A Veening
- VU University Medical CenterDepartment of Pediatrics, Division of Oncology/HematologyPO Box 7057Room 6 D 120AmsterdamNetherlands1007 MB
| | - Eline van Dulmen‐den Broeder
- VU University Medical CenterDepartment of Pediatrics, Division of Oncology/HematologyPO Box 7057Room 6 D 120AmsterdamNetherlands1007 MB
| | - Gertjan JL Kaspers
- VU University Medical CenterDepartment of Pediatrics, Division of Oncology/HematologyPO Box 7057Room 6 D 120AmsterdamNetherlands1007 MB
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Bogg TFT, Broderick C, Shaw P, Cohn R, Naumann FL. Feasibility of an inpatient exercise intervention for children undergoing hematopoietic stem cell transplant. Pediatr Transplant 2015; 19:925-31. [PMID: 26518227 DOI: 10.1111/petr.12614] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2015] [Indexed: 11/27/2022]
Abstract
With improving survival rates following HSCT in children, QOL and management of short- and long-term effects need to be considered. Exercise may help mitigate fatigue and declines in fitness and strength. The aims of this study were to assess the feasibility of an inpatient exercise intervention for children undergoing HSCT and observe the changes in physical and psychological health. Fourteen patients were recruited, mean age 10 yr. A 6MWT, isometric upper and lower body strength, balance, fatigue, and QOL were assessed prior to Tx and six wk post-Tx. A supervised exercise program was offered five days per week during the inpatient period and feasibility assessed through uptake rate. The study had 100% program completion and 60% uptake rate of exercise sessions. The mean (± s.d.) weekly activity was 117.5 (± 79.3) minutes. Younger children performed significantly more minutes of exercise than adolescents. At reassessment, strength and fatigue were stabilized while aerobic fitness and balance decreased. QOL revealed a non-statistical trend towards improvement. No exercise-related adverse events were reported. A supervised inpatient exercise program is safe and feasible, with potential physiological and psychosocial benefits.
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Affiliation(s)
- Tina Fung Ting Bogg
- School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia.,NSW Cancer Survivors Centre, Randwick, NSW, Australia.,Children's Hospital Institute of Sports Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Carolyn Broderick
- School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia.,Children's Hospital Institute of Sports Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Peter Shaw
- Department of Oncology, The Children's Hospital at Westmead, Westmead, NSW, Australia.,Discipline of Paediatrics and Child Health, University of Sydney Medical Program, Sydney, NSW, Australia
| | - Richard Cohn
- School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia.,NSW Cancer Survivors Centre, Randwick, NSW, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
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Momani TG, Hathaway DK, Mandrell BN. Factors Affecting Health-Related Quality of Life in Children Undergoing Curative Treatment for Cancer: A Review of the Literature. J Pediatr Oncol Nurs 2015; 33:228-40. [PMID: 26611756 DOI: 10.1177/1043454215609585] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) is an important measure to evaluate a child's reported treatment experience. Although there are numerous studies of HRQoL in children undergoing curative cancer treatment, there is limited literature on factors that influence this. OBJECTIVE To review published studies that describe the HRQoL and associated factors in children undergoing curative cancer treatment. METHOD Full-text publications in English from January 2005 to March 2013 were searched in PubMed, PsychINFO, and CINAHL for children ≤18 years of age undergoing curative cancer treatment. HRQoL-associated factors were categorized as cancer diagnosis, treatment, child, family, and community. RESULTS Twenty-six studies met the inclusion criteria. The most frequently used generic and cancer-specific instruments were PedsQL (Pediatric Quality of Life Inventory) Generic and PedsQL Cancer, respectively. Cancer diagnosis and treatment were the most frequently identified variables; fewer studies measured family and community domains. Gender, treatment intensity, type of cancer treatments, time in treatment, and cancer diagnosis were correlated with HRQoL. CONCLUSION Our study highlights the need to develop interventions based on diagnosis and treatment regimen to improve the HRQoL in children undergoing curative cancer treatment.
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Affiliation(s)
- Tha'er G Momani
- St. Jude Children's Research Hospital, Memphis, TN, USA University of Tennessee Health Science Center, Memphis, TN, USA
| | | | - Belinda N Mandrell
- St. Jude Children's Research Hospital, Memphis, TN, USA University of Tennessee Health Science Center, Memphis, TN, USA
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Jibb L, Nathan P, Stevens B, Seto E, Cafazzo J, Stephens N, Yohannes L, Stinson J. Psychological and Physical Interventions for
the Management of Cancer-Related Pain in Pediatric and Young Adult Patients: An Integrative Review. Oncol Nurs Forum 2015; 42:E339-57. [DOI: 10.1188/15.onf.e339-e357] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Vallet C, André N, Gentet JC, Verschuur A, Michel G, Sotteau F, Martha C, Grélot L. Pilot evaluation of physical and psychological effects of a physical trek programme including a dog sledding expedition in children and teenagers with cancer. Ecancermedicalscience 2015; 9:558. [PMID: 26284122 PMCID: PMC4531124 DOI: 10.3332/ecancer.2015.558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Indexed: 11/06/2022] Open
Abstract
AIM OF THE STUDY To evaluate the feasibility and to measure the effects of a six-week-long adapted physical activity programme (APAP), including 5 days of intense dog sledding, on the physical and psychological health of children and adolescents treated for cancer. METHODS Eleven children and teenagers (4 girls, 7 boys; mean age 14.3 ± 2.9 years) participated in this monocentric pilot programme of adapted physical activities from February 2013 to March 2013. Seven were still on treatment. The programme lasted 6 weeks. A series of physical tests and psychological questionnaires were carried out before and after the programme. RESULTS All children and teenagers completed the full programme. An improvement in all physical and psychological parameters was observed. Statistically significant differences were observed for global self-esteem (6.2 ± 2.1 to 7.7 ± 1.8; p = 0.02), perceived sport competence (5.3 ± 3.2 to 7.4 ± 2; p = 0.02) and perceived physical strength (5.6 ± 2.5 to 7.1 ± 1.8; p = 0.001). Regarding physical tests, the physical training led to statistically significant improvement for sit-ups (13.8 ± 2.6 to 21.75 ± 5.4; p = 0.01), muscle tone (76 ± 23.7 to 100 ± 22.9; p = 0.01), and resting heart rate (96.1 ± 3.2 to 91.6 ± 4.5; p = 0.03). CONCLUSION This programme is feasible in children and adolescents even during their oncologic treatment. During the 6-week programme, children and adolescents improved their physical and psychological health, and the putative benefits of the APAP are discussed. A larger randomised trial started in 2014.
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Affiliation(s)
- Clothilde Vallet
- Association ‘Sourire à la Vie’, Marseille 13016, France
- Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille 13005, France
| | - Nicolas André
- Association ‘Sourire à la Vie’, Marseille 13016, France
- Department of Paediatric Haematology and Oncology, Hôpital de la Timone Enfant, Marseille 13005, France
- Aix Marseille Université, Inserm, CRO2 UMR_S 911, Marseille 13005, France
| | - Jean-Claude Gentet
- Association ‘Sourire à la Vie’, Marseille 13016, France
- Department of Paediatric Haematology and Oncology, Hôpital de la Timone Enfant, Marseille 13005, France
| | - Arnauld Verschuur
- Association ‘Sourire à la Vie’, Marseille 13016, France
- Department of Paediatric Haematology and Oncology, Hôpital de la Timone Enfant, Marseille 13005, France
| | - Gérard Michel
- Association ‘Sourire à la Vie’, Marseille 13016, France
- Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille 13005, France
- Aix Marseille Université, Inserm, CRO2 UMR_S 911, Marseille 13005, France
| | | | - Cécile Martha
- Association ‘Sourire à la Vie’, Marseille 13016, France
- Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille 13005, France
- Department of Paediatric Haematology and Oncology, Hôpital de la Timone Enfant, Marseille 13005, France
- Aix Marseille Université, Inserm, CRO2 UMR_S 911, Marseille 13005, France
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille Cedex 09, France
- Faculty of Sport Sciences, Aix-Marseille University, Marseille 13009, France
| | - Laurent Grélot
- Faculty of Sport Sciences, Aix-Marseille University, Marseille 13009, France
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Götte M, Kesting SV, Winter CC, Rosenbaum D, Boos J. Motor performance in children and adolescents with cancer at the end of acute treatment phase. Eur J Pediatr 2015; 174:791-9. [PMID: 25428233 DOI: 10.1007/s00431-014-2460-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 11/13/2014] [Accepted: 11/17/2014] [Indexed: 11/30/2022]
Abstract
UNLABELLED Reduced motor performance may particularly limit reintegration into normal life after cessation of treatment in pediatric cancer patients. This study aimed at analyzing motor performance at the end of the acute treatment phase and reveals potential risk factors for motor deficits. A childhood cancer population with different tumor entities was assessed with the MOON test, which allows for comparison with age- and gender-matched reference values of healthy children, at the end of the acute treatment phase. Forty-seven patients were tested at 7.0 ± 2.6 months after diagnosis. Significant reductions of motor performance affected muscular explosive strength (P < 0.001), handgrip strength (P < 0.001), muscular endurance of legs (P = 0.035), hand-eye coordination (P < 0.001), static balance (P = 0.003), speed (P = 0.012), and flexibility (P < 0.001). Loss of upper extremity coordination did not achieve statistical significance. Associations between single motor deficits and the tumor entity, age, body mass index, and inactivity during treatment were revealed, whereas no associations were found for gender and vincristine application. CONCLUSION Overall, motor performance was low in the patient group studied. We recommend that individualized exercise interventions to attenuate motor deficits and promote physical activity are needed during cancer treatment in order to enhance motor performance and improve social participation during and after cancer therapy.
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Affiliation(s)
- Miriam Götte
- Department of Pediatric Hematology and Oncology, University Hospital of Münster, Albert-Schweitzer-Campus 1, A1, 48149, Münster, Germany,
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L’activité physique adaptée, une nécessité pour mettre en œuvre les recommandations. NUTR CLIN METAB 2015. [DOI: 10.1016/j.nupar.2015.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Wurz A, Chamorro-Vina C, Guilcher GMT, Schulte F, Culos-Reed SN. The feasibility and benefits of a 12-week yoga intervention for pediatric cancer out-patients. Pediatr Blood Cancer 2014; 61:1828-34. [PMID: 24938424 DOI: 10.1002/pbc.25096] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 04/17/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Increasing rates of survival present a new set of psychosocial and physical challenges for children undergoing treatment for cancer. Physical activity (PA) has been shown to be a safe and effective strategy to mitigate the significant burden of cancer and its treatments, with yoga increasingly gaining recognition as a gentle alternative. The purpose of this study was to determine the feasibility and benefits of a 12-week community-based yoga intervention on health-related quality of life (HRQL), select physical fitness outcomes and PA levels (PAL). PROCEDURE Eight pediatric cancer out-patients (4 male; 4 female; Mage = 11.88, SD = 4.26) participated in the 12-week intervention consisting of supervised yoga sessions 2 times/week. Participants (patients and parent proxies) completed measures assessing HRQL, physical fitness and PAL at baseline and post-intervention. RESULTS Rates of recruitment, retention, attendance and adverse events indicated the program was feasible. Wilcoxon Signed Rank tests indicated significant improvements for patient (P = 0.02) and parent reported HRQL (P = 0.03), functional mobility (P = 0.01), hamstring flexibility (left, P = 0.01 and right P = 0.02), and total PAL (P = 0.02) pre to post intervention. CONCLUSION This 12-week community-based yoga intervention was feasible and provides preliminary evidence for the benefits of yoga on HRQL, physical fitness and PAL in pediatric cancer out-patients. In a population where sedentary behavior and the associated co-morbidities are a growing concern, these results promote the continued exploration of yoga programming.
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Affiliation(s)
- Amanda Wurz
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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Götte M, Kesting S, Winter C, Rosenbaum D, Boos J. Experience of barriers and motivations for physical activities and exercise during treatment of pediatric patients with cancer. Pediatr Blood Cancer 2014; 61:1632-7. [PMID: 24753116 DOI: 10.1002/pbc.25071] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 03/25/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Due to growing evidence about the value of exercise in pediatric cancer patients, the purpose of this study was to determine factors that influence participation in physical activities and exercise in children and adolescents during treatment. PROCEDURE This cross-sectional qualitative study included 40 pediatric cancer patients during intensive treatment. Patients were recruited at the Department for Pediatric Hematology and Oncology, University Hospital of Muenster where a supervised exercise program has been implemented for hospital stays. The qualitative approach included semi-structured guideline interviews, transcription and coding based on grounded theory. Four major topics were discussed in the interviews: (1) values and beliefs, (2) barriers to exercise, (3) motivations to exercise, and (4) encouragement from parents and physicians. RESULTS Patients reported mainly positive attitudes toward physical activities during treatment and the local exercise program was desired and valued as essential for engaging in exercise during in-patient stays. Identified barriers included physical, psychological, and organizational aspects. Motivational aspects were based on improvements in physical fitness and mental well-being. Parents' behavior related to physical activities of their children differed between being supportive, inhibiting, and inert. Few patients received information about exercise during treatment by their physicians. CONCLUSIONS Interventions that aim at maintaining physical activities during treatment and eliminating exercise barriers are required due to the patients' positive attitudes and multiple motivations toward exercise. These interventions need to be supervised and should include health-counseling programs for patients, parents, and physicians to underline the importance of physical activities in childhood cancer patients.
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Affiliation(s)
- Miriam Götte
- Department of Pediatric Hematology and Oncology, University Hospital of Muenster, Muenster, Germany
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Assessment of physical performance using the 6-minute walk test in children receiving treatment for cancer. Cancer Nurs 2014; 36:E9-E16. [PMID: 23963198 DOI: 10.1097/ncc.0b013e31829f5510] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The study of physical performance in children with cancer is emerging as an important variable in symptom research. Studies have shown that children with cancer experience deficits in physical performance during treatment that may be present years after therapy. OBJECTIVE The aim of this study was to determine if distance on the 6-minute walk test (6MWT) changed in children during the first 3 cycles of cancer treatment and to compare the distances walked with healthy norms. METHODS This is a secondary data analysis of 19 boys and 10 girls, aged 6 to 17 years, who were newly diagnosed with cancer and were part of a larger study that measured changes in fatigue and physical performance during the first 3 cycles of chemotherapy. Participants performed the 6MWT between days 15 and 29 of the first and third cycles of chemotherapy. RESULTS Pediatric cancer patients did not have a significant change in the distance walked at cycle 3 of chemotherapy compared with cycle 1. When compared with 2 different normative data sets for healthy children, most children with cancer performed significantly below their peers. CONCLUSIONS Children had poor strength and endurance after 3 cycles of chemotherapy even when their disease was responding to treatment. Interventions are needed to promote rehabilitation and maintenance of physical performance, as both are important to quality of life and ongoing child development. IMPLICATIONS FOR PRACTICE Children receiving cancer treatment who are ambulatory may appear to be functioning normally but are in fact severely deconditioned compared with their healthy peers.
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