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Kohler BE, Sandler CX, Baque E, Bradford NK, Trost SG. Therapeutic exercise interventions in pediatric survivors of brain cancer and other solid tumors: A scoping review. Front Pediatr 2022; 10:979292. [PMID: 36210932 PMCID: PMC9535626 DOI: 10.3389/fped.2022.979292] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background Improved survival rates for children with solid tumors presents an ongoing challenge of how to maximize quality of survivorship and effectively manage the short- and long-term complications of disease and treatment. To gain an understanding of the extent and nature of research pertaining to therapeutic exercise interventions and identify knowledge gaps, we conducted a scoping review of exercise training studies conducted in pediatric survivors of brain cancer and other solid tumors. Method A systematic literature search was performed across four electronic databases. Papers were selected for full-text review if they included participants treated for brain cancer or other solid tumors, with at least 50% of participants aged ≤ 21 years, evaluated an exercise intervention ≥2-weeks in duration, and were published in an English, peer-reviewed journal. We included the following quantitative study designs; randomized controlled trials, non-randomized trials, and single-arm pre-test-post-test. Results Of the 7,482 citations identified, 17 papers met the inclusion criteria (presenting findings from eleven studies). Two studies were randomized controlled trials, five studies were non-randomized controlled trials, and four studies were a single-arm pre-test post-test design. Average age of participants ranged from 7.3-15.5 years, and time since diagnosis ranged from 3 to 70 months. Five studies included participants with brain tumors exclusively, three studies included other solid tumors, and three studies included a mixed sample (brain and other solid tumors). A wide range of exercise modalities were employed, including cycle ergometry, resistance training, sport, yoga, and active gaming. The length of the exercise program ranged from 3-40 weeks and frequency from 3-11 sessions per week. Exercise session duration ranged from 15-180 min, with most studies reporting 30-90-min sessions. Adherence ranged from 77 to 100%, with none of the studies reporting adverse events. Studies reported improvements in cardiorespiratory fitness, functional strength, physical activity, and quality of life. Conclusions A small number of mostly low methodological quality studies have examined the effects of therapeutic exercise in pediatric survivors of solid tumors. Although limited, the extant literature supports the feasibility and safety of therapeutic exercise interventions for pediatric survivors of brain cancer and other solid tumors.
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Affiliation(s)
- Brooke E. Kohler
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Carolina X. Sandler
- Sport and Exercise Science, School of Health Sciences, Western Sydney University, Sydney, NSW, Australia
- UNSW Fatigue Research Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Emmah Baque
- School of Health Sciences and Social Work, Griffith University, Nathan, QLD, Australia
| | - Natalie K. Bradford
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Cancer and Palliative Care Outcomes Centre, at Centre for Children's Health Research, Queensland University of Technology, South Brisbane, QLD, Australia
| | - Stewart G. Trost
- Faculty of Health at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
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Kasparian AM, Badawy SM. Utility of Fitbit devices among children and adolescents with chronic health conditions: a scoping review. Mhealth 2022; 8:26. [PMID: 35928511 PMCID: PMC9343978 DOI: 10.21037/mhealth-21-28] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 05/09/2022] [Indexed: 11/06/2022] Open
Abstract
Background While Fitbit® devices were initially intended for leisurely, consumer use, there has been recent interest among scientific and medical communities in the prospective use of Fitbit devices for clinical and research purposes. Those who have chronic health conditions are often required to spend considerable amounts of money and time undergoing physiological tests and activity monitoring to support, stabilize, and manage their health. This disease burden is only amplified in pediatric populations. Devices that are used to collect these data can be invasive, uncomfortable, and disconcerting. Using the Fitbit tracker to acquire such biometric data could ease this burden. Our scoping review seeks to summarize the research that has been conducted on the utilization of Fitbit devices in studies of children and adolescents with chronic health conditions and the feasibility, accuracy, and potential benefits of doing so. Methods Searches were conducted on PubMed for articles relating pediatric health to Fitbit device usage (using a Boolean search strategy). The eligibility criteria included trials being clinical and/or randomized controlled and articles being in English. Once articles were obtained, they underwent screening and exclusion processes and were charted for their titles, authors, objectives, results, and respective chronic illnesses. In the subsequent full-text review, further charting was conducted, collecting study designs, Fitbit parameters, feasibility, accuracy, and related health and clinical outcomes. Results Fitbit trackers were unanimously demonstrated to be feasible devices in this population for physical activity monitoring and were determined to be potentially beneficial in measuring and improving overall wellbeing and physical health in children with chronic illness. Nevertheless, sufficient evidence was not found in support of Fitbit accuracy. Additional biases were identified against the population of children with chronic health conditions that may further enable inaccurate data. Conclusions While Fitbit devices may be beneficial for those interested in improving physical health, discretion is advised for those seeking to collect accurate and/or medically necessitated data. Given the existing literature evaluated, medical-grade technologies are preferred in instances of the latter, as Fitbit devices have not been found to provide reliably accurate data.
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Affiliation(s)
- Alexandra M. Kasparian
- Department of Biology, Lafayette College, Easton, PA, USA
- Department of Physician Assistant Studies, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Sherif M. Badawy
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
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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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Physical Activity Promotion Programmes in Childhood Cancer Patients and Their Impact on Fatigue and Pain: A Systematic Review. CHILDREN 2021; 8:children8121119. [PMID: 34943313 PMCID: PMC8700190 DOI: 10.3390/children8121119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 12/20/2022]
Abstract
Cancer is one of the main causes of death in children, however, the techniques and interventions applied allow the cure of 80% of diagnosed cases. The aim of this review was to determine the benefits of a health and physical activity promotion programme to reduce pain and fatigue symptoms in children and adolescents with cancer. The databases PubMed, Embase, Scopus, Cochrane, Web of Science and PEDro were searched between December 2020 and January 2021 to elaborate this review, using the keywords child, cancer, exercise, fatigue and pain. The review was preregistered in PROSPERO (ID CRD42021262183). Six studies, out of 937 identified at baseline, were finally included in the review: four randomised controlled trials and two quasi-experimental studies. The total sample size of all the included studies was of 474 participants with very different types of cancer and evolution, and outcome variables were pain, fatigue, physical activity level, self-efficacy and quality of life. A health and physical activity promotion programme seems to improve fatigue in paediatric cancer patients and survivors, but no significant results were found related to pain.
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Irie K, Zhao S, Okamoto K, Liang N. Examining the Effect of Adverbs and Onomatopoeia on Physical Movement. Front Psychol 2021; 12:723602. [PMID: 34630234 PMCID: PMC8492989 DOI: 10.3389/fpsyg.2021.723602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/02/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The effect of promoting a physical reaction by the described action is called the action-sentence compatibility effect (ACE). It has been verified that physical motion changes depending on the time phase and grammatical expression. However, it is unclear how adverbs and onomatopoeia change motion simulations and subsequent movements. Methods: The subjects were 35 healthy adults (11 females; mean age 21.3). We prepared 20 sentences each, expressing actions related to hands and feet. These were converted into 80 sentences (stimulus set A), with the words "Slow" or "Quick" added to the words related to the speed of movement, and 80 sentences (stimulus set B) with the words "Fast" and onomatopoeia "Satto" added. Additionally, 20 unnatural sentences were prepared for each stimulus set as pseudo sentences. Choice reaction time was adopted; subjects pressed the button with their right hand only when the presented text was correctly understood (Go no-go task). The reaction time (RTs) and the number of errors (NoE) were recorded and compared. Results: As a result of a two-way repeated ANOVA, an interaction effect (body parts × words) was observed in RTs and NoE in set A. "Hand and Fast" had significantly faster RTs than "Hand and Slow" and "Foot and Fast." Furthermore, "Hand and Fast" had a significantly higher NoE than others. In set B, the main effects were observed in both RTs and NoE. "Hand" and "Satto" had significantly faster RTs than "Foot" and "Quick," respectively. Additionally, an interaction effect was observed in NoE, wherein "Foot and Satto" was significantly higher than "Hand and Satto" and "Foot and Quick." Conclusion: In this study, the word "Fast" promoted hand response, reaffirming ACE. The onomatopoeia "Satto" was a word that conveys the speed of movement, but it was suggested that the degree of understanding may be influenced by the body part and the attributes of the subject.
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Affiliation(s)
- Keisuke Irie
- Cognitive Motor Neuroscience, Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuo Zhao
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Kazuhiro Okamoto
- Department of Rehabilitation, Faculty of Health Science, Fukui Health Science University, Fukui, Japan
| | - Nan Liang
- Cognitive Motor Neuroscience, Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Khoo S, Mohbin N, Ansari P, Al-Kitani M, Müller AM. mHealth Interventions to Address Physical Activity and Sedentary Behavior in Cancer Survivors: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115798. [PMID: 34071342 PMCID: PMC8198944 DOI: 10.3390/ijerph18115798] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/19/2021] [Accepted: 05/25/2021] [Indexed: 12/25/2022]
Abstract
This review aimed to identify, evaluate, and synthesize the scientific literature on mobile health (mHealth) interventions to promote physical activity (PA) or reduce sedentary behavior (SB) in cancer survivors. We searched six databases from 2000 to 13 April 2020 for controlled and non-controlled trials published in any language. We conducted best evidence syntheses on controlled trials to assess the strength of the evidence. All 31 interventions included in this review measured PA outcomes, with 10 of them also evaluating SB outcomes. Most study participants were adults/older adults with various cancer types. The majority (n = 25) of studies implemented multicomponent interventions, with activity trackers being the most commonly used mHealth technology. There is strong evidence for mHealth interventions, including personal contact components, in increasing moderate-to-vigorous intensity PA among cancer survivors. However, there is inconclusive evidence to support mHealth interventions in increasing total activity and step counts. There is inconclusive evidence on SB potentially due to the limited number of studies. mHealth interventions that include personal contact components are likely more effective in increasing PA than mHealth interventions without such components. Future research should address social factors in mHealth interventions for PA and SB in cancer survivors.
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Affiliation(s)
- Selina Khoo
- Centre for Sport and Exercise Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia;
- Correspondence: (S.K.); (A.M.M.)
| | - Najihah Mohbin
- Centre for Sport and Exercise Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Payam Ansari
- DCU Business School, Dublin City University, Dublin, Ireland;
| | - Mahfoodha Al-Kitani
- Physical Education and Sports Sciences Department, College of Education, Sultan Qaboos University, Muscat 123, Oman;
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
- Correspondence: (S.K.); (A.M.M.)
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Kohler BE, Baque E, Sandler CX, Brookes DSK, Terranova CO, Rixon M, Hassall T, Trost SG. Physical ACTivity in Survivorship (PACTS): study protocol for a randomized controlled trial evaluating a goal-directed therapeutic exercise program in pediatric posterior fossa brain tumor survivors. BMC Pediatr 2021; 21:105. [PMID: 33648474 PMCID: PMC7919081 DOI: 10.1186/s12887-021-02566-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Posterior fossa brain tumors (PFBT) are the most common solid tumor in children. Recent increases in survival rates are encouraging; however, survivors may experience a plethora of disease- and treatment-related complications that can persist into adulthood. Therapeutic exercise interventions have been shown to improve quality of survivorship in other pediatric cancer diagnoses. There is also evidence that goal-directed interventions are effective at improving motor activities, function, and self-care in children with complex health conditions. Yet, there is currently no evidence on the efficacy of goal-directed therapeutic exercise in pediatric PFBT survivors. The Physical ACTivity in Survivorship (PACTS) study aims to investigate the effects of a novel goal-directed therapeutic exercise program on cardiorespiratory fitness and physical activity-related goal attainment in pediatric survivors of PFBT. METHOD PFBT survivors, aged five to 17 years, who underwent surgery at least 12 months earlier and completed radiation therapy and/or chemotherapy at least 6 months prior will be recruited from the Queensland Children's Hospital (Brisbane, Australia) (target n = 48). Following baseline assessment, participants are randomized into either the intervention or usual care group. The intervention group will receive weekly individualized, goal-directed exercise therapy delivered face-to-face for 12 weeks, along with an accompanying home-based program (three sessions per week). Outcomes will be assessed at baseline, immediately post-intervention, and at 6- and 12-months post-intervention. The primary outcomes are cardiorespiratory fitness (Peak VO2) and physical activity-related goal attainment. Secondary outcomes are cardiorespiratory endurance, high-level mobility skills, functional muscle strength, habitual physical activity, gait, balance, quality of life, fatigue, participation, perceived movement skill competence and parameters of body composition. DISCUSSION PACTS is the first study to investigate the efficacy of goal-directed therapeutic exercise in children with PFBT and provide evidence needed to inform clinical practice recommendations for managing quality of survivorship in PFBT survivors. TRIAL REGISTRATION ACTRN12619000841178 .
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Affiliation(s)
- Brooke E Kohler
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Emmah Baque
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Carolina X Sandler
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- UNSW Fatigue Research Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Denise S K Brookes
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Caroline O Terranova
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Matthew Rixon
- School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Tim Hassall
- Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Stewart G Trost
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
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Exercise Trials in Pediatric Brain Tumor: A Systematic Review of Randomized Studies. J Pediatr Hematol Oncol 2021; 43:59-67. [PMID: 32604333 DOI: 10.1097/mph.0000000000001844] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/29/2020] [Indexed: 12/29/2022]
Abstract
In pediatric brain tumor patients, treatment advances have increased survival rates to nearly 70%, while consequently shifting the burden of disease to long-term management. Exercise has demonstrated potential in improving multiple health impairments secondary to brain tumor treatment. However, these effects have not been consolidated through review. Therefore, we performed a systematic review of 6 health sciences databases (Medline, Embase, PsychINFO, CINAHL, SPORTDiscus, and Cochrane Central Database). Two reviewers screened studies against predefined inclusion criteria, namely that the study must: (i) be pediatric-specific; (ii) examine the effects of an exercise intervention; and (iii) employ a randomized or quasi-randomized trial design. The same 2 reviewers performed data extraction and analyses. From a pool of 4442, 5 articles-based on 2 independent trials-were included in our review (N=41). Exercise interventions were primarily aerobic, but included balance or muscle building components. Exercise had a positive effect on volumetric or diffusion-based neuroimaging outcomes, as well as motor performance and cardiorespiratory fitness. The effects of exercise on cognition remains unclear. Exercise did not worsen any of the outcomes studied. This review captures the state of the science, suggesting a potential role for exercise in children treated for brain tumor.
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Ito N, Petrella A, Sabiston C, Fisher A, Pugh G. A Systematic Review and Narrative Synthesis of Exercise Interventions to Manage Fatigue Among Children, Adolescents, and Young Adults with Cancer. J Adolesc Young Adult Oncol 2021; 10:361-378. [PMID: 33625879 DOI: 10.1089/jayao.2020.0136] [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: 10/22/2022] Open
Abstract
Exercise is known to improve fatigue among adult cancer patients however there is limited understanding of this relationship in children, adolescents, and young adults (AYA) with cancer. The aim is to evaluate the effect of exercise on fatigue outcomes among children and AYA with cancer and to identify important parameters of exercise (frequency, intensity, time, type, and setting), which may be relevant for future intervention design. A systematic search of PubMed, MedLine, CENTRAL, Embase, and Web of Science databases was conducted in December 2019, for studies within the last decade, reporting the effect of exercise on fatigue among cancer patients and survivors 0-24 years of age. Quality assessment was conducted using the Physiotherapy Evidence Database (PEDro) and "Before/After Studies with No Control Group" scales. Seventeen studies (n = 681 participants) were included, of which six were randomized controlled trials (RCTs), and the remaining being pilot (n = 5) or feasibility studies (n = 6). Across studies there was great heterogeneity in intervention delivery, frequency (range: 1-7 days a week), time (range: 10-60 minutes), and duration (range: 3-24 weeks). A positive effect of exercise on fatigue was observed, however, most changes in fatigue were not statistically significant. Exercise is beneficial for reducing fatigue in young cancer patients. However, due to the heterogeneity and quality of existing interventions, firm conclusions about the most effective mode and format of exercise intervention cannot be drawn. There is a need for more definitive large-scale RCTs that can provide data of sufficient quality.
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Affiliation(s)
- Nonoka Ito
- Centre for Sports and Exercise Medicine, Queen Mary University of London, London, United Kingdom
| | - Anika Petrella
- Department of Kinesiology, University of Toronto, Toronto, Canada
| | | | - Abigail Fisher
- Department of Behavioral Science and Health, University College London, London, United Kingdom
| | - Gemma Pugh
- Centre for Sports and Exercise Medicine, Queen Mary University of London, London, United Kingdom
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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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11
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Runco DV, Yoon L, Grooss SA, Wong CK. Nutrition & Exercise Interventions in Pediatric Patients with Brain Tumors: A Narrative Review. J Natl Cancer Inst Monogr 2020; 2019:163-168. [PMID: 31532532 DOI: 10.1093/jncimonographs/lgz025] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/02/2019] [Accepted: 07/05/2019] [Indexed: 01/25/2023] Open
Abstract
Brain tumors have been the most common pediatric solid tumor and leading cause of morbidity and mortality. Improved survival emphasizes the importance of adverse treatment effects especially related to nutrition and exercise. Although studies have examined nutrition and exercise outcomes, few randomized trials exist. This narrative review included a systematic literature search with analysis of controlled or single group studies examining clinical and quality-of-life impact of nutrition or exercise interventions. Seven articles were included. Three nutrition studies demonstrated improvement with proactive feeding tubes, nutritional supplementation, and nutritional status. Two exercise studies showed improvement in measures of fitness and neuroanatomy with exercise in pediatric brain tumor survivors; two cohort studies demonstrated a link between quality of life and physical activity. Preliminary studies show nutrition and exercise may improve physical well-being and quality of life, suggesting future controlled studies are warranted to inform clinical care of children with brain tumors.
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Affiliation(s)
- Daniel V Runco
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA.,Emory University School of Medicine, Department of Pediatrics, Division of Pediatric Hematology/Oncology/BMT, Atlanta, GA
| | - Lisa Yoon
- Department of Rehabilitative and Regenerative Medicine, Program in Physical Therapy, Columbia University Irving Medical Center, New York, NY
| | - Samantha A Grooss
- Center for Cancer and Blood Disorders, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Christopher K Wong
- Department of Rehabilitative and Regenerative Medicine, Program in Physical Therapy, Columbia University Irving Medical Center, New York, NY
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Tanner L, Keppner K, Lesmeister D, Lyons K, Rock K, Sparrow J. Cancer Rehabilitation in the Pediatric and Adolescent/Young Adult Population. Semin Oncol Nurs 2020; 36:150984. [DOI: 10.1016/j.soncn.2019.150984] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Cajita MI, Kline CE, Burke LE, Bigini EG, Imes CC. Feasible but Not Yet Efficacious: A Scoping Review of Wearable Activity Monitors in Interventions Targeting Physical Activity, Sedentary Behavior, and Sleep. CURR EPIDEMIOL REP 2020; 7:25-38. [PMID: 33365227 DOI: 10.1007/s40471-020-00229-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose of Review The present review aimed to explore the range and characteristics of interventions that utilize WAM and descriptively summarize the efficacy of these interventions. Recent Findings A total of 65 articles (61 studies) were included in this review. Most of the WAM-based interventions (n=58) were designed to improve physical activity (PA). Interventions targeting sedentary behavior (SB) were much less common (n=12), and even less frequent were WAM-based sleep interventions (n=3). Most studies tested the feasibility of WAM-based interventions; hence, efficacy of these interventions in improving PA, SB, and/or sleep could not be conclusively determined. Nonetheless, WAM-based interventions showed considerable potential in increasing PA and decreasing SB. Summary WAM-based PA interventions exhibited preliminary efficacy in increasing PA. Although not as many interventions were focused on SB, current interventions also showed potential in decreasing sedentary time. Meanwhile, more evidence is needed to determine the utility of WAM in improving sleep. Major challenges with including WAM as part of interventions are reduced engagement in using the devices over time and the rapid changes in technology resulting in devices becoming obsolete soon after completion of an efficacy trial.
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Affiliation(s)
- Maan Isabella Cajita
- University of Illinois at Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL, USA
| | - Christopher E Kline
- University of Pittsburgh, Department of Health and Physical Activity, Pittsburgh, PA, USA
| | - Lora E Burke
- University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA
| | - Evelyn G Bigini
- University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA
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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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