Physical Activity Promotion Programmes in Childhood Cancer Patients and Their Impact on Fatigue and Pain: A Systematic Review

Impact of Technology on Physical Activity Levels of Childhood Cancer Survivors: A Systematic Review

OBJECTIVES

Childhood cancer survivors often experience long-term health challenges like muscle weakness and obesity. Physical activity is essential for alleviating these effects, and technological interventions are being recommended to promote physical activity. This systematic review aimed to evaluate technological interventions' impact on childhood cancer survivors' PA levels.

METHODS

The systematic review followed PRISMA guidelines and included studies published until May 2024 from various databases. The Joanna Briggs Institute critical appraisal tools were used to assess study quality. The study was registered in PROSPERO under registration number CRD42024564857.

RESULTS

A total of nine studies were included in the review: four were randomized controlled trials (RCT), three were feasibility studies, and two were pilot studies. These studies, involving a total of 417 childhood cancer survivors, utilized a wide range of technological interventions. Six of the studies were of good quality, while three were of fair quality. Three studies used mobile apps, two used web-based platforms, two utilized m-health solutions, one incorporated a video game, and one employed a telehealth application. The results revealed that two-thirds of the mobile applications were ineffective in enhancing physical activity. In contrast, one of the m-health applications proved to be effective. Additionally, web-based platforms, telehealth applications, and video games demonstrated effectiveness in increasing physical activity.

CONCLUSIONS

Technological interventions show promise for improving physical activity among childhood cancer survivors, with six studies demonstrating significant benefits. More research is needed to identify effective strategies and optimize intervention designs, focusing on long-term outcomes.

IMPLICATIONS FOR NURSING PRACTICE

This systematic review assesses technology-based interventions aimed at promoting physical activity in childhood cancer survivors. The findings emphasize the potential and variability of digital tools, underscoring the necessity for additional research to refine intervention strategies and facilitate long-term physical activity among this group.

The Impact of Interactive Video Games Training on the Quality of Life of Children Treated for Leukemia

OBJECTIVES

The study aimed to assess the impact of interactive video games (IVGs) as a form of physical activity (PA) on the quality of life.

METHODS

The study used a quality-of-life questionnaire (KIDSCREEN-10) and the HBSC questionnaire. In order to determine individual IVGs training parameters, an initial assessment of cardiorespiratory fitness level was performed, using the Cardio Pulmonary Exercise Test-Godfrey's progressive protocol. Children in the intervention group participated in 12 interval training sessions using IVGs (Microsoft's Xbox 360 S console with Kinect,).

RESULTS

The study included 21 patients (7-13 years old; 12 boys and 9 girls) treated for acute lymphoblastic leukemia (n = 13) and acute myeloid leukemia (n = 8). Before the IVGs, all children had insufficient PA levels (90% of children in the intervention group and 90.91% of children in the control group did not engage in any PA during the last 7 days). After the intervention, 80% of the children in the IVGs group undertook PA lasting at least 60 min a day, three times a week. They exhibited better well-being, a subjective feeling of improved physical fitness (p < 0.0001), a greater subjective sense of strength and energy (p < 0.0001), and less feeling of sadness (p = 0.0016) than the children from the control group (p = 0.0205).

CONCLUSIONS

The results of our study confirmed that an attractive form of virtual game or sport is willingly undertaken by children undergoing cancer treatment, and has significant benefits in improving the quality-of-life parameters. There is a clear need to create specific recommendations and rehabilitation models for children with cancer.

Caregiver perceptions of child heath behaviors and weight during treatment for acute lymphoblastic leukemia

BACKGROUND

Changes in health behaviors and weight are common during the early phases of pediatric acute lymphoblastic leukemia treatment, and may negatively impact treatment tolerability. Given that ALL is most prevalent in children, caregivers play an essential role in shaping health behaviors during treatment. This study presents a qualitative analysis of semi-structured interviews with caregivers of youth in the early phases of ALL treatment.

PROCEDURE

Caregivers (N = 17, 95% female) of a child (M age = 6.76 years) diagnosed with ALL and on treatment for less than 1 year (M = 8.7 months since diagnosis) completed a semi-structured interview about perceptions of their child's nutrition, physical activity, sedentary time, and weight during ALL treatment. Thematic analysis followed Braun and Clark's six-step framework (2006). Two coders established reliability (alpha = .88) and used a multi-pass coding system to extract themes.

RESULTS

Caregivers' concerns around their child's weight during ALL treatment primarily centered around avoiding malnutrition. Weight gain during treatment was less of a concern and often viewed as protective. Caregivers reported encouraging their child to eat palatable, calorie-dense foods to mitigate risk for weight loss. Caregivers also expressed concern that children were less active and more sedentary due to treatment-related pain. Caregivers discussed health behaviors during treatment as being child-directed, rather than parent- or provider-directed.

CONCLUSION

Future interventions may consider strategies to engage in joint parent-child decisions and caregiver education around risks of excessive weight gain during treatment. Interventions should include anticipatory guidance and aim to support parents in developing skills to support their child's health behaviors during treatment.

Effects of strength exercise interventions on activities of daily living, motor performance, and physical activity in children and adolescents with leukemia or non-Hodgkin lymphoma: Results from the randomized controlled ActiveADL Study

OBJECTIVES

Pediatric patients with cancer experience impairments in muscle strength and physical activity (PA) that may reduce autonomy during hospitalization. To determine the effects of strength exercise interventions on the accomplishment of activities of daily living (ADLs), motor performance, and PA in children with leukemia or non-Hodgkin lymphoma, we randomly allocated patients (4-18 years) immediately after diagnosis into two exercise groups.

METHODS

The intervention group (IG; n = 21) received a specific strength training combined with a standard care exercise program, whereas the control group (CG; n = 20) was provided standard care exercise program without any targeted muscle strengthening. After the baseline visit, participants were followed-up three times until intensive treatment cessation. We assessed physical function limitations using the Activities Scale for Kids© (ASK) and Functional ADL Screen. Secondary outcomes were PA levels using accelerometer and motor performance as measured by MOON-test (motor performance in pediatric oncology-test).

RESULTS

In both groups, ADL accomplishment had significantly increased (p < 0.05). However, no significant between-group differences for ASK outcome were noted. Motor performance was reduced in all motor abilities.

CONCLUSIONS

Both exercise interventions were effective to maintain ADLs and motor performance during intensive treatment. In comparison, regular strength exercise interventions in the course of therapy tended to be more beneficial with regards to muscular explosive and endurance strength.