Online citations, reference lists, and bibliographies.
← Back to Search

Physical Exercise Training Interventions For Children And Young Adults During And After Treatment For Childhood Cancer.

K. Braam, P. van der Torre, T. Takken, M. Veening, E. van Dulmen-den Broeder, G. Kaspers
Published 2016 · Medicine

Save to my Library
Download PDF
Analyze on Scholarcy Visualize in Litmaps
Share
Reduce the time it takes to create your bibliography by a factor of 10 by using the world’s favourite reference manager
Time to take this seriously.
Get Citationsy
BACKGROUND A decreased physical fitness has been reported in patients and survivors of childhood cancer. This is influenced by the negative effects of the disease and the treatment of childhood cancer. Exercise training for adult cancer patients has frequently been reported to improve physical fitness. In recent years, literature on this subject has also become available for children and young adults with cancer, both during and after treatment. This is an update of the original review that was performed in 2011. OBJECTIVES To evaluate the effect of a physical exercise training intervention on the physical fitness (i.e. aerobic capacity, muscle strength, or functional performance) of children with cancer within the first five years from their diagnosis (performed either during or after cancer treatment), compared to a control group of children with cancer who did not receive an exercise intervention.To determine whether physical exercise within the first five years of diagnosis has an effect on fatigue, anxiety, depression, self efficacy, and HRQoL and to determine whether there are any adverse effects of the intervention. SEARCH METHODS We searched the electronic databases of Cochrane Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, and PEDro; ongoing trial registries and conference proceedings on 6 September 2011 and 11 November 2014. In addition, we performed a handsearch of reference lists. SELECTION CRITERIA The review included randomized controlled trials (RCTs) and clinical controlled trials (CCTs) that compared the effects of physical exercise training with no training, in people who were within the first five years of their diagnosis of childhood cancer. DATA COLLECTION AND ANALYSIS Two review authors independently identified studies meeting the inclusion criteria, performed the data extraction, and assessed the risk of bias using standardized forms. Study quality was rated by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) criteria. MAIN RESULTS Apart from the five studies in the original review, this update included one additional RCT. In total, the analysis included 171 participants, all during treatment for childhood acute lymphoblastic leukaemia (ALL).The duration of the training sessions ranged from 15 to 60 minutes per session. Both the type of intervention and intervention period varied in all the included studies. However, the control group always received usual care.All studies had methodological limitations, such as small numbers of participants, unclear randomization methods, and single-blind study designs in case of one RCT and all results were of moderate to very low quality (GRADE).Cardiorespiratory fitness was evaluated by the 9-minute run-walk test, timed up-and-down stairs test, the timed up-and-go time test, and the 20-m shuttle run test. Data of the 9-minute run-walk test and the timed up-and-down stairs test could be pooled. The combined 9-minute run-walk test results showed significant differences between the intervention and the control groups, in favour of the intervention group (standardized mean difference (SMD) 0.69; 95% confidence interval (CI) 0.02 to 1.35). Pooled data from the timed up-and-down stairs test showed no significant differences in cardiorespiratory fitness (SMD -0.54; 95% CI -1.77 to 0.70). However, there was considerable heterogeneity (I(2) = 84%) between the two studies on this outcome. The other two single-study outcomes, 20-m shuttle run test and the timed up-and-go test, also showed positive results for cardiorespiratory fitness in favour of the intervention group.Only one study assessed the effect of exercise on bone mineral density (total body), showing a statistically significant positive intervention effect (SMD 1.07; 95% CI 0.48 to 1.66). The pooled data on body mass index showed no statistically significant end-score difference between the intervention and control group (SMD 0.59; 95% CI -0.23 to 1.41).Three studies assessed flexibility. Two studies assessed ankle dorsiflexion. One study assessed active ankle dorsiflexion, while the other assessed passive ankle dorsiflexion. There were no statistically significant differences between the intervention and control group with the active ankle dorsiflexion test; however, in favour of the intervention group, they were found for passive ankle dorsiflexion (SMD 0.69; 95% CI 0.12 to 1.25). The third study assessed body flexibility using the sit-and-reach distance test, but identified no statistically significant difference between the intervention and control group.Three studies assessed muscle strength (knee, ankle, back and leg, and inspiratory muscle strength). Only the back and leg strength combination score showed statistically significant differences on the muscle strength end-score between the intervention and control group (SMD 1.41; 95% CI 0.71 to 2.11).Apart from one sub-scale of the cancer scale (Worries; P value = 0.03), none of the health-related quality of life scales showed a significant difference between both study groups on the end-score. For the other outcomes of fatigue, level of daily activity, and adverse events (all assessed in one study), there were no statistically significant differences between the intervention and control group.None of the included studies evaluated activity energy expenditure, time spent on exercise, anxiety and depression, or self efficacy as an outcome. AUTHORS' CONCLUSIONS The effects of physical exercise training interventions for childhood cancer participants are not yet convincing. Possible reasons are the small numbers of participants and insufficient study designs, but it can also be that this type of intervention is not as effective as in adult cancer patients. However, the first results show some positive effects on physical fitness in the intervention group compared to the control group. There were positive intervention effects for body composition, flexibility, cardiorespiratory fitness, muscle strength, and health-related quality of life (cancer-related items). These were measured by some assessment methods, but not all. However, the quality of the evidence was low and these positive effects were not found for the other assessed outcomes, such as fatigue, level of daily activity, and adverse events. There is a need for more studies with comparable aims and interventions, using a higher number of participants that also include diagnoses other than ALL.
This paper references
10.1016/S0022-3476(54)80100-4
Pediatric occupational therapy
G. Swartout (1954)
[Respiratory function tests].
G. Fournier-Massey (1970)
10.1007/978-1-4613-0941-3_22
Recovery of Function
S. Finger (1988)
10.1111/j.1600-065X.1990.tb00798.x
The Published Data
U. Storb (1990)
10.1002/1097-0142(19930701)72:1<276::AID-CNCR2820720148>3.0.CO;2-2
Impaired muscle strength in female adolescents and young adults surviving leukemia in childhood
L. Hovi (1993)
10.32388/09xu9a
Range of Motion
E. Berg (1995)
ACSM's Guidelines for Exercise Testing and Prescription
L. Pescatello (1995)
10.1161/01.CIR.93.5.1043
Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology.
A. J. Camm (1996)
10.1203/00006450-199805000-00008
Daily Energy Expenditure and Physical Activity in Survivors of Childhood Malignancy
J. Warner (1998)
10.1002/(SICI)1096-911X(199808)31:2<86::AID-MPO7>3.0.CO;2-V
Long-term gross motor performance following treatment for acute lymphoblastic leukemia.
M. Wright (1998)
10.1097/01893697-200119020-00035
Immune responses to exercise in children treated for cancer.
S. Shore (1999)
10.1136/thorax.56.11.895a
Shuttle walking test
S. Doffman (2001)
10.1002/1097-0142(20010915)92:6+<1689::AID-CNCR1498>3.0.CO;2-H
Effects of exercise on cancer‐related fatigue
F. Dimeo (2001)
10.1053/JPDN.2003.8
Pediatric oncology nursing.
M. Hockenberry (2003)
10.1016/J.EJCA.2003.12.005
Physical exercise results in the improved subjective well-being of a few or is effective rehabilitation for all cancer patients?
L. Oldervoll (2004)
10.1093/PTJ/84.8.736
Exercise as an intervention for cancer-related fatigue.
T. Watson (2004)
10.1002/PBC.10481
Effects of physical therapy intervention for children with acute lymphoblastic leukemia
V. Marchese (2004)
We consider that Tanir 2013 probably made a writing mistake as they reported in the same paper that the control group did and did not receive an exercise intervention
Hartman (2004)
10.1158/1055-9965.EPI-04-0703
Controlled Physical Activity Trials in Cancer Survivors: A Systematic Review and Meta-analysis
K. Schmitz (2005)
10.7326/0003-4819-143-9-200511010-00007
Limitations on Physical Performance and Daily Activities among Long-Term Survivors of Childhood Cancer
K. Ness (2005)
10.1093/PTJ/85.8.782
Proficiency of balance in children and youth who have had acute lymphoblastic leukemia.
M. Wright (2005)
10.1136/adc.2004.071241
Exercise capacity in apparently healthy survivors of cancer
E. De Caro (2006)
10.1080/13638490500523150
Physical function and fitness in long-term survivors of childhood leukaemia
M. van Brussel (2006)
10.1139/H06-014
Physical activity during treatment in children with leukemia: a pilot study.
S. Aznar (2006)
10.1093/ANNONC/MDM364
Cancer treatment-induced alterations in muscular fitness and quality of life: the role of exercise training.
C. Schneider (2007)
10.1001/JAMA.297.24.2705
Medical assessment of adverse health outcomes in long-term survivors of childhood cancer.
M. Geenen (2007)
10.3760/CMA.J.ISSN.1007-9742.2007.06.106
Placebo
赵红彬 (2007)
10.1016/J.JPAINSYMMAN.2006.09.025
Clinical field testing of an enhanced-activity intervention in hospitalized children with cancer.
P. Hinds (2007)
10.1182/BLOOD.V112.11.912.912
A Randomized Trial Investigating an Exercise Program to Prevent Osteoporosis and Motor Problems during Treatment for Childhood Acute Lymphoblastic Leukemia.
M. L. Winkel (2008)
10.1188/08.ONF.121-130
Childhood cancer survivors' perceived barriers to improving exercise and dietary behaviors.
W. Arroyave (2008)
10.1055/S-2007-964908
Functional capacity of children with leukemia.
A. F. San Juan (2008)
10.1002/pbc.21411
Body composition, exercise and energy expenditure in survivors of acute lymphoblastic leukaemia
J. Warner (2008)
10.1002/pbc.21325
Decrease in peripheral muscle strength and ankle dorsiflexion as long‐term side effects of treatment for childhood cancer
A. Hartman (2008)
10.1136/bmj.39493.646875.AE
Going from evidence to recommendations
G. Guyatt (2008)
10.1002/14651858.CD006145.pub2
Exercise for the management of cancer-related fatigue in adults.
F. Cramp (2008)
10.1136/bmj.39489.470347.AD
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
G. Guyatt (2008)
10.1002/pbc.21942
A randomized trial investigating an exercise program to prevent reduction of bone mineral density and impairment of motor performance during treatment for childhood acute lymphoblastic leukemia
A. Hartman (2009)
10.1002/cncr.24209
Predictors of inactive lifestyle among adult survivors of childhood cancer
K. Ness (2009)
10.1002/pbc.22055
Level of activity in children undergoing cancer treatment
Corinna C Winter (2009)
10.1097/MPH.0b013e3181978fd4
Fitness of Children With Standard-risk Acute Lymphoblastic Leukemia During Maintenance Therapy: Response to a Home-based Exercise and Nutrition Program
L. Moyer-Mileur (2009)
10.1002/cncr.24043
Promoting physical activity in childhood cancer survivors
C. Cox (2009)
Study assessed in adults with cancer te Winkel 2008 This study presents pilot data of a study
Hartman (2009)
published and unpublished
A Hartman (2009)
Friedman two-way test (Moyer-Mileur 2009), mixed-effects model (Yeh 2011), and repeated measure analyses (Hartman
Macedo (2009)
10.1519/JSC.0b013e3181b22ac5
Preliminary Findings of a 4-Month Intrahospital Exercise Training Intervention on IGFs and IGFBPs in Children with Leukemia
J. Ruiz (2010)
10.1038/leu.2010.54
Exercise in adult and pediatric hematological cancer survivors: an intervention review
K. Wolin (2010)
10.1002/pbc.22698
Effect of adapted physical activity sessions in the hospital on health‐related quality of life for children with cancer: A cross‐over randomized trial
E. Speyer (2010)
10.1590/S0103-05822010000400011
Treinamento muscular inspiratório em crianças com leucemia aguda: resultados preliminares
T. M. F. Macêdo (2010)
10.1249/JSR.0b013e3181de1214
Pediatric Resistance Training: Benefits, Concerns, and Program Design Considerations
A. Faigenbaum (2010)
10.1007/978-0-387-78665-0_6514
Randomized Controlled Trial
V. Preedy (2010)
10.1002/pbc.22271
Physical activity and childhood cancer
C. Winter (2010)
10.1249/MSS.0b013e3181c4dac1
Exercise during hematopoietic stem cell transplant hospitalization in children.
C. Chamorro-Viña (2010)
10.1002/14651858.CD008796
Exercise interventions for children and young adults during and after treatment for childhood cancer
K. Braam (2010)
Hartman 2009, and Marchese 2004, the differences were due to different methods of analysis. In this review, we assessed the final outcome differences between the study groups (Analysis
de Macedo (2010)
Characteristics of included studies [ordered by study
(2010)
10.1097/PEP.0b013e318227b3fc
Health-Related Fitness in Children and Adolescents
K. Ganley (2011)
10.1634/theoncologist.2011-0133
Physical exercise for cancer patients with advanced disease: a randomized controlled trial.
L. Oldervoll (2011)
10.1002/pbc.22713
Feasibility and parent satisfaction of a physical therapy intervention program for children with acute lymphoblastic leukemia in the first 6 months of medical treatment
Shadi Farzin Gohar (2011)
10.1055/s-0031-1271782
Implementation of structured physical activity in the pediatric stem cell transplantation.
A. Rosenhagen (2011)
10.1016/J.SCISPO.2011.06.002
Activité physique adaptée et qualité de vie liée à la santé lors d’un séjour hospitalier chez des enfants atteints d’un cancer : APOP, un essai randomisé en cross-over
E. Speyer (2011)
10.1002/14651858.CD006165.pub3
Interventions for latent autoimmune diabetes (LADA) in adults.
S. Brophy (2011)
10.1186/1471-2407-11-482
Isometric muscle training of the spine musculature in patients with spinal bony metastases under radiation therapy
H. Rief (2011)
10.1155/2011/461512
Exercise Interventions in Children with Cancer: A Review
Tseng-Tien Huang (2011)
10.1097/NCC.0b013e3181e4553c
A Pilot Study to Examine the Feasibility and Effects of a Home-Based Aerobic Program on Reducing Fatigue in Children With Acute Lymphoblastic Leukemia
C. Yeh (2011)
10.1097/PEP.0b013e318208cb22
The Utrecht approach to exercise in chronic childhood conditions: the decade in review.
M. van Brussel (2011)
10.1177/1740774511402368
Randomized controlled trial of a collaborative care intervention to manage cancer-related symptoms: lessons learned
J. Steel (2011)
10.1097/PEP.0b013e318235628c
Feasibility Study: The Effect of Therapeutic Yoga on Quality of Life in Children Hospitalized With Cancer
Russ Geyer (2011)
10.1186/1471-2407-12-401
EXERCISE in pediatric autologous stem cell transplant patients: a randomized controlled trial protocol
C. Chamorro-Viña (2012)
10.1002/14651858.CD006145.pub3
Exercise for the management of cancer-related fatigue in adults.
F. Cramp (2012)
10.1007/s00520-012-1707-1
The effect of individualized exercise interventions during treatment in pediatric patients with a malignant bone tumor
C. Winter (2012)
10.1002/14651858.CD008796.pub2
Physical exercise training interventions for children and young adults during and after treatment for childhood cancer.
K. Braam (2013)
10.1038/pr.2013.123
Clinical exercise interventions in pediatric oncology: a systematic review
F. Baumann (2013)
10.1002/pbc.24719
PHYSICAL ACTIVITY THROUGH HOME-BASED EXERCISE-GAMING AFTER CHILDHOOD BRAIN TUMOUR TREATMENT- A FEASABILITY STUDY
M. Sabel (2013)
10.1002/pon.3326
Effectiveness of an integrated adventure‐based training and health education program in promoting regular physical activity among childhood cancer survivors
Ho Cheung William Li (2013)
10.1016/j.cct.2013.05.012
Physical Activity in Pediatric Cancer patients with solid tumors (PAPEC): trial rationale and design.
L. Soares-Miranda (2013)
10.1002/rnj.58
Impact of Exercise on Lower Activity Levels in Children with Acute Lymphoblastic Leukemia: A Randomized Controlled Trial from Turkey
M. K. Tanir (2013)
10.1002/pbc.24306
Nutritional status of adolescents with hematological malignancies, bone tumors, and other solid tumors during the first year after diagnosis
R. Dalle Molle (2013)
10.1111/J.1099-1611.2013.3393
Effectiveness of an integrated adventure-based training and health education program in promoting physical activity among childhood cancer survivors
Whc Li (2013)
10.1016/j.leukres.2012.09.001
The emerging role of exercise and health counseling in patients with acute leukemia undergoing chemotherapy during outpatient management.
M. Jarden (2013)
The neuro-protective effects of exercise in children with brain tumours
D Mabbott (2013)
10.1186/1471-2431-14-94
Active video games to promote physical activity in children with cancer: a randomized clinical trial with follow-up
Lotta Kauhanen (2014)
10.1002/pbc.24937
Fit4Life: A weight loss intervention for children who have survived childhood leukemia
J. Huang (2014)
10.1016/J.REHAB.2014.03.1358
Effects of an adapted physical activity program with a playful pedagogy in a service of paediatric oncology
A. Herbinet (2014)
10.1016/j.chc.2014.05.007
Social skills training.
A. Mikami (2014)
Physical activity through home-based exercise-gaming after childhood brain tumour treatment. A method to improve motor and process
I Emanuelson (2014)
Effects on quality of life of participation in a combined physical exercise
EM S242–3. van Dijk-Lokkart (2014)
Interim analysis of the randomized prospective exercise therapy study in the pediatric stem cell transplantation (BISON). Bone Marrow
A Senn-Malashonak (2014)
published and unpublished
KI Braam (2014)
Published by John Wiley & Sons Ltd
Omid Azizi Farzan Modarresi (2015)
10.3760/CMA.J.ISSN.1671-0282.2016.02.029
Drug therapy
Feng Xiao (2016)



This paper is referenced by
10.1016/j.critrevonc.2021.103291
Psychosocial, Behavioral, and Supportive Interventions for Pediatric, Adolescent, and Young Adult Cancer Survivors: A Systematic Review and Meta-analysis.
Anao Zhang (2021)
10.1016/J.FT.2020.11.002
Prescripción del ejercicio en el paciente oncológico: una revisión sistemática
F. Avendaño (2021)
10.1007/978-3-030-49140-6_38
Physical Activity, Exercise and Sports in Young Cancer Patients
M. Götte (2021)
10.1177/00315125211002065
Motor and Basic Cognitive Functions in Children with Acute Lymphoblastic Leukemia Undergoing Induction or Consolidation Chemotherapy
Vesile Yildiz Kabak (2021)
10.1007/978-3-030-43032-0_16
Exercise and Physical Activity in Patients with Osteosarcoma and Survivors.
M. G. García (2020)
10.1007/978-3-030-25804-7_8
Technology to Support the Care of Children and Adolescents with Cancer
C. Baggott (2020)
10.1007/s00520-020-05629-0
Impact of respiratory physical therapy on heart rate autonomic control in children with leukemia
J. M. Kirizawa (2020)
10.1001/jamaoncol.2020.1658
Exercise and Well-being in Adult Survivors of Childhood Cancer-Time for Interventions.
J. Mack (2020)
10.1016/j.critrevonc.2020.103004
The effect of exercise and motor interventions on physical activity and motor outcomes during and after medical intervention for children and adolescents with acute lymphoblastic leukemia: A systematic review.
A. Coombs (2020)
10.2196/14549
Effectiveness of Serious Games to Increase Physical Activity in Children With a Chronic Disease: Systematic Review With Meta-Analysis
D. Bossen (2020)
10.1136/archdischild-2019-318017
Moving more: physical activity and its positive effects on long term conditions in children and young people
P. Dimitri (2020)
10.1016/j.bulcan.2020.08.008
Les soins de support pour améliorer l’accompagnement personnalisé des patients
C. Lervat (2020)
10.1055/a-1099-9592
Indoor Wall Climbing with Childhood Cancer Survivors: An Exploratory Study on Feasibility and Benefits.
J. Daeggelmann (2020)
10.1093/cvr/cvz031
Paediatric cardio-oncology: epidemiology, screening, prevention, and treatment
E. Chow (2019)
10.37382/jomts.v1i1.7
Efecto del ejercicio terapéutico en la calidad de vida de pacientes con cáncer de pulmón: Revisión sistemática de ensayos clínicos aleatorizados
Antonio Arredondo-López (2019)
10.1016/j.phoj.2019.12.004
Physical Activity level objectively measured by accelerometery in children undergoing cancer treatment at home and in a hospital setting: A pilot study.
L. B. Rehorst-Kleinlugtenbelt (2019)
10.1210/er.2018-00092
Long-Term Endocrine and Metabolic Consequences of Cancer Treatment: A Systematic Review.
J. Gebauer (2019)
10.1007/s00520-019-05131-2
Effects of a home-exercise programme in childhood survivors of acute lymphoblastic leukaemia on physical fitness and physical functioning: results of a randomised clinical trial
J. D. Manchola-González (2019)
10.1007/s40141-019-0213-5
Exercise in Children with Disabilities
Sherilyn W Driscoll (2019)
10.3138/PTC.2018-13.PP
A Scoping Review of Physical Therapy Interventions for Childhood Cancers.
P. Ospina (2019)
Improving the mental health of children and young people with long term conditions: Linked evidence syntheses
D. Moore (2019)
10.1007/s00520-019-05085-5
The VIE study: feasibility of a physical activity intervention in a multidisciplinary program in children with cancer
M. Caru (2019)
10.1002/pbc.27596
Improving body function and minimizing activity limitations in pediatric leukemia survivors: The lasting impact of the Stoplight Program
L. Tanner (2019)
10.4103/hm.hm_47_19
Satisfaction with an exercise physiology consultation after treatment for childhood cancer: An opportunity for healthy lifestyle education
D. Mizrahi (2019)
10.1111/ecc.13121
Classmates motivate childhood cancer patients to participate in physical activity during treatment: A qualitative study.
T. Thorsteinsson (2019)
10.1093/jncimonographs/lgz021
Dietary and Exercise Interventions for Pediatric Oncology Patients: The Way Forward.
A. Esbenshade (2019)
10.1016/S2352-3026(19)30050-X
The changing burden of long-term health outcomes in survivors of childhood acute lymphoblastic leukaemia: a retrospective analysis of the St Jude Lifetime Cohort Study.
D. Mulrooney (2019)
10.1177/1043454219858607
Kids Are Moving: A Physical Activity Program for Children With Cancer
M. Hooke (2019)
10.1016/j.ejpn.2018.12.005
Motor function in survivors of pediatric acute lymphoblastic leukemia treated with chemotherapy-only.
A. Goebel (2019)
10.3310/hta23220
Interventions to improve the mental health of children and young people with long-term physical conditions: linked evidence syntheses.
D. Moore (2019)
10.1093/jnci/djy229
Premature Aging in Young Cancer Survivors.
S. Armenian (2019)
10.1371/journal.pone.0196151
Psychosocial interventions for rehabilitation and reintegration into daily life of pediatric cancer survivors and their families: A systematic review
M. L. Peikert (2018)
See more
Semantic Scholar Logo Some data provided by SemanticScholar