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Sañudo B, Sánchez-Oliver AJ, Fernández-Gavira J, Gaser D, Stöcker N, Peralta M, Marques A, Papakonstantinou S, Nicolini C, Sitzberger C. Physical and Psychosocial Benefits of Sports Participation Among Children and Adolescents with Chronic Diseases: A Systematic Review. SPORTS MEDICINE - OPEN 2024; 10:54. [PMID: 38750266 PMCID: PMC11096140 DOI: 10.1186/s40798-024-00722-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 05/01/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND This study aims to identify sports interventions for children and adolescents (CaA) with chronic diseases and evaluate their impact on physical, psychological, and social well-being. The findings of this study will contribute to our understanding of the potential benefits of sports interventions for CaA with chronic diseases and inform future interventions to promote their overall health and well-being. METHODS A systematic review was conducted in eight databases. This systematic review followed PRISMA guidelines and utilized a comprehensive search strategy to identify studies on sport-based interventions for CaA with chronic diseases. The review included randomized controlled trials and observational studies that focused on physical and psychosocial outcomes. RESULTS We screened 10,123 titles and abstracts, reviewed the full text of 622 records, and included 52 primary studies. A total of 2352 participants were assessed with an average of 45 ± 37 participants per study. Among the included studies involving CaA with chronic diseases with an age range from 3 to 18 years, 30% (n = 15) autism spectrum disorders, 21% (n = 11) cerebral palsy, 19% (n = 10) were attention deficit hyperactivity disorder, and 17% (n = 9) obesity. Other diseases included were cancer (n = 5), asthma (n = 1) and cystic fibrosis (n = 1). Interventions involved various sports and physical activities tailored to each chronic disease. The duration and frequency of interventions varied across studies. Most studies assessed physical outcomes, including motor performance and physical fitness measures. Psychosocial outcomes were also evaluated, focusing on behavioural problems, social competencies, and health-related quality of life. CONCLUSION Overall, sport-based interventions effectively improved physical and psychosocial outcomes in CaA with chronic diseases. Interventions are generally safe, and participants adhere to the prescribed protocols favorably. Despite that, there is little evidence that interventions are being implemented. Future studies should include interventions tailored to meet the common issues experienced by CaA with chronic conditions, providing a comprehensive understanding of the impact of sports interventions on those affected. REGISTRATION The methodology for this review was pre-determined and registered in the PROSPERO database (registration number: CRD42023397172).
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Affiliation(s)
- Borja Sañudo
- Department of Physical Education and Sport, University of Seville, Seville, Spain
| | | | | | - Dominik Gaser
- Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Nicola Stöcker
- CRETHIDEV. Creative Thinking Development, Attiki, Greece
| | - Miguel Peralta
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Faculdade de Medicina, ISAMB, Universidade de Lisboa, Lisbon, Portugal
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Faculdade de Medicina, ISAMB, Universidade de Lisboa, Lisbon, Portugal
| | | | - Chiara Nicolini
- CEIPES. Centro Internazionale per la Promozione dell'Educazione e lo Sviluppo, Palermo, Italy
| | - Christina Sitzberger
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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Deng WH, Zürcher SJ, Schindera C, Jung R, Hebestreit H, Bänteli I, Bologna K, von der Weid NX, Kriemler S, Rueegg CS. Effect of a 1-year physical activity intervention on quality of life, fatigue, and distress in adult childhood cancer survivors-A randomized controlled trial (SURfit). Cancer 2024; 130:1869-1883. [PMID: 38315522 DOI: 10.1002/cncr.35207] [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: 09/21/2023] [Revised: 11/24/2023] [Accepted: 12/26/2023] [Indexed: 02/07/2024]
Abstract
INTRODUCTION Childhood cancer survivors (CCS) are at risk of experiencing lower quality-of-life, fatigue, and depression. Few randomized controlled trials have studied the effect of physical activity (PA) on these in adult long-term CCS. This study investigated the effect of a 1-year individualized PA intervention on health-related quality-of-life (HRQOL), fatigue, and distress symptoms in adult CCS. METHODS The SURfit trial randomized 151 CCS ≥16 years old, <16 at diagnosis and ≥5 years since diagnosis, identified through the Swiss Childhood Cancer Registry. Intervention participants received personalized PA counselling to increase intense PA by ≥2.5 h/week for 1 year. Controls maintained usual PA levels. The authors assessed physical- and mental-HRQOL, fatigue, and distress symptoms at baseline, 3, 6, and 12 months. T-scores were calculated using representative normative populations (mean = 50, standard deviation = 10). Generalized linear mixed-effects models with intention-to-treat (ITT, primary), and three per-protocol allocations were used. RESULTS At 12 months, ITT (-3.56 larger decrease, 95% confidence interval -5.69 to -1.43, p = .001) and two per-protocol analyses found significantly lower fatigue. Physical-HRQOL improved significantly in two per-protocol analyses at 12 months. No other effects were found. CONCLUSION SURfit showed that increased intense PA over 1 year improved fatigue in adult CCS. Survivors should be recommended PA to reduce the burden of late-effects.
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Affiliation(s)
- Wei H Deng
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Simeon J Zürcher
- Center for Psychiatric Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD), Bern, Switzerland
- 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
- Childhood Cancer Research Group, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Ruedi Jung
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Helge Hebestreit
- Pediatric Department, University Hospital, Julius-Maximilians University, Würzburg, Germany
| | - Iris Bänteli
- Department of Psychosomatic Medicine, University Hospital and University of Basel, Basel, Switzerland
| | - Katja Bologna
- Pediatric Department, Children's Hospital of Eastern Switzerland, St.Gallen, Switzerland
| | - 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
| | - Corina S Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Arpaci T, Altay N. Psychosocial interventions for childhood cancer survivors: Systematic review and meta-analysis of randomized control trials. Eur J Oncol Nurs 2024; 69:102541. [PMID: 38460392 DOI: 10.1016/j.ejon.2024.102541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE This study was aimed to review and analyze the evidence of the psychosocial interventions for survivors of childhood cancer. METHODS Electronic databases (PubMed, Embase, Medline, Web of Science, Science Direct, and Scopus) and manuel search were performed for psychosocial randomised controlled trials (RCTs) conducted with survivors who were diagnosed under the age of 18 and have completed treatment. Meta-analyses were performed to evaluate the effects of interventions on psychosocial health outcomes. The trials were published in English between 1 January 2000 to 30 June 2022 were included. Extracted data were analyzed using Review Manager 5.4. RESULTS Ten trials conducted with 955 childhood cancer survivors were included in the systematic review. Meta-analysis of six RCTs showed no difference in the general quality of life (SMD, 0.07; 95% CI: [-0.09 to 0.23], I2 0%, (p > 0.05)) and three RCTs showed no difference in the physical activity self-efficacy (SMD, 0.12; 95% CI: [-0.35 to 0.58], I2 75%, (p > 0.05)) between intervention and control group. Interventions longer than 24 weeks (including follow-up) were effective in the quality of life and physical activity self-efficacy of the survivors. The overall quality of the evidence was low due to overall low risk of bias for only half of the studies (50%). CONCLUSIONS Psychosocial interventions were not effective on quality of life and physical activity self-efficacy of childhood cancer survivors, however, long-term interventions provided improvement in these outcomes. REGISTRATION The protocol for the meta-analysis was registered at PROSPERO (CRD42022375053/22 Nov 2022).
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Affiliation(s)
- Tuba Arpaci
- Department of Nursing, Faculty of Health Sciences, Karamanoglu Mehmetbey University, 70200, Karaman, Türkiye.
| | - Naime Altay
- Department of Pediatric Nursing, Faculty of Nursing, Gazi University, 06490, Ankara, Türkiye.
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Egset KS, Røkke ME, Reinfjell T, Stubberud JE, Weider S. Cognitive and behavioural rehabilitation interventions for survivors of childhood cancer with neurocognitive sequelae: A systematic review. Neuropsychol Rehabil 2024:1-28. [PMID: 38390834 DOI: 10.1080/09602011.2024.2314880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/22/2023] [Indexed: 02/24/2024]
Abstract
There is considerable interest in cognitive and behavioural interventions to manage and improve neurocognitive (dys)functions in childhood cancer survivors and the literature is rapidly growing. This systematic review aimed to examine the literature of such interventions and their impact on executive functions (EFs) and attention. A search of relevant manuscripts was performed in PubMed, PsycINFO, and Web of Science in March 2023 in accordance with the PRISMA statement. After screening 3737 records, 17 unique studies published between 2002 and 2022 were charted and summarized. Participants (N = 718) were mostly children (M = 12.2 years), who were long-term survivors (M = 5.0 years post treatment) of brain or CNS tumours (48%). Identified interventions included computerized cognitive training, physical activity, and cognitive interventions with compensatory strategy training. The highest quality RCT studies included computerized training (i.e., Cogmed), neurofeedback, and exergaming. Evidence suggests that Cogmed may improve the performance of certain working memory tasks (near transfer) and possibly improve visual attention tasks for individuals with working memory impairments. However, the evidence did not support far transfer of effects to real life. No significant effects (near or far-transfer) were found following neurofeedback and exergaming interventions. Finally, a knowledge gap was identified for interventions directed at long-term survivors in adulthood.
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Affiliation(s)
- Kaja Solland Egset
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Magnhild Eitrem Røkke
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Trude Reinfjell
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jan Egil Stubberud
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Siri Weider
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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Ehrhardt MJ, Krull KR, Bhakta N, Liu Q, Yasui Y, Robison LL, Hudson MM. Improving quality and quantity of life for childhood cancer survivors globally in the twenty-first century. Nat Rev Clin Oncol 2023; 20:678-696. [PMID: 37488230 DOI: 10.1038/s41571-023-00802-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 07/26/2023]
Abstract
The contributions of cooperative groups to performing large-cohort clinical trials and long-term survivorship studies have facilitated advances in treatment, supportive care and, ultimately, survival for patients with paediatric cancers. As a result, the number of childhood cancer survivors in the USA alone is expected to reach almost 580,000 by 2040. Despite these substantial improvements, childhood cancer survivors continue to have an elevated burden of chronic disease and an excess risk of early death compared with the general population and therefore constitute a large, medically vulnerable population for which delivery of high-quality, personalized care is much needed. Data from large survivorship cohorts have enabled the identification of compelling associations between paediatric cancers, cancer therapy and long-term health conditions. Effectively translating these findings into clinical care that improves the quality and quantity of life for survivors remains an important focus of ongoing research. Continued development of well-designed clinical studies incorporating dissemination and implementation strategies with input from patient advocates and other key stakeholders is crucial to overcoming these gaps. This Review highlights the global progress made and future efforts that will be needed to further increase the quality and quantity of life-years gained for childhood cancer survivors.
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Affiliation(s)
- Matthew J Ehrhardt
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Nickhill Bhakta
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Global Paediatric Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Qi Liu
- Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
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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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Grydeland M, Bratteteig M, Rueegg CS, Lie HC, Thorsen L, Larsen EH, Brügmann-Pieper S, Torsvik IK, Götte M, Lähteenmäki PM, Kriemler S, Fridh MK, Anderssen SA, Ruud E. Physical Activity Among Adolescent Cancer Survivors: The PACCS Study. Pediatrics 2023; 152:e2023061778. [PMID: 37646086 DOI: 10.1542/peds.2023-061778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVES Physical activity (PA) may modify risks of late effects after cancer. We aimed to examine levels of PA and sedentary time (ST) in a large, international sample of adolescent childhood cancer survivors in relation to sociodemographic and cancer-related factors and compare levels of PA and ST to reference cohorts. METHODS Survivors from any cancer diagnosis who had completed cancer treatment ≥1 year ago, aged 9 to 16 years, were eligible for the multicenter Physical Activity in Childhood Cancer Survivors study. PA and ST were measured by ActiGraph GT3X+ accelerometers. We performed linear regression analyses to assess factors associated with moderate-to-vigorous PA (MVPA) and ST, and compared marginal means of total PA, MVPA, and ST in 432 survivors to sex- and age-stratified references (2-year intervals) using immediate t-tests for aggregated data. RESULTS Among survivors, 34% fulfilled the World Health Organization's PA recommendation of ≥60 min of daily MVPA on average and their ST was 8.7 hours per day. Being female, older, overweight, a survivor of central nervous system tumor, or having experienced relapse were associated with lower MVPA and/or higher ST. Generally, male survivors spent less time in MVPA compared with references, whereas female survivors had similar levels. Both male and female survivors had higher ST than references in nearly all age groups. CONCLUSIONS The low PA and high ST in this large sample of adolescent childhood cancer survivors is worrisome. Combined, our results call for targeted interventions addressing both PA and ST in follow-up care after childhood cancer.
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Affiliation(s)
| | - Mari Bratteteig
- Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Hanne C Lie
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine
| | - Lene Thorsen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Division of Cancer Medicine
- Division of Cancer Medicine, Department of Clinical Service
| | - Elna H Larsen
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine
| | - Sabine Brügmann-Pieper
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid K Torsvik
- Department of Pediatrics and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
| | - Miriam Götte
- West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Päivi M Lähteenmäki
- Department of Pediatric and Adolescent Hematology and Oncology, Turku University Hospital, FICAN-West, University of Turku, Turku, Finland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Martin K Fridh
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | - Ellen Ruud
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, University of Oslo, Oslo, Norway
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Brunet J, Sharma S. A scoping review of studies exploring physical activity and cognition among persons with cancer. J Cancer Surviv 2023:10.1007/s11764-023-01441-x. [PMID: 37561316 DOI: 10.1007/s11764-023-01441-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE This scoping review aimed to identify and synthesize published studies on physical activity (PA) and cognition among persons with cancer and elucidate knowledge gaps. METHODS Articles were identified through electronic and manual searches (02/21 and 03/22) using the following inclusion criteria: (1) empirical, peer-reviewed publication in English, (2) sample comprised persons with cancer, and (3) reported at least one statistical association between PA and cognition. Multiple reviewers independently performed study selection and data extraction, and results were mapped in tabular and narrative form. RESULTS Ninety-seven articles were eligible; these were largely published from 2017 to 2022 (54.6%), conducted in high-income countries (96.9%), and presented (quasi-)experimental studies (73.2%). Samples predominantly comprised women with breast cancer (48.5%), and recruitment often occurred post-treatment (63.9%). PA interventions included: aerobic (32.3%), resistance (4.8%), combined aerobic/resistance (38.7%), mind-body (19.4%), or other PA (4.8%). Most (66%) articles reported inconclusive findings; 32% were positive (in support of PA promoting cognition or vice versa), and 2.1% were negative. Diverse samples and studies with long-term follow-up were scarce. CONCLUSIONS The state of knowledge is insufficient and more rigorous, large-scale studies are required to provide definitive conclusions about the cognitive benefits of PA among persons with cancer. IMPLICATIONS FOR CANCER SURVIVORS Cancer-related cognitive impairment (CRCI) thwarts quality of life. This review summarizes what is known about the association between PA and cognition among persons with cancer and concludes that the evidence is currently equivocal. Hence, it remains uncertain if PA interventions can reduce CRCI, and large-scale PA intervention trials explicitly designed to promote cognition are greatly needed.
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Affiliation(s)
- Jennifer Brunet
- School of Human Kinetics, University of Ottawa, 125 University (MNT 339), Ottawa, ON, K1N 6N5, Canada.
- Institut du savoir Montfort, l'Hôpital Montfort, Ottawa, ON, Canada.
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
| | - Sitara Sharma
- School of Human Kinetics, University of Ottawa, 125 University (MNT 339), Ottawa, ON, K1N 6N5, Canada
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Sharma S, Brunet J. Young Adults' Lived Experiences with Cancer-Related Cognitive Impairment: An Exploratory Qualitative Study. Curr Oncol 2023; 30:5593-5614. [PMID: 37366905 DOI: 10.3390/curroncol30060422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Abstract
Cancer-related cognitive impairment (CRCI; e.g., disrupted memory, executive functioning, and information processing) affects many young adults, causing significant distress, reducing quality of life (QoL), and thwarting their ability to engage in professional, recreational, and social experiences. The purpose of this exploratory qualitative study was to investigate young adults' lived experiences with CRCI, and any strategies (including physical activity) they use to self-manage this burdensome side effect. Sixteen young adults (Mage = 30.8 ± 6.0 years; 87.5% female; Myears since diagnosis = 3.2 ± 3) who reported clinically meaningful CRCI whilst completing an online survey were interviewed virtually. Four themes comprising 13 sub-themes were identified through an inductive thematic analysis: (1) descriptions and interpretations of the CRCI phenomenon, (2) effects of CRCI on day-to-day and QoL, (3) cognitive-behavioural self-management strategies, and (4) recommendations for improving care. Findings suggest CRCI is detrimental to young adults' QoL and must be addressed more systematically in practice. Results also illuminate the promise of PA in coping with CRCI, but research is needed to confirm this association, test how and why this may occur, and determine optimal PA prescriptions for young adults to self-manage their CRCI.
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Affiliation(s)
- Sitara Sharma
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
- Institut du Savoir Montfort, Hôpital Montfort, Ottawa, ON K1N 6N5, Canada
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10
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Kang KA, Han SJ, Chun J, Kim HY, Oh Y, Yoon H. Healthy lifestyle interventions for childhood and adolescent cancer survivors: a systematic review and meta-analysis. CHILD HEALTH NURSING RESEARCH 2023; 29:111-127. [PMID: 37170490 PMCID: PMC10183760 DOI: 10.4094/chnr.2023.29.2.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/17/2023] [Indexed: 05/13/2023] Open
Abstract
PURPOSE This study investigated the effects of healthy lifestyle interventions (HLSIs) on health-related quality of life (HR-QoL) in childhood and adolescent cancer survivors (CACS). METHODS Major databases were searched for English-language original articles published between January 1, 2000 and May 2, 2021. Randomized controlled trials (RCTs) and non-RCTs were included. Quality was assessed using the revised Cochrane risk-of-bias tool, and a meta-analysis was conducted using RevMan 5.3 software. RESULTS Nineteen studies were included. Significant effects on HR-QoL were found for interventions using a multi-modal approach (exercise and education) (d=-0.46; 95% confidence interval [CI]=-0.84 to -0.07, p=.02), lasting not less than 6 months (d=-0.72; 95% CI=-1.15 to -0.29, p=.0010), and using a group approach (d=-0.46; 95% CI=-0.85 to -0.06, p=.02). Self-efficacy showed significant effects when HLSIs provided health education only (d=-0.55; 95% CI=-0.92 to -0.18; p=.003), lasted for less than 6 months (d=-0.40; 95% CI=-0.69 to -0.11, p=.006), and were conducted individually (d=-0.55; 95% CI=-0.92 to -0.18, p=.003). The physical outcomes (physical activity, fatigue, exercise capacity-VO2, exercise capacity-upper body, body mass index) revealed no statistical significance. CONCLUSION Areas of HLSIs for CACS requiring further study were identified, and needs and directions of research for holistic health management were suggested.
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Affiliation(s)
- Kyung-Ah Kang
- Professor, College of Nursing, Sahmyook University, Seoul, Korea
| | - Suk Jung Han
- Professor, College of Nursing, Sahmyook University, Seoul, Korea
| | - Jiyoung Chun
- Assistant Professor, College of Nursing, Sahmyook University, Seoul, Korea
| | - Hyun-Yong Kim
- Researcher, Logos Health Design Institute, Sahmyook University, Seoul, Korea
| | - Yerin Oh
- Researcher, College of Nursing, Sahmyook University, Seoul, Korea
| | - Heejin Yoon
- Researcher, College of Nursing, Sahmyook University, Seoul, Korea
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11
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Fleming B, Edison P, Kenny L. Cognitive impairment after cancer treatment: mechanisms, clinical characterization, and management. BMJ 2023; 380:e071726. [PMID: 36921926 DOI: 10.1136/bmj-2022-071726] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Cognitive impairment is a debilitating side effect experienced by patients with cancer treated with systemically administered anticancer therapies. With around 19.3 million new cases of cancer worldwide in 2020 and the five year survival rate growing from 50% in 1970 to 67% in 2013, an urgent need exists to understand enduring side effects with severe implications for quality of life. Whereas cognitive impairment associated with chemotherapy is recognized in patients with breast cancer, researchers have started to identify cognitive impairment associated with other treatments such as immune, endocrine, and targeted therapies only recently. The underlying mechanisms are diverse and therapy specific, so further evaluation is needed to develop effective therapeutic interventions. Drug and non-drug management strategies are emerging that target mechanistic pathways or the cognitive deficits themselves, but they need to be rigorously evaluated. Clinically, consistent use of objective diagnostic tools is necessary for accurate diagnosis and clinical characterization of cognitive impairment in patients treated with anticancer therapies. This should be supplemented with clinical guidelines that could be implemented in daily practice. This review summarizes the recent advances in the mechanisms, clinical characterization, and novel management strategies of cognitive impairment associated with treatment of non-central nervous system cancers.
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Affiliation(s)
- Ben Fleming
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Paul Edison
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
- College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Laura Kenny
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
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12
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Comparison of effectiveness of Nintendo Wii-based exergaming and home-based fun video exercises in pediatric patients with chronic kidney disease. Int J Rehabil Res 2023; 46:26-34. [PMID: 36416089 DOI: 10.1097/mrr.0000000000000554] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Functional capacity and quality of life (QoL) are reduced in children and adults with chronic kidney disease (CKD). Aerobic, strengthening exercises, and exergames are reported as effective in the treatment of symptoms associated with CKD. Unlike adult patients, there are insufficient studies investigating the effects of exercise on disease-related symptoms in pediatric CKD. This study aimed to compare the effects of Nintendo Wii-based exergaming and home-based fun video exercises on functional capacity, muscle strength, physical activity (PA), depression, fatigue, and QoL in pediatric patients with CKD. Twenty-three pediatric patients with CKD were included in the study and randomized to group I (Nintendo Wii Fit) and group II (home-based fun video exercises). Patients in both groups underwent exercise programs twice per week for 6 weeks. Functional capacity, muscle strength, PA, QoL, fatigue, and depression of the patients were evaluated before and after the treatments. Sixteen patients completed the study. After treatment, significant differences were observed in both groups on 6MWT, muscle strength, average daily steps, PedsQoL Child Self-Report PHSS, and the Visual Fatigue Scale. Left knee flexor muscle strength and average step counts were found to be superior in group I. Both exergaming and home-based fun video exercises provide positive effects on functional capacity, muscle strength, fatigue, PA, depression, and QoL in pediatric patients with CKD. We think that these exercise methods can help to protect physical and mental health of patients and should be included in treatment from the early stages of the disease.
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Evaluation of the Effectiveness of a Technology-Based Psychosocial Education and Counseling Program for Adolescent Survivors of Childhood Leukemia: A Randomized Controlled Trial. Cancer Nurs 2023; 46:14-28. [PMID: 35398870 DOI: 10.1097/ncc.0000000000001091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In addition to increased survivorship in childhood leukemia, a small but significant number of survivors experience psychosocial challenges that affect their health-related quality of life (QOL) that require interventions to address these challenges. OBJECTIVE The aim of this study was to evaluate the efficacy of the technology-based, psychosocial education and counseling program on survivors' QOL, self-efficacy, and coping skills within the scope of a health promotion model for adolescent survivors of childhood leukemia. METHODS The randomized controlled trial was conducted with adolescent survivors of childhood leukemia who were between the ages of 12 and 18 and had completed treatment at least 2 years previously. Survivors were randomized to a technology-based intervention (n = 24) or a control group (n = 31). Survivors' QOL, self-efficacy, and coping skills were measured at 4 time points (baseline, postintervention, 1 month postintervention, and 3 months postintervention). RESULTS The 3-month postintervention QOL total and psychosocial subscale scores in the intervention group were significantly higher than those in the control group ( P < .05). In addition, the emotional self-efficacy subscale scores and the active coping scores of the intervention group adolescents were significantly higher than those in the control group ( P < .05). Negative coping scores were lower in the intervention group than in the control group ( P < .05). CONCLUSION Technology-based, psychosocial counseling and education positively affects the QOL, emotional self-efficacy, and coping skills of adolescent survivors of childhood leukemia. IMPLICATIONS FOR PRACTICE This program could be integrated into follow-up care and used as one of the support methods in providing and maintaining long-term follow-up care by pediatric oncology nurses.
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Physical activity and exercise for cancer-related cognitive impairment among individuals affected by childhood cancer: a systematic review and meta-analysis. THE LANCET. CHILD & ADOLESCENT HEALTH 2023; 7:47-58. [PMID: 36309037 DOI: 10.1016/s2352-4642(22)00286-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/22/2022] [Accepted: 09/22/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Individuals affected by childhood cancer can have cognitive dysfunction that persists into adulthood and negatively affects quality of life. In this study, we aimed to evaluate the effects of physical activity and exercise on cognitive function among individuals affected by childhood cancer. METHODS In this systematic review and meta-analysis, we searched seven databases (CINAHL Plus, Cochrane Library, Embase, MEDLINE, PsycINFO, SPORTDiscus, and Web of Science) and two clinical trial registries (ClinicalTrials.gov and the International Clinical Trials Registry Platform) for randomised controlled trials (RCTs) and non-randomised studies of interventions (NRSIs) published (or registered) from database inception to Jan 30, 2022, with no language restrictions. We included studies that compared the effects of physical activity or exercise interventions with controls (no intervention or usual care) on cognitive function among individuals diagnosed with any type of cancer at age 0-19 years. Two reviewers (JDKB and FR) independently screened records for eligibility and searched references of the selected studies; extracted study-level data from published reports; and assessed study risk of bias of RCTs and NRSIs using the Cochrane risk of bias tool for randomised trials (RoB 2) and Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) tools, certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach, and any adverse events. We used intention-to-treat data and unpublished data if available. Cognitive function was assessed by standardised cognitive performance measures (primary outcome) and by validated patient-reported measures (secondary outcome). A random-effects meta-analysis model using the inverse-variance and Hartung-Knapp methods was used to calculate pooled estimates (Hedges' g) and 95% CI values. We estimated the heterogeneity variance by the restricted maximum likelihood method and calculated I2 values to measure heterogeneity. We examined funnel plots and used Egger's regression test to assess for publication bias. This study is registered with PROSPERO, CRD42021261061. FINDINGS We screened 12 425 titles and abstracts, which resulted in full-text assessment of 131 potentially relevant reports. We evaluated 22 unique studies (16 RCTs and six NRSIs) with data on 1277 individuals affected by childhood cancer and low-to-moderate risk of bias. Of the 1277 individuals, 674 [52·8%] were male and 603 [47·2%] were female; median age at study start was 12 (IQR 11-14) years, median time since the end of cancer treatment was 2·5 (IQR -1·1 to 3·0) years, and median intervention period was 12 [IQR 10-24] weeks. There was moderate-quality evidence that, compared with control, physical activity and exercise improved cognitive performance measures (five RCTs; Hedges' g 0·40 [95% CI 0·07-0·73], p=0·027; I2=18%) and patient-reported measures of cognitive function (13 RCTs; Hedges' g 0·26 [0·09-0·43], p=0·0070; I2=40%). No evidence of publication bias was found. Nine mild adverse events were reported. INTERPRETATION There is moderate-certainty evidence that physical activity and exercise improves cognitive function among individuals affected by childhood cancer, which supports the use of physical activity for managing cancer-related cognitive impairment. FUNDING Research Impact Fund of Research Grants Council of the Hong Kong University Grants Committee (R7024-20) and Seed Fund for Basic Research of the University of Hong Kong. COPYRIGHT © 2022 Published by Elsevier Ltd. All rights reserved.
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Ware ME, Kadan-Lottick NS, Devidas M, Terrell S, Chow EJ, Ehrhardt MJ, Hardy KK, Chemaitilly W, Hein W, Winick N, Teachey D, Esbenshade A, Armenian SH, Partin RE, Ness KK. Design and methods of a randomized web-based physical activity intervention among children with cancer: A report from the Children's Oncology Group. Contemp Clin Trials 2022; 122:106961. [PMID: 36228982 PMCID: PMC9669240 DOI: 10.1016/j.cct.2022.106961] [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: 07/06/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Promoting physical activity soon after treatment for childhood cancer may benefit health because sedentary lifestyle during curative therapy may perpetuate physical and emotional complications. The primary goals of this study are to evaluate the effects of a 6-month web-based, rewards-based physical activity intervention on fitness, biomarkers of cardiometabolic health, inflammation, adipokine status, quality of life and school attendance, and determine if effect of intervention on markers of cardiometabolic health is mediated by changes in fitness. The primary outcome of interest is fitness (physiological cost index, six-minute walk test) measured at end of intervention. METHODS This ongoing study is a two-arm, prospective, randomized design with accrual goals of 192 children for intervention and control groups. Children ≥8 years and < 16 years of age, not meeting recommended levels of physical activity, who completed therapy within the past 12 months are eligible. Both groups receive: 1) educational materials encouraging physical activity, 2) activity monitor, 3) access to web-based interface designed to motivate physical activity, 4) rewards based on physical activity levels, and 5) access to their activity data on the web-interface. Those randomized to intervention: 1) can view others' activity and interact with other participants, and 2) receive rewards based on physical activity levels throughout the intervention (vs. at the end of the intervention for control group). CONCLUSION Unique, scalable, and portable physical activity interventions that motivate young survivors are needed. This study will inform future web-based physical activity interventions for children with cancer by demonstrating effects of rewards and social interaction. CLINICAL TRIALS ClinicalTrials.gov Identifier: NCT03223753; COG Identifier: ALTE1631.
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Affiliation(s)
- Megan E Ware
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, United States of America
| | | | - Meenakshi Devidas
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States of America
| | - Sarah Terrell
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, United States of America
| | - Eric J Chow
- Fred Hutchinson Cancer Center, Seattle, WA, United States of America
| | - Matthew J Ehrhardt
- Oncology Department, St. Jude Children's Research Hospital, Memphis, TN, United States of America
| | - Kristina K Hardy
- Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC, United States of America
| | - Wassim Chemaitilly
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States of America
| | - Wendy Hein
- Children's Mercy, Kansas City, MO, United States of America
| | - Naomi Winick
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - David Teachey
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Adam Esbenshade
- Department of Pediatrics, Vanderbilt University, Nashville, TN, United States of America
| | - Saro H Armenian
- Department of Pediatrics, City of Hope, Duarte, CA, United States of America
| | - Robyn E Partin
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, United States of America
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, United States of America.
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Misiąg W, Piszczyk A, Szymańska-Chabowska A, Chabowski M. Physical Activity and Cancer Care—A Review. Cancers (Basel) 2022; 14:cancers14174154. [PMID: 36077690 PMCID: PMC9454950 DOI: 10.3390/cancers14174154] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/01/2022] [Accepted: 08/23/2022] [Indexed: 11/22/2022] Open
Abstract
Simple Summary The aim of this paper is to outline the role and potential benefits of physical activity for cancer patients. We present a review of publications on the subject in order to compare the findings reported in the literature and draw general conclusions that could help clinicians who provide cancer care to develop a more comprehensive treatment approach. This review may also help patients overcome barriers and become more motivated to take up physical activity, which would improve their quality of life. We wish to demonstrate to patients that physical activity should not be regarded as a burdensome medical recommendation but rather as a factor that can reduce the risk of cancer mortality and recurrence. Abstract In 2020, 19.3 million new cancer cases were diagnosed, and almost 10 million deaths from cancer were recorded. Cancer patients may experience fatigue, depression, anxiety, reduced quality of life and sleep problems. Cancer treatments cause numerous side effects and have a negative impact on all body systems. Physical activity is important for cancer patients. The aim of this review is to analyse recent studies on the role of physical activity in cancer patients and emphasize its importance. The review included 36 papers published in English between 2017 and 2021. The findings from these studies show that physical activity decreases the severity of side effects of cancer treatment, reduces fatigue, improves quality of life, has a positive impact on mental health and improves aerobic fitness in cancer patients. Moreover, it reduces the risk of cancer recurrence and death. Physical activity is recommended for patients with any type of cancer and at all stages of treatment. The type of physical activity should depend on the condition of the individual patient. It is extremely difficult to determine what type, intensity and duration of physical activity is likely to have the greatest effect.
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Affiliation(s)
- Weronika Misiąg
- Student Research Club No. 180, Faculty of Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Anna Piszczyk
- Student Research Club No. 180, Faculty of Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Anna Szymańska-Chabowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Mariusz Chabowski
- Department of Nursing and Obstetrics, Faculty of Health Science, Wroclaw Medical University, 51-618 Wroclaw, Poland
- Department of Surgery, 4th Military Teaching Hospital, 50-981 Wroclaw, Poland
- Correspondence: ; Tel.: +48-691-097-454
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Ha L, Wakefield CE, Mizrahi D, Diaz C, Cohn RJ, Signorelli C, Yacef K, Simar D. A Digital Educational Intervention With Wearable Activity Trackers to Support Health Behaviors Among Childhood Cancer Survivors: Pilot Feasibility and Acceptability Study. JMIR Cancer 2022; 8:e38367. [PMID: 35976683 PMCID: PMC9434388 DOI: 10.2196/38367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/05/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022] Open
Abstract
Background Childhood cancer survivors are at increased risk of cardiometabolic complications that are exacerbated by poor health behaviors. Critically, many survivors do not meet physical activity guidelines. Objective The primary aim was to evaluate the feasibility and acceptability of iBounce, a digital health intervention for educating and engaging survivors in physical activity. Our secondary aims were to assess the change in survivors’ physical activity levels and behaviors, aerobic fitness, and health-related quality of life (HRQoL) after participating in the iBounce program. Methods We recruited survivors aged 8 to 13 years who were ≥12 months post cancer treatment completion. The app-based program involved 10 educational modules, goal setting, and home-based physical activities monitored using an activity tracker. We assessed objective physical activity levels and behaviors using cluster analysis, aerobic fitness, and HRQoL at baseline and after the intervention (week 12). Parents were trained to reassess aerobic fitness at home at follow-up (week 24). Results In total, 30 participants opted in, of whom 27 (90%) completed baseline assessments, and 23 (77%) commenced iBounce. Our opt-in rate was 59% (30/51), and most (19/23, 83%) of the survivors completed the intervention. More than half (13/23, 57%) of the survivors completed all 10 modules (median 10, IQR 4-10). We achieved a high retention rate (19/27, 70%) and activity tracker compliance (15/19, 79%), and there were no intervention-related adverse events. Survivors reported high satisfaction with iBounce (median enjoyment score 75%; ease-of-use score 86%), but lower satisfaction with the activity tracker (median enjoyment score 60%). Parents reported the program activities to be acceptable (median score 70%), and their overall satisfaction was 60%, potentially because of technological difficulties that resulted in the program becoming disjointed. We did not observe any significant changes in physical activity levels or HRQoL at week 12. Our subgroup analysis for changes in physical activity behaviors in participants (n=11) revealed five cluster groups: most active, active, moderately active, occasionally active, and least active. Of these 11 survivors, 3 (27%) moved to a more active cluster group, highlighting their engagement in more frequent and sustained bouts of moderate-to-vigorous physical activity; 6 (56%) stayed in the same cluster; and 2 (18%) moved to a less active cluster. The survivors’ mean aerobic fitness percentiles increased after completing iBounce (change +17, 95% CI 1.7-32.1; P=.03) but not at follow-up (P=.39). Conclusions We demonstrated iBounce to be feasible for delivery and acceptable among survivors, despite some technical difficulties. The distance-delivered format provides an opportunity to engage survivors in physical activity at home and may address barriers to care, particularly for regional or remote families. We will use these pilot findings to evaluate an updated version of iBounce. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12621000259842; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=ACTRN12621000259842
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Affiliation(s)
- Lauren Ha
- School of Health Sciences, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Claire E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.,School of Clinical Medicine, Discipline of Paediatrics and Child Health, UNSW Sydney, Sydney, Australia
| | - David Mizrahi
- Prince of Wales Clinical School, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia.,The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Claudio Diaz
- School of Computer Science, Faculty of Engineering, The University of Sydney, Sydney, Australia
| | - Richard J Cohn
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.,School of Clinical Medicine, Discipline of Paediatrics and Child Health, UNSW Sydney, Sydney, Australia
| | - Christina Signorelli
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.,School of Clinical Medicine, Discipline of Paediatrics and Child Health, UNSW Sydney, Sydney, Australia
| | - Kalina Yacef
- School of Computer Science, Faculty of Engineering, The University of Sydney, Sydney, Australia
| | - David Simar
- School of Health Sciences, UNSW Medicine and Health, UNSW Sydney, Sydney, Australia
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Crowder SL, Buro AW, Stern M. Physical activity interventions in pediatric, adolescent, and young adult cancer survivors: a systematic review. Support Care Cancer 2022; 30:4635-4649. [PMID: 35064822 PMCID: PMC9175508 DOI: 10.1007/s00520-022-06854-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/19/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE The aim was to summarize the current literature for the effectiveness of physical activity interventions on physical functioning, body composition, and quality of life (QOL) in pediatric, adolescent and young adult cancer survivors. METHODS We conducted systematic structured searches of PubMed and Web of Science databases. Two independent researchers selected against inclusion criteria: (1) lifestyle intervention including physical activity and/or physical activity interventions for pediatric, adolescent, and young adults with any cancer diagnosis; (2) measured QOL, physical functioning (e.g., strength, activities of daily living), or body composition (e.g., changes in weight, percent body fat); and (3) randomized controlled trials. RESULTS Searches identified 4770 studies. Following the removal of duplicates and title and abstract screening, 83 full-text articles were assessed, and 9 studies met the inclusion criteria. Childhood and adolescent cancer survivors encompassed n = 7 studies while young adult cancer survivors were included in n = 2 studies. Three studies reported using a theoretical framework and six did not. Interventions ranged from 1 week to 6 months. Across all studies reviewed, n = 2 reported improvements in physical activity, n = 5 studies reported partial improvements, and n = 2 reported no improvements. CONCLUSIONS Interventions to improve physical activity behaviors reported mixed results. Only two physical activity interventions incorporated young adults with cancer; thus, physical activity interventions for young adult cancer survivors should be further explored. Future research should focus on personalized physical activity components encouraging behavior change techniques to maximize physical health and QOL improvements.
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Affiliation(s)
- Sylvia L Crowder
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 4117 E Fowler Ave., Tampa, FL, 33617, USA.
| | - Acadia W Buro
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 4117 E Fowler Ave., Tampa, FL, 33617, USA
| | - Marilyn Stern
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, MHC 2510, Tampa, FL, 33612, USA
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19
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Kim Y, Chae H, Park SJ. Feasibility and benefits of a videoconferencing-based home exercise programme for paediatric cancer survivors during the coronavirus disease 2019 pandemic. Eur J Cancer Care (Engl) 2022; 31:e13624. [PMID: 35606331 PMCID: PMC9347713 DOI: 10.1111/ecc.13624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/17/2022] [Accepted: 05/11/2022] [Indexed: 11/30/2022]
Abstract
Objective We aimed to determine the feasibility and benefits of a videoconferencing‐based home exercise programme to improve health‐related quality of life (HRQOL), posttraumatic growth and physical strength levels of paediatric cancer survivors during the coronavirus disease 2019 (COVID‐19). Methods Eight paediatric cancer survivors participated in the intervention for 8 weeks. The programme comprised home exercise sessions administered using Zoom, a videoconferencing platform. The supervised exercise sessions were performed two times per week; the participants were taught to perform joint exercises at home for the remaining 5 days of the week. HRQOL, posttraumatic growth and physical strength levels were assessed at baseline and after the intervention. Results The rates of recruitment, retention and attendance were 52.9%, 88.9% and 98.4%, respectively. There were no cases of adverse events. The programme significantly improved flexibility (z = −2.21, p = 0.03), muscle strength (z = −2.67, p = 0.01) and power (z = −2.41, p = 0.02) among five domains of physical fitness measured using a physical activity promotion system and also improved total physical strength (z = −2.67, p = 0.01). Posttraumatic growth decreased slightly, whereas HRQOL improved slightly; however, the change was not statistically significant. Conclusion The study findings present preliminary evidence of the feasibility and benefits of this videoconferencing‐based home exercise programme among paediatric cancer survivors.
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Affiliation(s)
- Yoonjung Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| | - Heemin Chae
- Department of Nursing, Graduate School, Chung-Ang University, Seoul, South Korea
| | - Sung Je Park
- College of sport science, Chung-Ang University, Anseong, South Korea
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20
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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: 0] [Impact Index Per Article: 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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Söntgerath R, Däggelmann J, Kesting SV, Rueegg CS, Wittke TC, Reich S, Eckert KG, Stoessel S, Chamorro-Viña C, Wiskemann J, Wright P, Senn-Malashonak A, Oschwald V, Till AM, Götte M. Physical and functional performance assessment in pediatric oncology: a systematic review. Pediatr Res 2022; 91:743-756. [PMID: 33859367 PMCID: PMC9064803 DOI: 10.1038/s41390-021-01523-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/26/2021] [Accepted: 03/29/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Research indicates reduced physical performance from diagnosis into survivorship of pediatric cancer patients. However, there is no systematic information or guideline available on the methods to assess physical performance and function in this population. The purpose was to systematically compile and describe assessments of physical performance and function in patients and survivors of pediatric cancer, including cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait and motor performance test batteries. METHODS We searched the databases PubMed, SPORTDiscus, and Cochrane Database and performed abstract and full-text selection of 2619 articles according to the Cochrane Handbook of Systematic Reviews. Information on patients characteristics, assessments, information on validity and reliability, and relevant references was extracted. RESULTS In summary, 63 different assessments were found in 149 studies including 11639 participants. Most studies evaluated cardiorespiratory fitness and muscle strength with the majority conducted off treatment. Some outcomes (e.g. speed) and diagnoses (e.g. neuroblastoma) were severely underrepresented. With the exception of gait, leukemia patients represented the largest group of individuals tested. CONCLUSIONS Insufficient data and patient heterogeneity complicate uniform recommendations for assessments. Our results support researchers and practitioners in selecting appropriate assessment to meet their specific research questions or individual daily practice needs. IMPACT This systematic review includes 149 studies and provides a comprehensive summary of 63 assessments to evaluate cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait or motor performance test batteries in patients and survivors of pediatric cancer. We present the most studied fields within the pediatric cancer population, which are cardiorespiratory fitness and muscle strength, off treatment phase, and leukemia patients. We propose research priorities by identification of subgroups in terms of cancer type, phase of treatment, and outcome of interest that are underrepresented in studies currently available.
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Affiliation(s)
- Regine Söntgerath
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - Julia Däggelmann
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiology and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Sabine V Kesting
- Institute of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
- Kinderklinik München Schwabing, TUM School of Medicine, Department of Pediatrics and Children's Cancer Research Center, Technical University of Munich, Munich, Germany
| | - Corina S Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | | | - Simon Reich
- Working Group Exercise Oncology Division of Medical Oncology, University Clinic Heidelberg and National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - Katharina G Eckert
- Department of Health Management & Public Health, IST University of Applied Sciences Düsseldorf, Düsseldorf, Germany
| | - Sandra Stoessel
- Center for Pediatric and Adolescent Medicine, Childhood Cancer Center, University Medical Center Mainz, Mainz, Germany
| | | | - Joachim Wiskemann
- Working Group Exercise Oncology Division of Medical Oncology, University Clinic Heidelberg and National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - Peter Wright
- Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Oxford, UK
| | - Anna Senn-Malashonak
- Department of Pediatric Oncology, Hematology and Hemostaseology, Goethe University Clinic Frankfurt, Frankfurt am Main, Frankfurt, Germany
| | - Vanessa Oschwald
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiology and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Anne-Marie Till
- Department of Pediatric Hematology and Oncology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Miriam Götte
- Department of Pediatric Hematology and Oncology, University Hospital Essen, Pediatrics III, Essen, Germany.
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22
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Gaser D, Peters C, Götte M, Oberhoffer-Fritz R, Feuchtinger T, Schmid I, von Luettichau I, Kesting S. Analysis of self-reported activities of daily living, motor performance and physical activity among children and adolescents with cancer: Baseline data from a randomised controlled trial assessed shortly after diagnosis of leukaemia or non-Hodgkin lymphoma. Eur J Cancer Care (Engl) 2022; 31:e13559. [PMID: 35150025 DOI: 10.1111/ecc.13559] [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] [Received: 08/02/2021] [Revised: 01/05/2022] [Accepted: 01/26/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Cancer diagnosis, treatment side effects and physical inactivity can lead to reduced muscle strength. Patients undergoing acute treatment experience many burdens that can restrict their mobility and autonomy, leading to limited independence and loss of resources to cope with everyday tasks. In this work, we analyse the status quo and potential influencing factors for the accomplishment of activities of daily living (ADLs) shortly after cancer diagnosis. METHODS We recruited participants ages 4-18 years diagnosed with acute leukaemia or non-Hodgkin lymphoma. For the baseline analysis, we assessed (1) physical function limitations using the Activities Scale for Kids©, (2) exercise-related ADLs simulated with the Functional ADL Screen, (3) motor performance using the Motor Performance in Paediatric Oncology test and (4) physical activity (PA) level measured using an accelerometer. RESULTS We conducted the baseline assessment 19.2 ± 12.6 days post-diagnosis in 41 patients. All participants reported functional limitations in ADLs and PA. Motor performance was reduced for all abilities. Cumulative steroid dose was negatively correlated with hand grip strength (r = -0.50, p = 0.009). CONCLUSION Shortly after diagnosis of paediatric cancer, patients experience various physical impairments that can be counteracted with regular, instructed exercise interventions.
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Affiliation(s)
- Dominik Gaser
- Department of Pediatrics and Children's Cancer Research Center, TUM School of Medicine, Kinderklinik München Schwabing, Technical University of Munich, Munich, Germany.,Department of Sport and Health Sciences, Chair of Preventive Pediatrics, Technical University of Munich, Munich, Germany.,Pediatric Oncology Network, KIONET BAVARIA, Bavaria, Germany
| | - Christiane Peters
- Department of Sport and Health Sciences, Chair of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Miriam Götte
- Department of Hematology and Oncology, Clinic of Pediatrics III, West German Cancer Center Essen, University Hospital, Essen, Germany
| | - Renate Oberhoffer-Fritz
- Department of Sport and Health Sciences, Chair of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Tobias Feuchtinger
- Department of Pediatric Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany.,Pediatric Oncology Network, KIONET BAVARIA, Bavaria, Germany
| | - Irene Schmid
- Department of Pediatric Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany.,Pediatric Oncology Network, KIONET BAVARIA, Bavaria, Germany
| | - Irene von Luettichau
- Department of Pediatrics and Children's Cancer Research Center, TUM School of Medicine, Kinderklinik München Schwabing, Technical University of Munich, Munich, Germany.,Pediatric Oncology Network, KIONET BAVARIA, Bavaria, Germany
| | - Sabine Kesting
- Department of Pediatrics and Children's Cancer Research Center, TUM School of Medicine, Kinderklinik München Schwabing, Technical University of Munich, Munich, Germany.,Department of Sport and Health Sciences, Chair of Preventive Pediatrics, Technical University of Munich, Munich, Germany.,Pediatric Oncology Network, KIONET BAVARIA, Bavaria, Germany
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23
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Tso WWY, Wong RS, Tung KTS, Rao N, Fu KW, Yam JCS, Chua GT, Chen EYH, Lee TMC, Chan SKW, Wong WHS, Xiong X, Chui CS, Li X, Wong K, Leung C, Tsang SKM, Chan GCF, Tam PKH, Chan KL, Kwan MYW, Ho MHK, Chow CB, Wong ICK, lp P. Vulnerability and resilience in children during the COVID-19 pandemic. Eur Child Adolesc Psychiatry 2022; 31:161-176. [PMID: 33205284 PMCID: PMC7671186 DOI: 10.1007/s00787-020-01680-8] [Citation(s) in RCA: 107] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/28/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is having a profound impact on the health and development of children worldwide. There is limited evidence on the impact of COVID-19 and its related school closures and disease-containment measures on the psychosocial wellbeing of children; little research has been done on the characteristics of vulnerable groups and factors that promote resilience. METHODS We conducted a large-scale cross-sectional population study of Hong Kong families with children aged 2-12 years. Parents completed an online survey on family demographics, child psychosocial wellbeing, functioning and lifestyle habits, parent-child interactions, and parental stress during school closures due to COVID-19. We used simple and multiple linear regression analyses to explore factors associated with child psychosocial problems and parental stress during the pandemic. RESULTS The study included 29,202 individual families; of which 12,163 had children aged 2-5 years and 17,029 had children aged 6-12 years. The risk of child psychosocial problems was higher in children with special educational needs, and/or acute or chronic disease, mothers with mental illness, single-parent families, and low-income families. Delayed bedtime and/or inadequate sleep or exercise duration, extended use of electronic devices were associated with significantly higher parental stress and more psychosocial problems among pre-schoolers. CONCLUSIONS This study identifies vulnerable groups of children and highlights the importance of strengthening family coherence, adequate sleep and exercise, and responsible use of electronic devices in promoting psychosocial wellbeing during the COVID-19 pandemic.
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Affiliation(s)
- Winnie W. Y. Tso
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Rosa S. Wong
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Keith T. S. Tung
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Nirmala Rao
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - King Wa Fu
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Jason C. S. Yam
- grid.10784.3a0000 0004 1937 0482The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Gilbert T. Chua
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Eric Y. H. Chen
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Tatia M. C. Lee
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Sherry K. W. Chan
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Wilfred H. S. Wong
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Xiaoli Xiong
- grid.33199.310000 0004 0368 7223Huazhong University of Science and Technology, Wuhan, China
| | - Celine S. Chui
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Xue Li
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Kirstie Wong
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China ,grid.83440.3b0000000121901201UCL School of Pharmacy, London, UK
| | - Cynthia Leung
- grid.16890.360000 0004 1764 6123The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Sandra K. M. Tsang
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Godfrey C. F. Chan
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Paul K. H. Tam
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Ko Ling Chan
- grid.16890.360000 0004 1764 6123The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Mike Y. W. Kwan
- grid.415229.90000 0004 1799 7070Princess Margaret Hospital, Kwai Chung, Hong Kong SAR, China
| | - Marco H. K. Ho
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Chun Bong Chow
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Ian C. K. Wong
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China ,grid.83440.3b0000000121901201UCL School of Pharmacy, London, UK ,grid.194645.b0000000121742757Department of Pharmacology and Pharmacy, The University of Hong Kong, L02-56, 2/F, Laboratory Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Patrick lp
- grid.194645.b0000000121742757The University of Hong Kong, Pokfulam, Hong Kong SAR, China ,grid.194645.b0000000121742757Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Room 115, 1/F, New Clinical Building, 102 Pokfulam Road, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China
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24
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Binarelli G, Joly F, Tron L, Lefevre Arbogast S, Lange M. Management of Cancer-Related Cognitive Impairment: A Systematic Review of Computerized Cognitive Stimulation and Computerized Physical Activity. Cancers (Basel) 2021; 13:5161. [PMID: 34680310 PMCID: PMC8534081 DOI: 10.3390/cancers13205161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/05/2021] [Accepted: 10/11/2021] [Indexed: 01/27/2023] Open
Abstract
Cancer-related cognitive impairment (CRCI) occurs frequently in patients living with cancer, with consequences on quality of life. Recently, research on the management of these difficulties has focused on computerized cognitive stimulation and computerized physical activity programs. This systematic review presents the state of knowledge about interventions based on computerized-cognitive stimulation and/or physical activity to reduce CRCI. The review followed the PRISMA guidelines. A search was conducted in PUBMED and Web of Science databases. Risk of bias analysis was conducted using the Rob2 tool and the quality of evidence was conducted following the GRADE approach. A total of 3776 articles were initially identified and 20 of them met the inclusion criteria. Among them, sixteen investigated computerized-cognitive stimulation and four computerized-physical activity. Most of the studies were randomized controlled trials and assessed the efficacy of a home-based intervention on objective cognition in adults with cancer. Overall, cognitive improvement was found in 11/16 computerized-cognitive stimulation studies and 2/4 computerized-physical activity studies. Cognitive stimulation or physical activity improved especially cognitive complaints, memory, and attention. These results suggest the efficacy of both computerized-cognitive stimulation and physical activity. However, we report a high risk of bias for the majority of studies and a low level of quality of evidence. Therefore, further investigations are needed to confirm the efficacy of these interventions and to investigate the possible added benefit on cognition of a combined computerized-cognitive/physical intervention.
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Affiliation(s)
- Giulia Binarelli
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (G.B.); (F.J.)
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
| | - Florence Joly
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (G.B.); (F.J.)
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
| | - Laure Tron
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
| | - Sophie Lefevre Arbogast
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
| | - Marie Lange
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (G.B.); (F.J.)
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
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25
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Late outcomes in survivors of childhood acute myeloid leukemia: a report from the St. Jude Lifetime Cohort Study. Leukemia 2021; 35:2258-2273. [PMID: 33495497 PMCID: PMC8310532 DOI: 10.1038/s41375-021-01134-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/24/2020] [Accepted: 01/07/2021] [Indexed: 01/29/2023]
Abstract
Cumulative burden of chronic health conditions and neurocognitive and physical function were examined among survivors of childhood acute myeloid leukemia (AML) treated with hematopoietic cell transplant (HCT; n = 66) or conventional therapy (CT; n = 67). Survivors and controls underwent a comprehensive clinical assessment, and health conditions were graded using a modified version of the Common Terminology Criteria for Adverse Events. By age 40 years, HCT and CT survivors had an average 17.4 (95% confidence interval [CI] 14.6-20.1) and 9.3 (7.7-11.1) grade 1-4 conditions versus 3.8 (3.3-4.2) in community controls. Compared to controls, HCT survivors had a higher prevalence of hypertriglyceridemia (45.5% vs. 18.3%), hypercholesterolemia (47.0% vs. 30.9%), hypothyroidism (27.3% vs. 4.0%), and primary hypogonadism (p < 0.001). CT survivors had a higher prevalence of cardiomyopathy (11.9% vs. 2.7%) and hypertension (53.7% vs. 44.3%). Neurocognitive impairment was elevated across all domains compared to controls but did not differ by treatment modality. Compared to controls, a higher proportion of HCT survivors had impairments in strength and endurance; whereas flexibility and mobility impairments were noted among CT survivors. Despite successful advances in childhood AML therapy, many therapeutic exposures remain unchanged. These findings support ongoing investigations of novel therapies and strategies to ameliorate the risk of late morbidities.
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26
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Hong HC, Kim YM, Min A. Factors influencing quality of life among childhood cancer survivors in Korea: A quantile regression approach. Res Nurs Health 2021; 45:108-122. [PMID: 34322889 DOI: 10.1002/nur.22170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/13/2021] [Accepted: 07/02/2021] [Indexed: 12/20/2022]
Abstract
Cancer treatment in childhood may negatively affect survivors' quality of life. In this study, we aimed to determine the contributing factors for health-related quality of life (HRQOL) in survivors of childhood cancer in Korea using quantile regression analysis. This study was a secondary analysis. Data were collected from 130 childhood cancer survivors (CCS) from November 2018 to July 2019. Participants completed the Memorial Symptom Assessment Scale, Depression Anxiety Stress Scale, Health-Promoting Lifestyle Profile-II, and 36-Item Short Form Health Survey (physical component summary [PCS] and mental component summary [MCS]). Quantile and multiple linear regressions were used to analyze the factors contributing to HRQOL. The quantile and linear regression models revealed different results on the contributing factors to HRQOL in CCS. Mean PCS and MCS scores were 78.55 (SD = 15.08) and 64.02 (SD = 18.00), respectively. Symptoms (e.g., difficulty concentrating, worrying, pain, and lack of energy), physical activity, spiritual growth, interpersonal relationships, stress management, depression, and anxiety were significant influencing factors in some PCS quantiles, while symptoms, spiritual growth, interpersonal relationships, depression, and stress were significant influencing factors in some MCS quantiles. The findings of this study showed specific contributing factors in CCS with different levels of HRQOL. There is a need for targeted interventions related to risk reduction and stratification for CCS with different HRQOL levels. Symptom management strategies, early detection programs for CCS with psychological distress, and clinical and counseling interventions for CCS with poor HRQOL need to be developed.
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Affiliation(s)
- Hye Chong Hong
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Young Man Kim
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Jeollabuk-do, South Korea
| | - Ari Min
- Department of Nursing, Chung-Ang University, Seoul, South Korea
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27
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Cheung AT, Li WHC, Ho LLK, Chan GCF, Chung JOK. Parental perspectives on promoting physical activity for their children surviving cancer: A qualitative study. PATIENT EDUCATION AND COUNSELING 2021; 104:1719-1725. [PMID: 33234443 DOI: 10.1016/j.pec.2020.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/04/2020] [Accepted: 11/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Physical activity is vital for the healthy development of pediatric cancer survivors. We aimed to explore parental perception on the importance, the barriers to and facilitators of participating in physical activity for their children surviving cancer. METHODS A qualitative study, using a descriptive phenomenological approach, was conducted. Purposive sample of parents of pediatric cancer survivors aged 9-16 years and had completed treatment at least six months previously were participated in one-to-one semi-structured interviews conducted by two trained research nurses. Data analysis followed Colaizzi's descriptive phenomenology method. RESULTS Twenty-eight parents (64.3 % female) of pediatric cancer survivors were interviewed. Most parents lacked awareness and knowledge regarding the importance and benefits of physical activity in their child's survivorship. Major barriers identified were parental concern about their child performing physical activity, time constraints and lack of recreational facilities and activity provision. Parents reported that parental support, family involvement and child's interests and enjoyment appeared to be crucial facilitators of survivors' physical activity. CONCLUSION This study identified the barriers to and facilitators of engaging in physical activity of pediatric cancer survivors from the parental perspectives. PRACTICAL IMPLICATIONS The findings of the study is important for the development of health education to promote regular physical activity among pediatric cancer survivors.
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Affiliation(s)
- Ankie Tan Cheung
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong
| | | | | | | | - Joyce Oi Kwan Chung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
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28
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Hong HC, Min A, Kim YM. The effectiveness of digital self-management interventions on health outcomes among childhood cancer survivors: A systematic review and meta-analysis. J Adv Nurs 2021; 77:4387-4399. [PMID: 34129263 DOI: 10.1111/jan.14925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/28/2021] [Accepted: 05/24/2021] [Indexed: 01/21/2023]
Abstract
AIMS The study aimed to review the evidence about existing digital interventions for childhood cancer survivors and examine their effectiveness on health outcomes. DESIGN Systematic review and meta-analysis. DATA SOURCES PUBMED, EMBASE, Cochrane, CINAHL, Web of Science, PsycArticles, SCOPUS and PQDT Global databases were searched, and the date last searched was 16 September 2019. REVIEW METHODS This systematic review followed PRISMA guidelines. Randomized and nonrandomized controlled trials, as well as before-and-after studies, were included. The main outcomes were health-related quality of life and moderate-to-vigorous physical activity. Two authors independently reviewed included studies and assessed methodological quality. Meta-analysis was conducted using statistical software STATA 16.0. RESULTS Out of the eight eligible studies, four were included in the meta-analysis. The digital self-management interventions were not effective on health-related quality of life and moderate-to-vigorous physical activity. Additionally, the digital self-management interventions increased the moderate-to-vigorous physical activity over time but was not statistically significant. CONCLUSIONS There is insufficient evidence on the effectiveness of digital self-management interventions in improving health outcomes among childhood cancer survivors. Future randomized controlled trials should be conducted from multiple locations and should include objective measures and means to encourage interaction with health care providers. IMPACT Digital interventions are increasingly implemented to improve health outcomes among childhood cancer survivors, but their results are inconsistent. Well-designed digital interventions may be beneficial for this population over time. The recommendations proposed in the current review may be useful for developing digital interventions and designing related studies in the future, thereby reducing late effects and improving healthy behaviours among this population.
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Affiliation(s)
- Hye Chong Hong
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Ari Min
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Young Man Kim
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, South Korea
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29
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Bashore L, Alexander GK, Park E. Engagement in Physical Activity Among Young Adult Childhood and Adolescent Cancer Survivors: Integration of Nature Technology. J Adolesc Young Adult Oncol 2021; 10:740-744. [PMID: 33835841 DOI: 10.1089/jayao.2020.0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This report addresses physical activity (PA) levels and education preferences in young adult cancer survivors (YACS) and outlines strategies for the design of successful interventions. A cross-sectional design was used to assess PA in 124 YACS, using the International Physical Activity Questionnaire-Short Form. Recommended levels were reported by 20.2% and 42.5% for high and moderate PA in metabolic equivalent of task (MET) minutes/week, respectively, while 37.3% reported low level PA in MET-minutes/week. Eighty percent reported likely to use technology for education about PA. Prior research supports using technology to administer tailored interventions to promote consistent PA among YACS, ideally in nature-based activities.
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Affiliation(s)
- Lisa Bashore
- Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, Texas, USA
| | - Gina K Alexander
- Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, Texas, USA
| | - Eunduck Park
- Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, Texas, USA
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Physical activity for pediatric cancer survivors: a systematic review of randomized controlled trials. J Cancer Surviv 2021; 15:876-889. [PMID: 33389553 PMCID: PMC7778568 DOI: 10.1007/s11764-020-00981-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/11/2020] [Indexed: 11/25/2022]
Abstract
Purpose To collate evidence and evaluate the effects of physical activity interventions on physical activity level among pediatric cancer survivors who had completed active cancer treatment. Methods Relevant published studies were identified in May 2020 via five databases and reference checking. Searches were limited to randomized controlled trials or controlled clinical trials, published in English involving pediatric cancer survivors aged 18 years or below. Interventions were related to promote physical activity among the survivors. Included studies were assessed using the revised version of the Cochrane’s Risk of Bias Tool. Results Eight randomized controlled trials (620 pediatric cancer survivors and 53 caregivers of pediatric cancer survivors) were included. All studies investigated interventions for pediatric cancer survivors to increase their physical activity level. The interventions used varied across the eight included studies: three mHealth—medical and public health practice supported by mobile devices; two eHealth—the use of information and communication technologies to improve health care; two adventure-based training; and one educational program. Measures of physical activity level also varied: five used various objective measurements (i.e., accelerometer, pedometer, multisensory activity monitor); three used different self-reported questionnaires. Owing to high variability of the interventions and measures, it was impossible to perform meta-analysis. Overall, eHealth and mHealth interventions showed effectiveness and feasibility to promote physical activity among pediatric cancer survivors. Conclusions eHealth and mHealth interventions appear to be increasingly important strategies to promote physical activity among pediatric cancer survivors. Implications for Cancer Survivors Future larger-scale studies using a core-set of assessment tools are warranted to further promote regular physical activity in pediatric cancer survivors.
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Chandeying N, Thongseiratch T. Online Interventions to Improve Mental Health of Pediatric, Adolescent, and Young Adult Cancer Survivors: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:784615. [PMID: 35002804 PMCID: PMC8733740 DOI: 10.3389/fpsyt.2021.784615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Over the last 10 years, online interventions to improve mental health have increased significantly. This study's primary objective was to determine the effectiveness of online interventions in improving the mental health of pediatric, adolescent, and young adult (PAYA) cancer survivors. The secondary objective was to identify the independent variables associated with online intervention efficacy for mental health improvement. Methods: On June 25-30, 2021, we searched the Medline, PsycINFO, EMBASE, and Cochrane databases for eligible English language publications that reported randomized controlled trials of online interventions aimed at improving mental health among PAYA cancer survivors. The results were analyzed using a systematic review and a three-level meta-analysis. Results: Thirteen studies met the inclusion criteria. In six (42%) studies, the intervention focused on physical activity enhancement, while ten (77%) studies used self-directed interventions. Online interventions were more efficacious, compared to control conditions, in improving sleep g = 0.35 (95% CI 0.04-0.66) and psychological well-being g = 0.32 (95% CI 0.09-0.56), but not for reducing the symptoms of depression g = 0.17 (95% CI -0.13 to 0.47), anxiety g = 0.05 (95% CI -0.15 to 0.25), and pain g = 0.13 (95% CI -0.13 to 0.39). Conclusion: Online interventions were generally effective in improving mental health in PAYA cancer survivors, although negative results were found in some critical outcomes. More high-quality evidence is needed for definite conclusions to be drawn. The study protocol was registered in PROSPERO (CRD42021266276).
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Affiliation(s)
- Nutthaporn Chandeying
- Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Therdpong Thongseiratch
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
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Psychological Outcomes, Health-Related Quality of Life, and Neurocognitive Functioning in Survivors of Childhood Cancer and Their Parents. Pediatr Clin North Am 2020; 67:1103-1134. [PMID: 33131537 DOI: 10.1016/j.pcl.2020.07.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Childhood cancer disrupts the lives of patients and their families and affects acute and long-term psychological health. This article summarizes (1) psychological challenges, including depression, anxiety, worries, and posttraumatic stress, as well as positive outcomes such as benefit finding and posttraumatic growth in young survivors and parents; (2) health-related quality of life; (3) interventions to support survivors and parents with psychological difficulties; and (4) neurocognitive problems and interventions to help alleviate them. Although many survivors and parents fare well in the long term, many survivors may benefit from interventions. Interventions should be further evaluated and integrated into routine clinical care.
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Ha L, Mizrahi D, Ness KK. A Decision-Making Algorithm for Children With Suspected Coronavirus Disease 2019. JAMA Pediatr 2020; 174:1222. [PMID: 32955581 DOI: 10.1001/jamapediatrics.2020.3003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Lauren Ha
- Faculty of Medicine, University of New South Wales, Sydney, Sydney, New South Wales, Australia
| | - David Mizrahi
- Faculty of Medicine, University of New South Wales, Sydney, Sydney, New South Wales, Australia
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee
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Schulte F, Forbes C, Wurz A, Patton M, Russell KB, Pluijm S, Krull KR. Childhood Cancer Survivorship: Daily Challenges. Pediatr Clin North Am 2020; 67:1083-1101. [PMID: 33131536 DOI: 10.1016/j.pcl.2020.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Survivors of childhood cancer are at risk of experiencing fatigue, pain, lower levels of physical activity, increased engagement in risky health behavior, and poor social adjustment, after finishing treatment. Risks are more pronounced for survivors of specific diagnoses or receiving specific treatment protocols. Interventions to address these outcomes are in their infancy. Future research should focus on exploring the antecedents and consequences of these outcomes. In the meantime, researchers and cancer centers should attempt to provide high-quality and accessible health information to survivors through various media outlets to encourage healthy behaviors.
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Affiliation(s)
- Fiona Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hematology, Oncology and Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada.
| | - Caitlin Forbes
- University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Amanda Wurz
- University of Calgary, Calgary, Alberta, Canada
| | | | | | - Saskia Pluijm
- Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Kevin R Krull
- St. Jude Children's Research Hospital, Memphis, TN, USA
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Ha L, Mizrahi D, Wakefield CE, Cohn RJ, Simar D, Signorelli C. The Use of Activity Trackers in Interventions for Childhood Cancer Patients and Survivors: A Systematic Review. J Adolesc Young Adult Oncol 2020; 10:1-14. [PMID: 32897805 DOI: 10.1089/jayao.2020.0099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Activity trackers have emerged as promising devices used to motivate and/or objectively monitor physical activity (PA) levels. It is unknown how activity trackers have been used in interventions for children and adolescents affected by cancer. This review aimed to investigate the effectiveness of wearable activity trackers to monitor and/or improve PA levels and health outcomes in pediatric oncology. Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we conducted an electronic search of four databases (Cumulative Index to Nursing and Allied Health Literature [CINAHL], Medline, Embase, and SportDiscus) between January 2000 and March 2020. The review included PA interventions that used an activity tracker with children (≤18 years) diagnosed with cancer. We excluded studies including adult participants (>18 at time of study participation) and cross-sectional or case-report studies. Twelve studies examining 517 children and adolescent patients and survivors of pediatric cancer (age range: 4-18 years) were included. Intervention delivery ranged from 2 weeks to 12 months. Two of 12 studies reported increases in PA and 6 showed improvements in health outcomes, including aerobic fitness and negative mood. PA interventions using activity trackers within pediatric oncology are highly diverse in study design, study population, and intervention features. Preliminary data suggest that interventions using wearable activity trackers may have a positive impact on health outcomes in children and adolescents affected by cancer. Future research is needed to establish optimal intervention approaches to using activity trackers to increase PA in children affected by cancer.
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Affiliation(s)
- Lauren Ha
- School of Medical Sciences, UNSW Medicine, UNSW Sydney, Sydney, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
| | - David Mizrahi
- Prince of Wales Clinical School, UNSW Medicine, UNSW Sydney, Sydney, Australia
| | - Claire E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, Australia
| | - Richard J Cohn
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, Australia
| | - David Simar
- School of Medical Sciences, UNSW Medicine, UNSW Sydney, Sydney, Australia
| | - Christina Signorelli
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, Australia
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Devine KA, Viola A, Levonyan-Radloff K, Mackowski N, Bozzini B, Chandler A, Xu B, Ohman-Strickland P, Mayans S, Farrar-Anton A, Sahler OJZ, Masterson M, Manne S, Arent S. Feasibility of FitSurvivor: A technology-enhanced group-based fitness intervention for adolescent and young adult survivors of childhood cancer. Pediatr Blood Cancer 2020; 67:e28530. [PMID: 32589339 PMCID: PMC7674223 DOI: 10.1002/pbc.28530] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/23/2020] [Accepted: 06/08/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND This study evaluated the feasibility of a technology-enhanced group-based fitness intervention for adolescent and young adult (AYA) survivors of childhood cancer. PROCEDURE AYA survivors ages 13-25 years were randomized to the intervention (eight in-person group sessions with mobile app and FitBit followed by 4 weeks of app and FitBit only) or waitlist control. Assessments were at 0, 2, 3, 6, and 9 months. Feasibility was evaluated by enrollment, retention, attendance, app engagement, and satisfaction. Secondary outcomes included physical activity, muscular strength/endurance, cardiorespiratory fitness, health-related quality of life, and fatigue. RESULTS A total of 354 survivors were mailed participation letters; 68 (19%) were screened, of which 56 were eligible and 49 enrolled (88% of those screened eligible, 14% of total potentially eligible). Forty-nine survivors (Mage = 18.5 years, 49% female) completed baseline assessments and were randomized (25 intervention, 24 waitlist). Thirty-seven (76%) completed the postintervention assessment and 32 (65%) completed the final assessment. On average, participants attended 5.7 of eight sessions (range 1-8). Overall intervention satisfaction was high (M = 4.3, SD = 0.58 on 1-5 scale). Satisfaction with the companion app was moderately high (M = 3.4, SD = 0.97). The intervention group demonstrated significantly greater improvement in lower body muscle strength compared to the waitlist postintervention, and small but not statistically significant changes in other secondary measures. CONCLUSIONS A group-based intervention with a mobile app and fitness tracker was acceptable but has limited reach due to geographical barriers and competing demands experienced by AYA survivors.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Sherri Mayans
- Hackensack Meridian Health, Hackensack University Medical Center
| | | | | | | | | | - Shawn Arent
- Rutgers, The State University of New Jersey,University of South Carolina
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Park BK, Kim JY, Rogers VE. Development and Usability Evaluation of a Facebook-Based Intervention Program for Childhood Cancer Patients: Mixed Methods Study. J Med Internet Res 2020; 22:e18779. [PMID: 32720897 PMCID: PMC7420636 DOI: 10.2196/18779] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/22/2020] [Accepted: 06/11/2020] [Indexed: 01/23/2023] Open
Abstract
Background Childhood cancers previously considered to be incurable now have 5-year survival rates up to 84%. Nevertheless, these patients remain at risk of morbidity and mortality from therapy-related complications. Thus, patient education and self-management strategies for promoting a healthy lifestyle are of tantamount importance for improving short- and long-term health outcomes. A Facebook-based “Healthy Teens for Soaam” (a Korean term for childhood cancers) program was developed to help improve knowledge and self-management practices of teens with cancer related to their disease and treatment. Objective The two-fold purpose of this usability study was (1) to describe the process of developing an 8-week Facebook-based intervention program for teens with cancer, and (2) to evaluate its usability to refine the program. Methods Multiple phases and methods were employed to develop and evaluate the usability of the program. Study phases included: (1) needs assessment through focus group interviews and qualitative content analysis, (2) development of module content, (3) expert review and feedback on module content, (4) Facebook-based program development, (5) usability evaluation by heuristic evaluation, (6) usability evaluation by targeted end-user testing, and (7) modification and final version of the program. Usability of the final version was confirmed through feedback loops of these phases. Results Based on 6 focus group discussion sessions, it was determined that teens with cancer were interested in seeing stories of successful childhood cancer cases and self-management after discharge, and preferred multimedia content over text. Therefore, each Facebook module was redesigned to include multimedia materials such as relevant video clips tailored for teens. Usability assessed by heuristic evaluation and user testing revealed several critical usability issues, which were then revised. Potential end users tested the final program and perceived it to be usable and useful for teens with cancer. Conclusions To our knowledge, “Healthy Teens for Soaam” is the first Facebook-based intervention program for teens with cancer. We actively worked with current childhood cancer patients and survivors to develop and improve this program, achieved good usability, and met the expressed needs and preferences of target end users. This 8-week Facebook-based educational program for teens with cancer, developed as the first step of an upcoming intervention study, will be useful for improving knowledge and self-management strategies of teens.
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Affiliation(s)
- Bu Kyung Park
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, Republic of Korea
| | - Ji Yoon Kim
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Valerie E Rogers
- School of Nursing (retired), University of Maryland Baltimore, Baltimore, MD, United States
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Zhi X, Xie M, Zeng Y, Liu JE, Cheng ASK. Effects of Exercise Intervention on Quality of Life in Adolescent and Young Adult Cancer Patients and Survivors: A Meta-Analysis. Integr Cancer Ther 2020; 18:1534735419895590. [PMID: 31845599 PMCID: PMC6918037 DOI: 10.1177/1534735419895590] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cancer and its treatment significantly impact the quality of life (QOL) of adolescent and young adult (AYA) patients. This meta-analysis examined the effects of exercise interventions on the generic and cancer-specific QOL of AYA cancer patients and survivors. METHODS Four databases were searched from January 2010 to September 2019. RevMan 5.3 was used to synthesize the effects of exercise intervention on the QOL of AYA cancer patients and survivors. RESULTS A total of 11 eligible studies have been included in this paper. Direct outcome comparisons found that pooled overall effects on generic QOL were in favor of exercise interventions, but only with marginal significance (Z= 1.96, P = 0.05). When performing the subscale analysis of the generic QOL, three trials assessed the effects of exercise interventions on the emotional domain of QOL, and the weighted mean difference (WMD) for the overall intervention effect was 3.47 (95% confidence interval [CI] = 0.42 to 6.51). Additionally, exercise interventions increased the minutes of physical activity per week undertaken by AYA cancer patients and survivors (Z= 2.88, P = 0.004). CONCLUSION Exercise interventions had positive effects on generic QOL and increased the minutes of physical activity per week undertaken by AYA cancer patients and survivors. In addition, exercise intervention programs appear to be safe, as there were no studies that reported adverse events. Future research, with rigorous methodological standards and larger sample sizes, should be designed to confirm the positive effects of exercise interventions on the QOL of AYA cancer patients and survivors.
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Affiliation(s)
- Xiaoxu Zhi
- Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Man Xie
- Jieyang People's Hospital, Jieyang, China
| | - Yingchun Zeng
- The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jun-E Liu
- Capital Medical University, Beijing, China
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39
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Chow EJ, Leger KJ, Bhatt NS, Mulrooney DA, Ross CJ, Aggarwal S, Bansal N, Ehrhardt MJ, Armenian SH, Scott JM, Hong B. Paediatric cardio-oncology: epidemiology, screening, prevention, and treatment. Cardiovasc Res 2020; 115:922-934. [PMID: 30768157 DOI: 10.1093/cvr/cvz031] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 01/18/2019] [Accepted: 02/13/2019] [Indexed: 12/11/2022] Open
Abstract
With 5-year survival of children with cancer exceeding 80% in developed countries, premature cardiovascular disease is now a major cause of early morbidity and mortality. In addition to the acute and chronic cardiotoxic effects of anthracyclines, related chemotherapeutics, and radiation, a growing number of new molecular targeted agents may also have detrimental effects on the cardiovascular system. Survivors of childhood cancer also may have earlier development of conventional cardiovascular risk factors such as hypertension, dyslipidaemia, and diabetes, which further increase their risk of serious cardiovascular disease. This review will examine the epidemiology of acute and chronic cardiotoxicity relevant to paediatric cancer patients, including genetic risk factors. We will also provide an overview of current screening recommendations, including the evidence regarding both imaging (e.g. echocardiography and magnetic resonance imaging) and blood-based biomarkers. Various primary and secondary prevention strategies will also be discussed, primarily in relation to anthracycline-related cardiomyopathy. Finally, we review the available evidence related to the management of systolic and diastolic dysfunction in paediatric cancer patients and childhood cancer survivors.
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Affiliation(s)
- Eric J Chow
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.,Clinical Research and Public Health Sciences Divisions, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N., PO Box 19024, Mailstop M4-C308, Seattle, WA 98109, USA
| | - Kasey J Leger
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Neel S Bhatt
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Daniel A Mulrooney
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Colin J Ross
- Faculty of Pharmaceutical Sciences, University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada
| | - Sanjeev Aggarwal
- Division of Pediatric Cardiology, Children's Hospital of Michigan, Wayne State University, Detroit, MI, USA
| | - Neha Bansal
- Division of Pediatric Cardiology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Matthew J Ehrhardt
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Saro H Armenian
- Department of Population Sciences, City of Hope Medical Center, Duarte, CA, USA
| | - Jessica M Scott
- Exercise Oncology Research Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Borah Hong
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
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40
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Bossen D, Broekema A, Visser B, Brons A, Timmerman A, van Etten-Jamaludin F, Braam K, Engelbert R. Effectiveness of Serious Games to Increase Physical Activity in Children With a Chronic Disease: Systematic Review With Meta-Analysis. J Med Internet Res 2020; 22:e14549. [PMID: 32234697 PMCID: PMC7160705 DOI: 10.2196/14549] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 11/21/2019] [Accepted: 01/27/2020] [Indexed: 12/18/2022] Open
Abstract
Background Physical activity (PA) is important for children with a chronic disease. Serious games may be useful to promote PA levels among these children. Objective The primary purpose of this systematic review was to evaluate the effectiveness of serious games on PA levels in children with a chronic disease. Methods PubMed, EMBASE, PsycINFO, ERIC, Cochrane Library, and CINAHL were systematically searched for articles published from January 1990 to May 2018. Both randomized controlled trials and controlled clinical trials were included to examine the effects of serious games on PA levels in children with a chronic disease. Two investigators independently assessed the intervention, methods, and methodological quality in all articles using the Cochrane risk of bias tool. Both qualitative and quantitative analyses were performed. Results This systematic review included 9 randomized controlled trials (886 participants). In 2 of the studies, significant between-group differences in PA levels in favor of the intervention group were reported. The meta-analysis on PA levels showed a nonsignificant effect on moderate to vigorous PA (measured in minutes per day) between the intervention and control groups (standardized mean difference 0.30, 95% CI –0.15 to 0.75, P=.19). The analysis of body composition resulted in significantly greater reductions in BMI in the intervention group (standardized mean difference –0.24, 95% CI –0.45 to 0.04, P=.02). Conclusions This review does not support the hypothesis that serious games improve PA levels in children with a chronic disease. The meta-analysis on body composition showed positive intervention effects with significantly greater reductions in BMI in favor of the intervention group. A high percentage of nonuse was identified in the study of serious games, and little attention was paid to behavior change theories and specific theoretical approaches to enhance PA in serious games. Small sample sizes, large variability between intervention designs, and limited details about the interventions were the main limitations. Future research should determine which strategies enhance the effectiveness of serious games, possibly by incorporating behavior change techniques.
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Affiliation(s)
- Daniël Bossen
- ACHIEVE Center of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Aline Broekema
- ACHIEVE Center of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Bart Visser
- ACHIEVE Center of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Annette Brons
- Digital Life Centre, Faculty of Digital Media and Creative Industries, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | | | | | - Katja Braam
- ACHIEVE Center of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Raoul Engelbert
- ACHIEVE Center of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.,Amsterdam University Medical Center, Rehabilitation, University of Amsterdam, Amsterdam, Netherlands.,Amsterdam University Medical Center, Pediatrics, University of Amsterdam, Amsterdam, Netherlands
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41
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Xavier WDS, Pacheco STDA, Silva LFD, Nascimento LC, Lopes LC, Araújo BBMD, Nunes MDR. Intervenções não farmacológicas na melhoria da qualidade de vida de crianças/adolescentes oncológicos. ACTA PAUL ENFERM 2020; 33. [DOI: 10.37689/acta-ape/2020ar0022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
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42
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Salchow J, Mann J, Koch B, von Grundherr J, Jensen W, Elmers S, Straub LA, Vettorazzi E, Escherich G, Rutkowski S, Dwinger S, Bergelt C, Sokalska-Duhme M, Bielack S, Calaminus G, Baust K, Classen CF, Rössig C, Faber J, Faller H, Hilgendorf I, Gebauer J, Langer T, Metzler M, Schuster S, Niemeyer C, Puzik A, Reinhardt D, Dirksen U, Sander A, Köhler M, Habermann JK, Bokemeyer C, Stein A. Comprehensive assessments and related interventions to enhance the long-term outcomes of child, adolescent and young adult cancer survivors - presentation of the CARE for CAYA-Program study protocol and associated literature review. BMC Cancer 2020; 20:16. [PMID: 31906955 PMCID: PMC6945396 DOI: 10.1186/s12885-019-6492-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 12/23/2019] [Indexed: 12/21/2022] Open
Abstract
Background Improved, multimodal treatment strategies have been shown to increase cure rates in cancer patients. Those who survive cancer as a child, adolescent or young adult (CAYA), are at a higher risk for therapy-, or disease-related, late or long-term effects. The CARE for CAYA-Program has been developed to comprehensively assess any potential future problems, to offer need-based preventative interventions and thus to improve long-term outcomes in this particularly vulnerable population. Methods The trial is designed as an adaptive trial with an annual comprehensive assessment followed by needs stratified, modular interventions, currently including physical activity, nutrition and psycho-oncology, all aimed at improving the lifestyle and/or the psychosocial situation of the patients. Patients, aged 15–39 years old, with a prior cancer diagnosis, who have completed tumour therapy and are in follow-up care, and who are tumour free, will be included. At baseline (and subsequently on an annual basis) the current medical and psychosocial situation and lifestyle of the participants will be assessed using a survey compiled of various validated questionnaires (e.g. EORTC QLQ C30, NCCN distress thermometer, PHQ-4, BSA, nutrition protocol) and objective parameters (e.g. BMI, WHR, co-morbidities like hyperlipidaemia, hypertension, diabetes), followed by basic care (psychological and lifestyle consultation). Depending on their needs, CAYAs will be allocated to preventative interventions in the above-mentioned modules over a 12-month period. After 1 year, the assessment will be repeated, and further interventions may be applied as needed. During the initial trial phase, the efficacy of this approach will be compared to standard care (waiting list with intervention in the following year) in a randomized study. During this phase, 530 CAYAs will be included and 320 eligible CAYAs who are willing to participate in the interventions will be randomly allocated to an intervention. Overall, 1500 CAYAs will be included and assessed. The programme is financed by the innovation fund of the German Federal Joint Committee and will be conducted at 14 German sites. Recruitment began in January 2018. Discussion CAYAs are at high risk for long-term sequelae. Providing structured interventions to improve lifestyle and psychological situation may counteract against these risk factors. The programme serves to establish uniform regular comprehensive assessments and need-based interventions to improve long-term outcome in CAYA survivors. Trial registration Registered at the German Clinical Trial Register (ID: DRKS00012504, registration date: 19th January 2018).
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Affiliation(s)
- J Salchow
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - J Mann
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - B Koch
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J von Grundherr
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - W Jensen
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Elmers
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L A Straub
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - E Vettorazzi
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Escherich
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Rutkowski
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Dwinger
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Bergelt
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - S Bielack
- Klinikum Stuttgart, Olgahospital, Stuttgart, Germany
| | | | - K Baust
- University Hospital Bonn, Bonn, Germany
| | - C F Classen
- University Hospital Rostock, Rostock, Germany
| | - C Rössig
- University Children's Hospital Münster, Münster, Germany
| | - J Faber
- Mainz University Medical Center, Mainz, Germany
| | - H Faller
- University Hospital Würzburg, Würzburg, Germany
| | | | - J Gebauer
- University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - T Langer
- University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - M Metzler
- University Hospital Erlangen, Erlangen, Germany
| | - S Schuster
- University Hospital Erlangen, Erlangen, Germany
| | - C Niemeyer
- Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - A Puzik
- Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - D Reinhardt
- University Hospital Essen, Essen, Germany.,German Cancer Consortium, Essen, Germany
| | - U Dirksen
- University Hospital Essen, Essen, Germany.,German Cancer Consortium, Essen, Germany
| | - A Sander
- Hannover Medical School, Hannover, Germany
| | - M Köhler
- Medical Faculty University Hospital Magdeburg, Magdeburg, Germany
| | | | - C Bokemeyer
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Stein
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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43
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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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