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

• Published in: Supportive care in cancer 2020-07, Vol.28 (7), p.3171-3178
• Main Authors: Manchola-González, Jahn Dubery, Bagur-Calafat, Caritat, Girabent-Farrés, Montserrat, Serra-Grima, Josep Ricard, Pérez, Roser Álvarez, Garnacho-Castaño, Manuel Vicente, Badell, Isabel, Ramírez-Vélez, Robinson
• Format: Article
• Language: English
• Subjects: Anaerobic threshold; Childhood; Clinical trials; Exercise; Exercise therapy; Health aspects; Heart beat; Heart rate; Leukemia; Medicine; Medicine & Public Health; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Palliative care; Physical fitness; Rehabilitation Medicine
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-019-05131-2

Purpose The aim of this study was to evaluate the effects of a home-exercise programme on physical fitness indicators and physical functioning after completion of chemotherapy in children and adolescents diagnosed with acute lymphoblastic leukaemia (ALL). Methods Twenty-four survivors of ALL were assigned to usual care (control group, n = 12, 11.0 ± 3.7 years) or to a home-exercise programme (intervention group, n = 12, 11.8 ± 4.3 years). Peak oxygen uptake (VO 2 peak ml/kg/min), minute ventilation (VE L/min), output of carbon dioxide (VCO 2 L/min), respiratory exchange ratio (RER), peak heart rate (beats/min), maximal load (W), VO 2 at anaerobic threshold (VO 2 at AT, ml/kg/min), pulse oxygen (PO 2 ml/beat), heart rate at anaerobic threshold (beats/min), handgrip test (pounds), flexibility (cm), Timed Up & Go test TUG (s), and Timed Up and Down Stairs test (TUDS s) were measured at baseline and over 16 weeks of intervention. Results Adjusted mixed linear models revealed a significant group-time interaction + 6.7 (95% CI = 0.6–12.8 ml/kg/min; η 2 partial = 0.046, P = 0.035) for VO 2 peak. Similarly, changes in mean values were observed after the home-exercise programme compared with baseline for VE (L/min) − 8.8 (3.0) ( P = 0.035), VCO 2 − 0.2 (0.08), ( P = 0.041), maximal load (W) − 35.5 (12.8) ( P = 0.024), TUDS (s) 0.8 (2.6) ( P = 0.010), and TUG (s) 0.6 (0.1) ( P = 0.001); however, the group-time interaction was not significant. Conclusion The home-exercise programme resulted in changes in measures of VO 2 peak, VE, VCO 2 , and functional capacity during daily life activities (TUDS and TUG test). This is an interesting and important study that surely adds to the current body of knowledge/literature on the safety of exercise interventions, especially in children with haematological cancer.