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Voland A, Krell V, Götte M, Niels T, Köppel M, Wiskemann J. Exercise Preferences in Young Adults with Cancer-The YOUEX Study. Curr Oncol 2023; 30:1473-1487. [PMID: 36826074 PMCID: PMC9955702 DOI: 10.3390/curroncol30020113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
(1) Background: Strong evidence supports the persuasive positive effects of exercise for cancer patients and survivors. Different approaches of exercise programs have been established; however, the special interests of young adults (YAs) with cancer have rarely been considered in exercise interventions. Therefore, the study YOUng EXercisers (YOUEX) aimed to investigate exercise preferences in YAs. (2) Methods: YOUEX was a three-arm, patient preference-based non-randomized, longitudinal, pre-post exercise intervention, offering three different exercise modules to YAs during or after acute therapy (Module 1: online supervised group-based (M1); Module 2: online unsupervised (M2); Module 3: in-person supervised (M3)). The intervention period was 12 weeks with another 12-week follow-up period, the modules could be changed or amended after 6 and 12 weeks. (3) Results: 92 YAs were allocated to the study. At baseline, 50 YAs (54%) chose M2, 32 YAs (35%) M1 and 10 YAs (11%) M3. The analysis revealed high acceptability and feasibility of the online exercise programs (M1, M2). There was a high impact of the COVID-19 pandemic on the execution of M3. YAs showed diverse preferences in module selection due to differences in, e.g., cancer therapy status or favored level of supervision. (4) Conclusions: YAs need personalized exercise programs that consider their individual interests and needs. Online exercise programs can be a promising addition to existing exercise opportunities. They are an effective way to increase physical activity levels in YAs.
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Affiliation(s)
- Annelie Voland
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Verena Krell
- Department of Sports Medicine, Charité—Universitätsmedizin Berlin, 10115 Berlin, Germany
- Department of Sports Medicine, Humboldt—Universität zu Berlin, 10115 Berlin, Germany
| | - Miriam Götte
- West German Cancer Center, University Hospital Essen, 45122 Essen, Germany
| | - Timo Niels
- Department I of Internal Medicine, Center of Integrated Oncology Aachen Bonn Cologne Düsseldorf, University Hospital of Cologne, 50937 Cologne, Germany
| | - Maximilian Köppel
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Joachim Wiskemann
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg University Hospital, 69120 Heidelberg, Germany
- Correspondence:
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König TT, Heimann A, Scharenberg S, Kriemler S, Muensterer O, Siaplaouras J. [Opportunities in Differentiated School Sports Exemption - Results of An Online-Survey and Review of the Literature]. KLINISCHE PADIATRIE 2023; 235:38-44. [PMID: 35139544 DOI: 10.1055/a-1721-2755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Physical education and sports participation in school play a major role in overall activity of children and adolescents. A differentiated school sports exemption (DSE) allows sports participation adapted to the individual's ability. METHOD Online-survey among physicians (2019) and physical education (PE) teachers (in two waves, 2017 and 2019), on their opinion towards the concept of DSE with respect to professional and demographic parameters. Answers were scaled on a 6-point Likert scale. Means and 95% confidence intervals (95%-CI) were calculated. RESULTS Complete questionnaires of 97 physicians and 280 teachers were included. A mean of 10,3% (95%-CI: 9,5-11,1%) of students, did not participate in PE class. In most cases, students were excused directly by their parents without consulting a physician. Most frequent reasons for exemption were missing sports gear (62%), common colds (54%), or acute injuries (50%). Chronic disease or disability was rare (8%). Most teachers did not feel well prepared to deal with children with chronic diseases or disabilities in PE class. Many physicians (24%) had never considered DSE. However, the concept was well accepted among both physicians and teachers. It was considered more practicable than exemption from being marked. DISCUSSION According to participants, DSE is expedient and feasible. As a secondary option, students with chronic disease or disability may be exempted from being marked in PE class by their physician. CONCLUSION The concept of DSE was widely accepted, but rarely used. It can be applied in various scenarios. In order to improve sports participation, a national standardized procedure should to be implemented.
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Affiliation(s)
- Tatjana Tamara König
- Department of Pediatric Surgery, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander Heimann
- Department of Pediatric Surgery, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Swantje Scharenberg
- Research Center of Physical Education and Sports for Children and Adolenscents, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Oliver Muensterer
- Department of Pediatric Surgery, Ludwig Maximilians University Munich, Munchen, Germany
| | - Jannos Siaplaouras
- Pediatric Cardiology, Private Practice at Herz-Jesu-Krankenhaus, Fulda, Germany
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Brown MC, Podmore M, Araújo-Soares V, Skinner R, Sharp L. Childhood cancer survivors' perceptions of the barriers and facilitators to physical activity: a systematic review and thematic synthesis of qualitative evidence using the Theoretical Domains Framework. Health Psychol Rev 2022; 17:277-300. [PMID: 35081866 DOI: 10.1080/17437199.2022.2032795] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AbstractDue to the potential for late adverse effects of treatment, and in particular cardiovascular problems, physical activity (PA) is recommended for childhood cancer survivors (CCSs). However, many CCSs have low levels of activity. This review aimed to systematically identify, appraise and synthesise qualitative research evidence on the barriers and facilitators to PA from the perspective of CCSs. Six databases (MEDLINE, Embase, PsycINFO, CINAHL, SPORTDiscus, and Scopus) were searched from inception to February 2021 to identify qualitative data on PA gathered from CCSs diagnosed ≤18 years of age, and who had completed active treatment. Two reviewers screened for eligibility and assessed methodological quality using CASP. An inductive thematic synthesis was undertaken to identify descriptive themes relating to barriers and facilitators to PA, before mapping these onto the Theoretical Domains Framework (TDF). Confidence in review findings was assessed using the GRADE-CERQual approach. Eight original studies including 126 CCSs were eligible. A total of 45 descriptive themes (29 facilitators and 16 barriers) were mapped onto nine domains of the TDF; they were most commonly mapped onto the Environmental Context and Resources (n = 13 descriptive themes) and the Social Influences (n = 13) domains. Between two and four descriptive themes were mapped onto each of the remaining seven domains. Study quality was variable and overall confidence in review findings was low. Although a range of perceived influences on PA were identified, few studies were eligible, and fewer focused specifically on identifying the barriers and facilitators to PA. These findings provide a first step required for the development of PA interventions for CCSs. However, conclusive/strong evidence for the barriers and facilitators to PA is lacking highlighting the need for further research on the perceived influences on PA in CCSs. PROSPERO Registration: CRD42019147829.
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Affiliation(s)
- Morven C Brown
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| | - Mary Podmore
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK.,Faculty of Behavioural, Management and Social Sciences, Department of Health Technology and Services Research, University of Twente, The Netherlands
| | - Roderick Skinner
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK.,Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.,Department of Paediatric and Adolescent Haematology and Oncology, Great North Children's Hospital, Newcastle upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
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Hoag JA, Bingen K, Karst J, Palou A, Yan K, Zhang J. Playing With a Purpose: The Impact of Therapeutic Recreation During Hospitalization. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:6-14. [PMID: 35722870 DOI: 10.1177/27527530211059437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: Youth undergoing cancer treatment and hematopoietic stem cell transplant (HSCT) spend significant time in the hospital, which is disruptive to their physical, social, and emotional development. Therapeutic recreation (TR) can help individuals with an illness maintain or improve their health, quality of life, and physical functioning. TR is an understudied intervention, particularly with youth in the hospital setting. Methods: Forty-nine children (median age = 12 years, interquartile range [IQR] 11-15 years) hospitalized for cancer treatment or HSCT were assigned to participate in either the historical control or TR intervention. Participants wore a Fitbit charge HR for three days to measure movement. At the end of the study participation, they completed self-report measures of mood, social connectedness, and health-related quality of life. Results: Compared with historical controls, the TR intervention group had improved positive affect and decreased mood disturbance (p = 0.03); had better sleep quality (p = 0.003); and was more satisfied with the leisure activities offered in the hospital (p = 0.01). There were no differences in the number of steps taken per day, somatic distress, cooperation with cares, or interaction with medical personnel or caregivers. Both groups reported poor availability and support of peer companions. Discussion: TR is one avenue to increase leisure activities and positively impact mood. More thought needs to be given to how TR programs can be leveraged to increase physical activity and social connectedness.
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Affiliation(s)
| | | | - Jeffrey Karst
- 5506Medical College of Wisconsin, Milwaukee, WI, USA
| | - Akasha Palou
- 5506Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ke Yan
- 5506Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jian Zhang
- 5506Medical College of Wisconsin, Milwaukee, WI, USA
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Physical activity levels, exercise preferences, and exercise barriers in Korean children and adolescents after cancer treatment. Support Care Cancer 2021; 30:1787-1796. [PMID: 34599665 DOI: 10.1007/s00520-021-06588-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/21/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of the current study was to explore physical activity (PA) levels, exercise preferences, and perceived barriers to PA in childhood cancer survivors. METHODS This cross-sectional study surveyed 120 childhood cancer survivors aged 8-18 years from the pediatric oncology center in South Korea between March and August 2017. The modified Exercise & Quality of Life questionnaire, Korea Youth Risk Behavior Web-based Survey, and Godin Leisure-Time Questionnaire were used to assess PA levels, preferences, and exercise barriers. RESULTS Among 120 participants (72 boys, 48 girls) whose average age at the time of the survey was 14.57 ± 3.00 years and the average age at diagnosis was 8.22 years, the three most common diagnoses were acute leukemia (43.3%), brain tumor (13.3%), and malignant lymphoma (10.8%). Only 16 participants (5%) met the PA recommendations for children (at least 60 min of moderate PA per day). The most preferred sporting activities included soccer, basketball, strengthening exercises, badminton, dance, and taekwondo. They generally had positive attitudes toward exercise, and more than 63% of participants intended to exercise the following month. The five most prevalent perceived barriers to exercise were lack of time, poor health, reluctance to sweat, lack of exercise skills, and no exercise partners. CONCLUSIONS While most childhood cancer survivors did not meet the PA recommendation, most of them agreed that exercise was beneficial, and they intended to participate in the exercise. Exercise and PA programs should be tailored to the personal health and preferences of childhood cancer survivors.
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Larsen MH, Larsen EH, Ruud E, Mellblom A, Helland S, Lie HC. "I have to do things differently now, but I make it work"-young childhood cancer survivors' experiences of self-management in everyday living. J Cancer Surviv 2021; 16:728-740. [PMID: 34097249 PMCID: PMC9300523 DOI: 10.1007/s11764-021-01066-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/28/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE Living with late effects can affect young childhood cancer survivors' (CCSs) self-management (SM) abilities. In this study, we explored different approaches to SM of everyday life by young CCS. METHODS This is a sub-study of a larger study on Physical Activity among Childhood Cancer Survivors (the PACCS study). We conducted individual interviews with 22 CCS aged 9 to 18 years who were at least 1 year off-treatment. An hybrid inductive-decductive thematic analysis was used. RESULTS Three main themes were identified: (1) managing everyday life with fatigue, (2) building self-management competence, and (3) cancer survivor as part of identity. Late effects, especially fatigue, contributed to a perceived ability gap compared to peers, limiting participation in everyday activities. CCS developed new SM skills to overcome such challenges and pushed themselves physically and mentally to master and balance activities and rest to regain energy. CCS changed activities, adapted their expectations, or legitimized their apparent lack of SM skills to regain a sense of self-efficacy. Managing the impact of cancer on relationships with family and friends also required use of SM strategies. CONCLUSIONS The findings expand our currently limited knowledge of young CCS and SM skills they develop to manage everyday life after treatment completion. These, combined with ongoing support from family and peers, "make it work". IMPLICATIONS FOR CANCER SURVIVORS The perspectives of young CCS illustrate their SM skills and support needs beyond transitioning off-treatment. Conceptualizing this within follow-up care may contribute to a feeling of mastery and increased satisfaction among CCS.
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Affiliation(s)
- Marie H Larsen
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo (UIO), Postboks 1111, Blindern, 0317, Oslo, Norway.
| | - Elna H Larsen
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo (UIO), Postboks 1111, Blindern, 0317, Oslo, Norway.,Department of Paediatric Haematology and Oncology, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, Postbox 4950, Nydalen, 0424, Oslo, Norway
| | - Ellen Ruud
- Department of Paediatric Haematology and Oncology, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, Postbox 4950, Nydalen, 0424, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo (UIO), Postboks 1111, Blindern, 0317, Oslo, Norway
| | - Anneli Mellblom
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo (UIO), Postboks 1111, Blindern, 0317, Oslo, Norway.,Regional Centre for Child and Adolescent Mental Health Eastern and Southern Norway (RBUP), Postboks 4623 Nydalen, 0405, Oslo, Norway
| | - Sunniva Helland
- The Children and Youth Clinic, Haukeland University Clinic, Jonas Lies vei 65, 5021, Bergen, Norway
| | - Hanne Cathrine Lie
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo (UIO), Postboks 1111, Blindern, 0317, Oslo, Norway
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