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

• Published in: Cochrane database of systematic reviews 2016-03, Vol.3 (3), p.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; Cancer; Child; Child health; Controlled Clinical Trials as Topic; Exercise; Female; Humans; Late effects: therapy‐related side effects after treatment; 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; Supportive care: therapy‐related side effects during treatment
• ISSN: 1469-493X; 1469-493X
• DOI: 10.1002/14651858.CD008796.pub3

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. 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. 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. 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. 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. 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