Physical exercise training interventions for children and young adults during and after treatment for childhood cancer

• Published in: Cochrane database of systematic reviews 2013-04 (4), p.CD008796-CD008796
• Main Authors: Braam, Katja I, van der Torre, Patrick, Takken, Tim, Veening, Margreet A, van Dulmen-den Broeder, Eline, Kaspers, Gertjan J L
• Format: Article
• Language: English
• Subjects: Adolescent; Antineoplastic Agents - therapeutic use; Body Mass Index; Bone Density; Child; Controlled Clinical Trials as Topic; Exercise; Female; Humans; Male; Muscle Strength - physiology; Muscle, Skeletal - physiology; Neoplasms - therapy; Physical Endurance - physiology; Physical Fitness; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Quality of Life; Randomized Controlled Trials as Topic; Range of Motion, Articular - physiology
• ISSN: 1469-493X
• DOI: 10.1002/14651858.cd008796.pub2

A decreased physical fitness and impaired social functioning has been reported in patients and survivors of childhood cancer. This is influenced by the negative effects of disease and treatment of childhood cancer and by behavioural and social elements. Exercise training for adults during or after cancer therapy has frequently been reported to improve physical fitness and social functioning. More recently, literature on this subject became available for children and young adults with cancer, both during and after treatment. This review aimed to evaluate the effect of a physical exercise training intervention (at home, at a physical therapy centre, or hospital based) on the physical fitness of children with cancer, in comparison with the physical fitness in a care as usual control group. The intervention needed to be offered within the first five years from diagnosis.The second aim was to assess the effects of a physical exercise training intervention in this population on fatigue, anxiety, depression, self efficacy, and health-related quality of life and to assess the adverse effects of the intervention. For this review the electronic databases of CENTRAL, MEDLINE, EMBASE, CINAHL, PEDro, and ongoing trial registries were searched on 6 September 2011. In addition, a handsearch of reference lists and conference proceedings was performed in that same month. The review included randomised 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. By the use of standardised forms two review authors independently identified studies meeting the inclusion criteria, performed the data extraction, and assessed the risk of bias. Quality of the studies was rated by using the Grading of Recommendation Assessment, Development and Evaluation (GRADE) criteria. Five articles were included in this review: four RCTs (14, 14, 28, and 51 participants) and one CCT (24 participants). In total 131 participants (74 boys, 54 girls, three unknown) were included in the analysis, all being treated for childhood acute lymphoblastic leukaemia (ALL). The study interventions were all implemented during chemotherapy treatment.The duration of the training sessions ranged from 15 to 60 minutes per session. Both the type of intervention, as well as the intervention period, which ranged from 10 weeks to two years, varied in all the