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Caru M, Dandekar S, Gordon B, Conroy DE, Barb ED, Doerksen SE, Smink GM, McKeone DJ, Shah NB, Greiner RJ, Schramm JW, Rao P, McGregor L, Schmitz KH. Implementing a behavioral physical activity program in children and adolescent survivors of childhood cancer: a pilot randomized controlled trial. J Behav Med 2024:10.1007/s10865-024-00497-z. [PMID: 38735024 DOI: 10.1007/s10865-024-00497-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/30/2024] [Indexed: 05/13/2024]
Abstract
Purpose We aimed to document the acceptability (enrollment rate) and feasibility (phone call delivery rate) of implementing a behavioral PA intervention over 12 weeks, in addition to documenting its effects on patient-reported outcomes and physical functioning. This study also describes the costs of carrying out a behavioral PA intervention. A total of 40 participants were randomized in a 1:1 ratio. The tailored behavioral PA intervention was developed based on the most recent PA guidelines in pediatric oncology and on the COM-B framework to enact PA behavior changes. The prescription (frequency, intensity, time and type (FITT)) was adjusted each week during the weekly support calls. The control group did not receive the intervention. 26 males and 14 females (13.6 years old on average and 2.9 years post-cancer treatment on average) participated in our study. The acceptability rate was 90.9% and the feasibility rate was > 85%. We found that 85% improved PA frequency, 80% improved PA intensity, 100% improved PA time, and 50.0% achieved the recommended PA guidelines. No adverse events were reported over the duration of the intervention. Physical function improved with longer 6-minute walk distances in the intervention group (465.8 ± 74.5 m) than in the control group (398.7 ± 92.9 m) (p = 0.016). PROs scores for all participants were within the limits of the normal range. The estimated cost per participant of carrying out this intervention was USD $126.57. Our 12-week behavioral PA intervention, based on the COM-B framework, was found to be acceptable, feasible and safe in childhood cancer survivors. This study is an important step in the right direction to make exercise standard practice in pediatric oncology.
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Affiliation(s)
- Maxime Caru
- Department of Pediatrics, Division of Hematology and Oncology, Pennsylvania State Health Children's Hospital, 500 University Drive, Hershey, PA, 17033, USA.
- Department of Public Health Sciences, Penn State University College of Medicine, Hershey, PA, USA.
| | - Smita Dandekar
- Department of Pediatrics, Division of Hematology and Oncology, Pennsylvania State Health Children's Hospital, 500 University Drive, Hershey, PA, 17033, USA
| | - Brett Gordon
- Department of Public Health Sciences, Penn State University College of Medicine, Hershey, PA, USA
| | - David E Conroy
- Department of Kinesiology, Penn State University, University Park, PA, USA
| | - Emily D Barb
- School of Kinesiology, Pennsylvania State University-Harrisburg, Middletown, PA, USA
| | - Shawna E Doerksen
- Division of Hematology and Oncology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Gayle M Smink
- Department of Pediatrics, Division of Hematology and Oncology, Pennsylvania State Health Children's Hospital, 500 University Drive, Hershey, PA, 17033, USA
| | - Daniel J McKeone
- Department of Pediatrics, Division of Hematology and Oncology, Pennsylvania State Health Children's Hospital, 500 University Drive, Hershey, PA, 17033, USA
| | - Nidhi B Shah
- Department of Pediatrics, Division of Hematology and Oncology, Pennsylvania State Health Children's Hospital, 500 University Drive, Hershey, PA, 17033, USA
| | - Robert J Greiner
- Department of Pediatrics, Division of Hematology and Oncology, Pennsylvania State Health Children's Hospital, 500 University Drive, Hershey, PA, 17033, USA
| | - Joseph W Schramm
- Department of Pediatrics, Division of Hematology and Oncology, Pennsylvania State Health Children's Hospital, 500 University Drive, Hershey, PA, 17033, USA
| | - Pooja Rao
- Department of Pediatrics, Division of Hematology and Oncology, Pennsylvania State Health Children's Hospital, 500 University Drive, Hershey, PA, 17033, USA
| | - Lisa McGregor
- Department of Pediatrics, Division of Hematology and Oncology, Pennsylvania State Health Children's Hospital, 500 University Drive, Hershey, PA, 17033, USA
| | - Kathryn H Schmitz
- School of Kinesiology, Pennsylvania State University-Harrisburg, Middletown, PA, USA
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Kappelmann L, Götte M, Krombholz A, Hüter J, Fischer B. Factors That Influence Physical Activity Behavior in Children and Adolescents During and After Cancer Treatment: A Qualitative Systematic Review of the Literature. Pediatr Exerc Sci 2024; 36:106-114. [PMID: 37890837 DOI: 10.1123/pes.2022-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 07/31/2023] [Accepted: 08/23/2023] [Indexed: 10/29/2023]
Abstract
PURPOSE The aim of this systematic review is to reveal the social, personal, and contextual factors that influence physical activity (PA) in children and adolescents during and after cancer treatment. METHOD SPORTDiscus, Cochrane, Web of Science, PubMed, and FIS Education electronic database were systematically searched. RESULTS The 13 included studies show that social support (parents, siblings, and friends) in particular is rated as important by cancer survivors; for example, doing PA together. Depending on the treatment status and state of health, particularities arise. During the acute treatment phase, parents issued more prohibitions regarding PA than after treatment. The state of health and concern about infections are described as inhibiting factors. Not all hospitals generally offer special exercise programs for cancer patients, and in some cases, only sporadic exercise sessions were conducted by specialized staff. In addition, the hospital atmosphere, such as cramped rooms, tends to be associated with demotivating effects. CONCLUSIONS Both inhibiting and promoting factors in the area of social, personal, and contextual factors could be identified. The most fundamental factor for PA is the physical condition. Social factors, such as parents or friends, often have a motivating effect and can promote PA. Inhibiting factors are mainly context-related, such as an environment unsuitable for PA. Although the review highlights interesting aspects, further treatment-related and longitudinal studies could provide deeper insights.
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Affiliation(s)
- Laura Kappelmann
- Department of Sport Science, Christian-Albrechts-University of Kiel, Kiel,Germany
| | - Miriam Götte
- West German Cancer Center, University Hospital Essen, Essen,Germany
| | - Arno Krombholz
- Faculty of Sport Science, Ruhr-University Bochum, Bochum,Germany
| | - Jan Hüter
- Faculty of Sport Science, Ruhr-University Bochum, Bochum,Germany
| | - Britta Fischer
- Department of Sport Science, Christian-Albrechts-University of Kiel, Kiel,Germany
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Shen C, Gu L, Li N, Wang R, Yang X, Chu Z. Attitudes and perceptions of cancer patients and healthcare providers towards prehabilitation: A thematic synthesis. Br J Health Psychol 2024; 29:395-429. [PMID: 37985361 DOI: 10.1111/bjhp.12705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE Prehabilitation, which is the process of enhancing functional capacity before undergoing surgery or other treatments, has been shown to improve cancer patients' outcomes. Patient and healthcare provider attitudes and perceptions are essential factors in the successful implementation of prehabilitation. The purpose of this systematic review is to synthesize qualitative evidence and explore the barriers and facilitators to prehabilitation implementation. METHODS From the earliest available date to October 2023, 7 databases (PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, and MEDLINE) were searched for a systematic review. Data were extracted, thematically analysed, and mapped onto the Capability, Opportunity, and Motivation Model of Behaviour (COM-B). The Critical Appraisal Skills Programme (CASP) tool was used to assess the quality of the studies. RESULTS A total of 26 studies were included, involving 377 patients, 51 caregivers, and 156 healthcare providers. 16 factors were identified and mapped onto the COM-B model: reflective/automatic motivation, physical/social opportunity, physical/ psychological capability. CONCLUSIONS Patients and healthcare provides identified a lack of reflective motivation and physical opportunities as the most significant barriers to engagement in prehabilitation. Personalized approaches, social support, and healthcare providers' engagement are key factors for prehabilitation. Future research should focus on developing effective interventions to enhance the uptake and sustainability of prehabilitation.
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Affiliation(s)
- Chen Shen
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Lianqi Gu
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Na Li
- The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Rao Wang
- The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xin Yang
- The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhiping Chu
- The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Adamovich T, Watson R, Murdoch S, Giovino L, Kulkarni S, Luchak M, Smith-Turchyn J. Barriers and facilitators to physical activity participation for child, adolescent, and young adult cancer survivors: a systematic review. J Cancer Surviv 2024; 18:245-262. [PMID: 35665472 DOI: 10.1007/s11764-022-01217-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this systematic review is to explore and describe the barriers and facilitators to physical activity (PA) participation for child, adolescent, and young adult cancer survivors. METHODS MEDLINE, Embase, AMED, CINAHL, Cochrane, and Web of Science were searched for manuscripts published between January 2000 and February 2021. To be included in this review, studies had to report qualitative or quantitative data on barriers and facilitators to PA participation in child (4 to < 10 years), adolescent (10 to 19 years), and young adult (> 19 to < 40 years) cancer survivors. Six independent reviewers assessed methodological quality using the Mixed Methods Appraisal Tool (MMAT-version 18) in duplicate. RESULTS Fifteen studies were included in this systematic review. Fatigue and psychological factors were the most prevalent barriers shared between children, adolescents, and young adults. Support from others was a shared facilitator between age groups. CONCLUSION Psychological barriers and social support are important to address in younger cancer survivors. Clinicians can use these findings to create exercise interventions to facilitate and overcome barriers to PA participation. IMPLICATIONS FOR CANCER SURVIVORS While PA is beneficial for cancer survivors of all ages, different barriers and facilitators to PA participation exist depending on a survivors age and life stage. Survivors should discuss PA with their healthcare team at all timepoints in the cancer treatment trajectory in order to gain the associated benefits during and after treatment.
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Affiliation(s)
- Tatsiana Adamovich
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Rebecca Watson
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Sydney Murdoch
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Liana Giovino
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Sunket Kulkarni
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Michael Luchak
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Jenna Smith-Turchyn
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada.
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Doi Y, Ogawa M, Ishihara K, Inoue J, Izawa KP. Effects of Group Exercise Intervention on Quality of Life and Physical Parameters in Patients with Childhood Cancer: A Systematic Review. Curr Oncol 2024; 31:1035-1046. [PMID: 38392071 PMCID: PMC10887515 DOI: 10.3390/curroncol31020077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/14/2024] [Accepted: 02/14/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Although the survival rates of childhood cancer are increasing, children diagnosed as having cancer experience psychological and physical problems and a declining quality of life (QOL). METHODS A systematic review of PubMed databases was conducted up to September 2023 to identify studies reporting the effects of group exercise intervention in children with cancer. The inclusion criteria were pre-specified, including children aged ≤19 years old who received group exercise intervention and interventional studies written in English. Studies involving non-exercise intervention or non-group intervention were excluded. RESULTS Five studies were included in the present review. In three studies, QOL and physical parameters were improved after group exercise intervention, and in two studies, only physical parameters were improved. Improvements in QOL were achieved through psychosocial variables, improved scores of subscales of pain and hurt, nausea, and procedure-related anxiety, and reduced cancer-related fatigue. All studies had high numbers of participants who completed the intervention. However, all studies showed a high risk of bias regarding the selection of the reported results, and most studies showed a high risk of bias regarding deviations from the intended intervention and outcome measurement. CONCLUSION The reviewed studies showed that group exercise intervention for children with cancer could improve their QOL and/or physical parameters.
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Affiliation(s)
- Yurina Doi
- Department of Health Science, Faculty of Medicine, Kobe University, 7-10-2 Tomogaoka, Kobe 654-0142, Japan;
| | - Masato Ogawa
- Department of Rehabilitation, Faculty of Health Sciences, Osaka Health Sciences University, 1-9-27 Temma, Osaka 530-0043, Japan;
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Kobe 654-0142, Japan;
- Cardiovascular stroke Renal Project (CRP), 7-10-2 Tomogaoka, Kobe 654-0142, Japan
| | - Kodai Ishihara
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Kobe 654-0142, Japan;
- Cardiovascular stroke Renal Project (CRP), 7-10-2 Tomogaoka, Kobe 654-0142, Japan
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, 6-2-23 Morikitamachi, Kobe 658-0001, Japan
| | - Junichiro Inoue
- Division of Rehabilitation Medicine, Kobe University Hospital International Clinical Cancer Research Center, 1-5-1 Minatojima Minamimachi, Kobe 650-0047, Japan;
| | - Kazuhiro P. Izawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Kobe 654-0142, Japan;
- Cardiovascular stroke Renal Project (CRP), 7-10-2 Tomogaoka, Kobe 654-0142, Japan
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Alelayan H, Zhao Y, Lin K, Meng J, Huang H, Liao X. Can performance status mediate the relationship between therapy-related symptoms and health-related quality of life in children with cancer? A mediation model. Eur J Oncol Nurs 2024; 68:102513. [PMID: 38309256 DOI: 10.1016/j.ejon.2024.102513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/15/2023] [Accepted: 01/22/2024] [Indexed: 02/05/2024]
Abstract
PURPOSE Understanding the interplay among health-related quality of life (HRQoL), therapy-related symptoms, and performance status can offer insights into potential strategies to enhance HRQoL for pediatric cancer patients. This study aimed to examine the mediating effect of performance status on the relationship between symptom burden and HRQoL in children and adolescents with cancer. METHOD A cross-sectional study was conducted. Participants were recruited from two tertiary hospitals located in Guangzhou, China. HRQoL, therapy-related symptoms, and performance status were assessed using the DISAKIDS Chronic Generic Measure (DCGM-37), Therapy-Related Symptom Checklist for Children (TRSC-C), and Lansky Play Performance Scale (LPPS), respectively. RESULTS A total of 287 children with cancer (aged 11.08 ± 2.34 years) were included. The DCGM-37 scores were 59.70 ± 9.64. Emotion (56.45 ± 14.56) and physical limitations (58.59 ± 15.38) were the most affected domains. The number of symptoms experienced was 12.49 ± 5.95. The DCGM-37 demonstrated strong negative correlations with the TRSC-C (r = -0.60, P < 0.001) and number of symptoms (r = -0.62, P < 0.001), but mild-to-moderate negative correlations (r -0.16∼ -0.42, P < 0.05) with individual symptoms. The TRSC-C demonstrated an indirect effect on the DCGM-37 via the LPPS (Bootstrap-corrected standardized β = -0.05, 95 % CI -0.10∼ -0.01; SE = 0.02). Additional analysis showed that tripping/falling (OR = 4.02, 95 % CI 2.02-7.98; P < 0.001) and sore mouth (OR = 2.38, 95 % CI 1.56-3.64; P < 0.001) were associated factors for presenting poor performance status in children undergoing acute chemotherapy. CONCLUSIONS The accumulated symptom burden, rather than individual symptoms, weighs heavily on the HRQoL. Performance status partially mediated the relationship between symptom burdens and HRQoL among these patients.
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Affiliation(s)
- Hasan Alelayan
- School of Nursing, Southern Medical University, China; Nursing Department, Zengchang Campus, Nanfang Hospital, Southern Medical University, China
| | - Yuxuan Zhao
- School of Nursing, Southern Medical University, China; Nursing Department, Zengchang Campus, Nanfang Hospital, Southern Medical University, China
| | - Kai Lin
- Nursing Department, Zengchang Campus, Nanfang Hospital, Southern Medical University, China
| | - Jiangnan Meng
- Pediatric Department, Nanfang Hospital, Southern Medical University, China
| | - Haiying Huang
- Hematology and Oncology of Pediatric Department, Guangzhou Women's and Children's Medical Center, China
| | - Xiaoyan Liao
- School of Nursing, Southern Medical University, China; Nursing Department, Zengchang Campus, Nanfang Hospital, Southern Medical University, China; School of Nursing, Guangzhou Medical University, China.
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Shabanian J, Capaldi JM, Luna-Lupercio B, Finster LJ, Noskoff K, Gan H, Davies S, Whiteway SL, Shirazipour CH. Healthcare providers' promotion of physical activity among child and adolescent cancer survivors: strategies and challenges. J Cancer Surviv 2023; 17:1546-1560. [PMID: 35759086 PMCID: PMC9244136 DOI: 10.1007/s11764-022-01218-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/19/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE This study aims to investigate how healthcare providers (HCPs) promote physical activity (PA) to child and adolescent cancer survivors. METHODS Semi-structured interviews were conducted with HCPs (n = 16; women n = 12; men n = 4) who provide care for cancer survivor youth (age 3 to 18). Participants represented 7 professions, including child life specialists, oncologists, nurse practitioners, physical therapists, and social workers. A reflexive thematic analysis was conducted to explore the techniques that HCPs use to promote PA for this patient population and ways PA promotion can improve. RESULTS HCPs use five strategies to promote PA to cancer survivor youth: (1) broadening the definition of PA, (2) tailoring PA recommendations, (3) including families, (4) connecting patients to programming, and (5) promoting patient motivation. CONCLUSIONS This research highlights techniques that HCPs use to promote PA to young cancer survivors and reveals the need for additional ways to support HCPs to improve PA promotion for child and adolescent cancer survivors. While HCPs emphasized the importance of PA for this patient population, they navigate barriers that limit the quality of PA discussions. IMPLICATIONS FOR CANCER SURVIVORS Further research should explore interventions to improve PA promotion and PA participation among child and adolescent cancer survivors. By understanding the perspectives of HCPs, patients, and their families, PA promotion strategies can be improved, and more programs that support both patients and practitioners may be developed.
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Affiliation(s)
- Julia Shabanian
- Cedars-Sinai Medical Center, Cancer Research Center for Health Equity, 700 N San Vicente Blvd, 5th Floor, West Hollywood, CA, 90069, USA
| | - Jessica M Capaldi
- Cedars-Sinai Medical Center, Cancer Research Center for Health Equity, 700 N San Vicente Blvd, 5th Floor, West Hollywood, CA, 90069, USA
| | - Bianca Luna-Lupercio
- Cedars-Sinai Medical Center, Cancer Research Center for Health Equity, 700 N San Vicente Blvd, 5th Floor, West Hollywood, CA, 90069, USA
| | - Laurel J Finster
- Cedars-Sinai Medical Center, Cancer Research Center for Health Equity, 700 N San Vicente Blvd, 5th Floor, West Hollywood, CA, 90069, USA
| | | | - Hilary Gan
- Teen Cancer America, Los Angeles, CA, USA
| | | | - Susan L Whiteway
- Walter Reed National Military Medical Center, Bethesda, MD, USA
- Uniformed Services University Health Sciences, Bethesda, MD, USA
| | - Celina H Shirazipour
- Cedars-Sinai Medical Center, Cancer Research Center for Health Equity, 700 N San Vicente Blvd, 5th Floor, West Hollywood, CA, 90069, USA.
- Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
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Carniel CF, Rosin BM, de Souza BC, Raimundo RD. Pediatric oncohematological exercise program in hospital: clinical trial study protocol. Future Oncol 2023; 19:1385-1395. [PMID: 37497690 DOI: 10.2217/fon-2023-0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
Leukemias are the most common types of hematological cancers in children, and negatively impact functional capacity. There is evidence in the literature that therapeutic exercises can have a positive impact on functions. The aim of this study is to evaluate functional capacity, muscle strength, fatigue and quality of life through the application of a protocol of therapeutic exercises during pediatric leukemia hospitalization. Children will be allocated into two groups: one will carry out a protocol of therapeutic exercises, while the other will undergo conventional respiratory physiotherapy. The protocol is approved by the ethics and research committee of the host institution (No. 5.439.594). Results will be disseminated through peer-reviewed journal articles and conferences. Clinical trial registration: RBR-8sxnfyd (https://ensaiosclinicos.gov.br).
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Affiliation(s)
- Cintia Freire Carniel
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, 09060-590, Brazil
| | - Beatriz M Rosin
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, 09060-590, Brazil
| | - Bruna Cunha de Souza
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, 09060-590, Brazil
| | - Rodrigo Daminello Raimundo
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, 09060-590, Brazil
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Rapti C, Dinas PC, Chryssanthopoulos C, Mila A, Philippou A. Effects of Exercise and Physical Activity Levels on Childhood Cancer: An Umbrella Review. Healthcare (Basel) 2023; 11:healthcare11060820. [PMID: 36981477 PMCID: PMC10048410 DOI: 10.3390/healthcare11060820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 03/14/2023] Open
Abstract
Patients and survivors of childhood cancer experience adverse effects related to the disease and its treatment. These adverse effects are associated with both physiological and psychological health. Exercise helps manage the side effects and improve the health outcomes. The objective of this umbrella review is to search the current literature in the context of exercise and physical activity as complementary interventions on pediatric cancer and to provide comprehensive information about the derived health outcomes. A literature search was conducted on the Cochrane, PubMed, and Embase databases for systematic reviews published up to January 2023. Moreover, a hand search of reference lists was performed. We included participants under 19 years of age at diagnosis of any type of childhood cancer, without restriction on the type or phase of treatment, who participated in exercise interventions. The results showed a beneficial impact on fatigue, muscle strength, aerobic capacity, activity and participation levels, psychosocial health, cardiovascular/cardiorespiratory fitness, physical function, bone mineral density, and brain volume and structure, with limited and not serious adverse effects. These findings documented that exercise interventions had a positive effect on many physiological and psychological health outcomes in pediatric cancer patients and survivors.
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Affiliation(s)
- Christina Rapti
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Petros C. Dinas
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Costas Chryssanthopoulos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Alexandra Mila
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Anastassios Philippou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
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Self-reported physical activity behaviors of childhood cancer survivors: comparison to a general adolescent population in Korea. Support Care Cancer 2023; 31:164. [PMID: 36781555 DOI: 10.1007/s00520-023-07612-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/25/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE Adequate physical activity (PA) can significantly contribute to the prevention of undesirable health outcomes in childhood cancer survivors (CCS). This study aimed to identify the patterns of PA and related factors in Korean CCS. METHODS Study subjects were 184 adolescents selected from an ongoing cohort study of Korean CCS and 1,840 sex- and school grade-matched controls randomly selected from the participants of the 2019 Korea Youth Risk Behavior Web-based Survey. Information on PA and sedentary behaviors was collected by self-administered questionnaire. We estimated body mass index (BMI)-adjusted odds ratio (OR) and 95% confidence interval (CI) for the advisable healthy behaviors of CCS compared with healthy controls using conditional logistic regression analysis. In addition, the associations of advisable healthy behaviors of CCS with sociodemographic and clinical factors were estimated using multiple logistic regression analysis. RESULTS CCS were less likely to be physically active than controls, but this finding was evident only in males. The ORs (95% CIs) for regular exercise, moderate intensity PA, vigorous intensity PA, and walking were 0.42 (0.27-0.65), 0.39 (0.24-0.63), 0.53 (0.33-0.84), and 0.64 (0.42-0.98), respectively, in male CCS compared with same-sex controls. Compared with same-sex controls, male CCS were 4.60 times and female survivors were 15.19 times more likely to sleep longer than 8 h a day. Among CCS, males were 2.92 times and 3.07 times more likely to perform moderate intensity PA and muscle-strengthening exercise, respectively, than female. Higher BMI (OR: 1.16), highest family income (OR: 3.98), and a caregiver who performed regular exercise (OR: 2.08) were positively associated with vigorous intensity PA of CCS. With increasing time after treatment completion, the probability of engaging in sedentary activity for less than 6 h per day decreased (OR = 0.89, 95% CI 0.79-1.00). CONCLUSION Korean adolescent CCS were physically inactive compared with control adolescents. Several sociodemographic factors such as sex, family income, caregiver PA, and obesity level were associated with PA behaviors of CCS. IMPLICATIONS Strategic effort would be needed to increase physical activity of childhood cancer survivors in adolescent period with consideration of various sociodemographic factors found in this study.
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McGrady ME, Perez MN, Bernstein J, Strenk M, Kiger MA, Norris RE. Adherence and Barriers to Inpatient Physical Therapy Among Adolescents and Young Adults with Hematologic Malignancies. J Adolesc Young Adult Oncol 2022; 11:605-610. [PMID: 35049383 DOI: 10.1089/jayao.2021.0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
This study described inpatient physical therapy (PT) adherence and barriers to inpatient PT among adolescents and young adults (AYAs) with hematologic malignancies receiving care at a Midwestern children's hospital. Forty-seven AYAs receiving care over a 2-year period were included. PT contact was established in 93% of hospitalizations. AYAs declined an average of 34% of PT visits, resulting in PT visits on 27% of hospitalized days, 1 day less than the goal of 3 days a week. The most frequent reasons for decline included: AYA sleeping (22%), AYA undergoing medical procedure (18%), and AYA not feeling well (12%).
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Affiliation(s)
- Meghan E McGrady
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Megan N Perez
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jennifer Bernstein
- Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Mariann Strenk
- Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Michelle A Kiger
- Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Robin E Norris
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.,Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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12
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Petersen NN, Larsen HB, Pouplier A, Schmidt‐Andersen P, Thorsteinsson T, Schmiegelow K, Fridh MK. Childhood cancer survivors' and their parents' experiences with participation in a physical and social intervention during cancer treatment: A RESPECT study. J Adv Nurs 2022; 78:3806-3816. [PMID: 35942568 PMCID: PMC9804908 DOI: 10.1111/jan.15381] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/21/2022] [Accepted: 07/09/2022] [Indexed: 01/09/2023]
Abstract
AIMS This study explores experiences of childhood cancer survivors and their parents with a combined physical and social activity intervention during treatment, including how the survivors and their parents perceive physical activity post-treatment. DESIGN A process evaluation using semi-structured interviews. METHODS Using a criterion-sampling strategy, 18 Danish childhood cancer survivors (aged 11-18 years) and their parents were interviewed from September 2019 through May 2020. Data analysis used an inductive thematic approach focused on meaning. RESULTS Three themes emerged: (1) being physically active during hospitalization; (2) peers as motivators and (3) physical activity post-treatment. During hospitalization, daily motivation to do physical activity was dependent on the daily well-being, that is, presence of the side effects from the child's treatment. Healthy classmates provided distraction, reduced loneliness and promoted normality for those hospitalized. For most of the survivors, their healthy peers provided motivation for being physically active during treatment. When surplus energy was lacking, some survivors preferred doing physical activity alone with a professional. Those who were physically active in the hospital sustained being physically active post-treatment while their parents continued seeking advice about appropriate activity levels. CONCLUSION Childhood cancer survivors and their parents benefited from the intervention which also provided guidance to remaining physically active post-treatment. This was particularly true for the participants with leukaemia. IMPACT Healthcare professionals should support children with cancer to be physically active during hospitalization. Including social and physical components in their care plan and being aware of individual preferences is pivotal to improving the survivors' level of physical and social well-being during and post-treatment. PATIENT OR PUBLIC CONTRIBUTION The participants were involved in designing the interview guides to ensure that the interview guides were understandable for the participants to provide rich descriptions of their experiences with a physical and social activity intervention during hospitalization.
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Affiliation(s)
- Natasha Nybro Petersen
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
| | - Hanne Bækgaard Larsen
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark,Faculty of Health SciencesUniversity of Copenhagen and The Pediatric Clinic, Juliane Marie Centre, University Hospital (Rigshospitalet)CopenhagenDenmark
| | - Anna Pouplier
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
| | - Peter Schmidt‐Andersen
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
| | - Troels Thorsteinsson
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark,Faculty of Health SciencesUniversity of Copenhagen and The Pediatric Clinic, Juliane Marie Centre, University Hospital (Rigshospitalet)CopenhagenDenmark
| | - Martin Kaj Fridh
- Department of Pediatrics and Adolescent MedicineUniversity Hospital (Rigshospitalet)CopenhagenDenmark
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13
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Xu F, Jin X, Chen Y, Guan Z, Zhou R, Xu X, Mao J, Shen Z, Jin L, Liu Y, Chen H, Gu R, Wang J, Wang H. Associated factors on physical activity among childhood cancer survivors in Mainland China: a qualitative exploration applied health belief model. Support Care Cancer 2022; 30:9221-9232. [PMID: 36056273 DOI: 10.1007/s00520-022-07324-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/09/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Regular physical activity (PA) is essential for childhood cancer survivors (CCS), yet most CCS have difficulty participating in it. The level of PA participation among CCS in China is lower than those of western countries, leading to a worse long-term survival of CCS in China. Here, the study aims to explore the associated factors on the PA performance among CCS. METHODS From September to December 2020, the study used purposive sampling to recruit 35 families (88.9%) as sampling units among two hospitals in Hangzhou City, China. The data collection conducted two designs on semi-structured interviews with different roles under family structure - children (n = 35) and parents (n = 35) - respectively. The design of predetermined questions relied on the health belief model (HBM) as a thematic framework. The qualitative analysis applied codebook thematic analysis and used the deductive approach to finalize the main findings. RESULTS The study only presented preliminary conclusions from interviews with CCS, which resulted in four themes (changes in PA performance; perceptions on participating PA; cognitions of PA; impacts from others) with eight sub-themes. In particular, CCS replied diversity changes in PA, but most of them mentioned the inactive PA after diagnosis, especially the decline of moderate-to-vigorous PA (MVPA). As for the "perceptions of PA," almost all CCS had substantial perceived benefits about PA, specifically on their physical well-being. All children also expressed perceived barriers to PA, including the side effects of disease and treatment, fatigue, academic burden, changes in psychological status, and lack of companions. On the cognitions of PA, the CCS had limited realizations of regular PA and low self-efficacy on MVPA. Furthermore, CCS expressed their need for support from their parents, school teachers, and healthcare providers. But in reality, they recieved less support on PA from these important people. CONCLUSION The changes in PA after illness among CCS are apparent and unavoidable because of the interaction impacts from internal factors (e.g., personal characters, cognization, perceptions of PA) and external factors (e.g., disease effects, interpersonal supports). The findings explained the main elements under HBM but also provided explored views as the evidence on developing theories and guiding motivations and practices on PA among CCS. IMPLICATIONS FOR CANCER SURVIVORS In this exploratory study of 35 CCS, we identified the current situation of PA among CCS in China and explored the associated factors. As the first qualitative study on the CCS in mainland China, the study considered particular effects on social culture and living environment.
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Affiliation(s)
- Fengjiao Xu
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China
| | - Xiaoyuan Jin
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China
| | - Ying Chen
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China
| | - Zhonghai Guan
- Department of Oncology Surgery, the Children's Hospital of Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China
| | - Rui Zhou
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China
| | - Xiaojun Xu
- Department of Hematology &Oncology, the Children's Hospital of Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China
| | - Junqing Mao
- Department of Oncology Surgery, the Children's Hospital of Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China
| | - Zhipeng Shen
- Department of Neurosurgery, the Children's Hospital of Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China
| | - Libin Jin
- Department of Department of Orthopedic, the Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China
| | - Yunxia Liu
- Department of Oncology, Hangzhou Third People's Hospital, Zhejiang Province, Hangzhou, People's Republic of China
| | - Hao Chen
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China
| | - Renjun Gu
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China
| | - Jinhu Wang
- Department of Oncology Surgery, the Children's Hospital of Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China.
| | - Hongmei Wang
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China.
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A National Implementation Approach for Exercise as Usual Care in Pediatric and Adolescent Oncology: Network ActiveOncoKids. Pediatr Exerc Sci 2022; 34:219–226. [PMID: 35700978 DOI: 10.1123/pes.2021-0218] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/04/2022] [Accepted: 03/01/2022] [Indexed: 01/19/2023]
Abstract
The diagnosis of cancer as well as accompanying acute and late effects of treatment are influencing physical activity behavior of patients with childhood cancer and survivors. Research has shown that a pediatric cancer diagnosis is associated with impairments of physical performance, and function, as well as reduced physical, and psychosocial, health conditions. From an ethical perspective, lack of knowledge of health care providers, lack of physical activity promotion, and environmental, and structural barriers to physical activity restrict children's right to move and actively engage in physical activities. Network ActiveOncoKids is a German-wide initiative with the main goal of enabling children, adolescents, and young adults with exercise opportunities during and after cancer treatment. Since the network's foundation in 2012, Network ActiveOncoKids focuses on: (1) physical activity support for patients and families, (2) policy change to establish structures and guidelines, and (3) generating evidence through scientific projects. The purpose of this paper is to present an overview of Network ActiveOncoKids structure, aims, and projects. This topical review will highlight the network's structural development, research work, and implementation progress of exercise programs for patients with pediatric cancer and survivors, link international collaborations, and discuss future directions.
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15
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Götte M, Gauß G, Dirksen U, Driever PH, Basu O, Baumann FT, Wiskemann J, Boos J, Kesting SV. Multidisciplinary Network ActiveOncoKids guidelines for providing movement and exercise in pediatric oncology: Consensus-based recommendations. Pediatr Blood Cancer 2022; 69:e29953. [PMID: 36073842 DOI: 10.1002/pbc.29953] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/01/2022] [Accepted: 08/09/2022] [Indexed: 01/23/2023]
Abstract
BACKGROUND Pediatric cancer leads to reduced participation in exercise and only few patients comply with national physical activity recommendations. Physically inactive behavior hinders motor development and increases physical and psychological adverse effects of therapy and incidence of sequelae. Currently, there is neither nationwide coverage nor uniform level of knowledge regarding exercise promotion. The objective of the guideline is to facilitate qualified exercise interventions through standardized procedures in addition to regular physiotherapy and overall avoid physical inactivity in pediatric cancer patients. METHODS This guideline addresses the multidisciplinary treatment team and informs physiotherapists and decision-makers in tertiary care hospitals and health insurance companies. The requirements of the Association of the Scientific Medical Societies in Germany were followed. Contents were based on best practice experience of experts, patient advocates, as well as on scientific evidence. RESULTS The guideline includes 11 recommendations. Recommendations 1-4 declare the relevance of implementing exercise interventions and address general framework conditions. Recommendations 5-11 focus on the design of exercise programs, prevention and safety issues, relative contraindications for specific training loads, and options to overcome barriers to exercise. CONCLUSION This guideline summarizes existing and established structures and evidence in the context of movement and exercise in pediatric oncology. It takes into consideration the rights, varying needs, and characteristics of children and adolescents as well as national and international experience in this field. In the future, relevant research gaps need to be addressed by high-quality intervention studies to provide the scientific background for a stronger evidence-based guideline.
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Affiliation(s)
- Miriam Götte
- Department of Pediatric Hematology/Oncology, Clinic for Pediatrics III, West German Cancer Centre, University Hospital Essen, Essen, Germany
| | - Gabriele Gauß
- Department of Pediatric Hematology/Oncology, Clinic for Pediatrics III, West German Cancer Centre, University Hospital Essen, Essen, Germany
| | - Uta Dirksen
- Department of Pediatric Hematology/Oncology, Clinic for Pediatrics III, West German Cancer Centre, University Hospital Essen, Essen, Germany
| | - Pablo Hernáiz Driever
- Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Oliver Basu
- Department of Pediatric Hematology/Oncology, Clinic for Pediatrics III, West German Cancer Centre, University Hospital Essen, Essen, Germany
| | - Freerk T Baumann
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University Hospital of Cologne, Cologne, Germany
| | - Joachim Wiskemann
- Working Group Exercise Oncology, Department of Medical Oncology, University Clinic Heidelberg and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Joachim Boos
- Faculty of Medicine, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Sabine Verena Kesting
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany.,Department of Pediatrics and Children's Cancer Research Center, Kinderklinik München Schwabing, TUM School of Medicine, Technical University of Munich, Munich, Germany
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16
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Grimshaw SL, Taylor NF, Conyers R, Shields N. Promoting positive physical activity behaviors for children and adolescents undergoing acute cancer treatment: Development of the CanMOVE intervention using the Behavior Change Wheel. Front Pediatr 2022; 10:980890. [PMID: 36313891 PMCID: PMC9607881 DOI: 10.3389/fped.2022.980890] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Increasing participation in physical activity has the potential to improve outcomes for children and adolescents with cancer during treatment and into survivorship. The aim of this study is to outline the theoretical process behind development of CanMOVE, a behavior change intervention designed to increase physical activity for children and adolescents with cancer. Study design This study followed a theoretical design process consistent with the Behavior Change Wheel to inform the design of a complex intervention. Materials and methods The three stages of the Behavior Change Wheel intervention design process include: (1) understanding physical activity behavior within the pediatric cancer setting, (2) identifying potential intervention functions, and (3) identifying appropriate behavior change and implementation strategies. Qualitative and behavior change literature relevant to the pediatric cancer treatment setting were used to inform each stage. Results An individualized and flexible approach to physical activity promotion that considers intrinsic factors specific to the child/adolescent and their environment is required. Fifteen behavioral change strategies were identified to form the intervention components of CanMOVE. Implementation strategies were identified to build motivation, opportunity and capacity toward increasing physical activity behaviors. Key intervention components of CanMOVE include standardized assessment and monitoring (physical activity, physical function, and health-related quality of life), provision of an activity monitor to both child/adolescent and parent, and one-on-one capacity building sessions with a healthcare professional. Capacity building sessions include education, goal setting, an active supervised physical activity session, barrier identification and problem solving, and action planning. Conclusion CanMOVE is a novel approach to physical activity promotion in the pediatric cancer treatment setting. The use of a theoretical intervention design process will aid evaluation and replication of CanMOVE when it is assessed for feasibility in a clinical setting. The design process utilized here can be used as a guide for future intervention development.
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Affiliation(s)
- Sarah L. Grimshaw
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC, Australia
| | - Nicholas F. Taylor
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Rachel Conyers
- Murdoch Children’s Research Institute, Melbourne, VIC, Australia
| | - Nora Shields
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC, Australia
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17
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Blosch C, Krombholz A, Beller R, Gauß G, Reinhardt D, Götte M. Design and Evaluation of an Outdoor Exercise Program for Pediatric Cancer Survivors. CHILDREN 2022; 9:children9081117. [PMID: 35892620 PMCID: PMC9332767 DOI: 10.3390/children9081117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 11/22/2022]
Abstract
Exercise programs for young people after cancer are not part of regular oncological care. This study describes and evaluates a regional outdoor exercise program and presents data with regard to the promoting and inhibiting factors for participation among pediatric cancer survivors. Exercise options, number of participants, and the cohort were evaluated descriptively for one year. A self-developed questionnaire was used to evaluate satisfaction, mood, motivations, and barriers to exercise. Overall N = 26 survivors (14.6 ± 5.5 years) participated in at least one activity in 2019 including try-out days (N = 10) and active weekend camps (N = 2). No adverse events occurred in 302 physical activity hours. Twenty-one survivors participated in the survey. The largest motivational aspect to participate was “to try out a new sport” (83.9%). Survivors reported “good mood”, and ‘being happy’ after exercising. The largest barrier was concern about ‘not being able to keep up with others’ (38.1%). Around one-third (try-out day) and 50% (active weekend camp) of survivors did not feel confident to continue exercising outside the supervised exercise oncology program. This survey shows high enthusiasm for this exercise program with different outdoor activities and suggests that similar interventions may be accepted by this population.
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Affiliation(s)
- Christopher Blosch
- Department of Pediatric Hematology/Oncology, West German Cancer Centre, Clinic for Pediatrics III, University Hospital Essen, 45147 Essen, Germany; (C.B.); (R.B.); (G.G.); (D.R.)
| | - Arno Krombholz
- Faculty of Sport Science, Ruhr University, 44801 Bochum, Germany;
| | - Ronja Beller
- Department of Pediatric Hematology/Oncology, West German Cancer Centre, Clinic for Pediatrics III, University Hospital Essen, 45147 Essen, Germany; (C.B.); (R.B.); (G.G.); (D.R.)
| | - Gabriele Gauß
- Department of Pediatric Hematology/Oncology, West German Cancer Centre, Clinic for Pediatrics III, University Hospital Essen, 45147 Essen, Germany; (C.B.); (R.B.); (G.G.); (D.R.)
| | - Dirk Reinhardt
- Department of Pediatric Hematology/Oncology, West German Cancer Centre, Clinic for Pediatrics III, University Hospital Essen, 45147 Essen, Germany; (C.B.); (R.B.); (G.G.); (D.R.)
| | - Miriam Götte
- Department of Pediatric Hematology/Oncology, West German Cancer Centre, Clinic for Pediatrics III, University Hospital Essen, 45147 Essen, Germany; (C.B.); (R.B.); (G.G.); (D.R.)
- Correspondence: ; Tel.: +49-201-723-8083
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18
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Psychosocial Determinants of Lifestyle Change after a Cancer Diagnosis: A Systematic Review of the Literature. Cancers (Basel) 2022; 14:cancers14082026. [PMID: 35454932 PMCID: PMC9032592 DOI: 10.3390/cancers14082026] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/28/2022] [Accepted: 04/07/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Although cancer survivors may experience health benefits from favorable lifestyle changes, many cancer survivors do not adhere to lifestyle recommendations or make favorable lifestyle changes after cancer diagnosis. This systematic review of the literature aimed to provide an overview of the scientific literature on sociodemographic, psychological and social determinants that may facilitate or hamper lifestyle change after the diagnosis cancer. It provides a structured overview of the large variety of determinants of changes in different lifestyle behaviors (physical activity, diet, smoking, alcohol, sun protection, and multiple lifestyle behaviors) derived from the 123 included papers (71 quantitative and 52 qualitative). Findings demonstrate the important role of oncology healthcare professionals in promoting healthy lifestyle changes in cancer survivors and inform researchers and healthcare professionals about the methods and strategies they can use to promote healthy lifestyle changes in cancer survivors. Abstract The aim of this study is to provide a systematic overview of the scientific literature on sociodemographic, psychological and social determinants that may facilitate or hamper lifestyle change after the diagnosis cancer. Four databases (PubMed, PsychINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science) were searched for relevant papers up to October 2021. Of the 9586 references yielded by the literature search, 123 papers were included: 71 quantitative and 52 qualitative papers. Findings showed a large variety of determinants influencing lifestyle change after cancer diagnosis, with differences between lifestyle behaviors (physical activity, diet, smoking, alcohol, sun protection, and multiple lifestyle behaviors) and findings from quantitative vs. qualitative studies. Findings demonstrate the important role of oncology healthcare professionals in promoting healthy lifestyle changes in cancer survivors. In addition, findings inform researchers involved in the development of health promotion programs about the methods and strategies they can use to promote healthy lifestyle changes in cancer survivors. Favorable lifestyle changes are expected to have beneficial effects on cancer risk and overall health in cancer survivors.
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Totally Excited about Moving Mobility and Exercise (TEAM Me): A Successful Multidisciplinary Exercise Quality Improvement Initiative for Pediatric and Young Adult Oncology and Stem Cell Transplant Inpatients. CHILDREN 2022; 9:children9020186. [PMID: 35204907 PMCID: PMC8870635 DOI: 10.3390/children9020186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 01/31/2023]
Abstract
Background: Pediatric, adolescent and young adult (PAYA) patients are less active than their healthy counterparts, particularly during inpatient stays. Methods: We conducted a quality improvement initiative to increase activity levels in patients admitted to our pediatric oncology and cellular therapy unit using a Plan-Do-Study-Act (PDSA) model. An interdisciplinary team was assembled to develop an incentive-based inpatient exercise and activity program titled Totally Excited About Moving Mobility and Exercise (TEAM Me). As part of the program, patients were encouraged by their care team to remain active during their inpatient stay. As an additional incentive, patients earned stickers to display on TEAM Me door boards along with tickets that could be exchanged for prizes. Activity was assessed by documentation of physical therapy participation, tests of physical function, and surveys of staff perceptions of patient activity levels, motivations, and barriers. Results: Compared to baseline, patient refusals to participate in physical therapy decreased significantly (24% vs. 2%) (p < 0.02), and staff perceptions of patient motivation to stay active increased from 40% to 70% in the post implementation period. There were no changes in physical function tests. Conclusions: An incentive-based exercise program for young oncology inpatients greatly improved patient activity levels, participation in physical therapy and influenced professional caregivers’ beliefs.
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Guimarães JAC, Guerra PH, Ueno DT, Spósito LAC, Sebastião E, Nakamura PM. Barriers to physical activity among cancer pediatric cancer patients and survivors: a scoping review. MOTRIZ: REVISTA DE EDUCACAO FISICA 2022. [DOI: 10.1590/s1980-657420220005621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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21
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Gaser D, Peters C, Oberhoffer-Fritz R, Götte M, Feuchtinger T, Schmid I, Haller B, von Luettichau I, Kesting S. 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. Front Pediatr 2022; 10:982996. [PMID: 36425395 PMCID: PMC9679409 DOI: 10.3389/fped.2022.982996] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
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.
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Affiliation(s)
- Dominik Gaser
- Kinderklinik München Schwabing, Department of Pediatrics and Children's Cancer Research Centre, TUM School of Medicine, Technical University of Munich, Munich, Germany.,Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.,Pediatric Oncology Network, KIONET Bavaria, Erlangen, Germany
| | - Christiane Peters
- Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Renate Oberhoffer-Fritz
- Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Miriam Götte
- Clinic of Pediatrics III, Department of Hematology and Oncology, West German Cancer Centre Essen, University Hospital, Essen, Germany
| | - Tobias Feuchtinger
- Pediatric Oncology Network, KIONET Bavaria, Erlangen, Germany.,Dr. von Hauner Children's Hospital, Pediatric Hematology and Oncology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Irene Schmid
- Pediatric Oncology Network, KIONET Bavaria, Erlangen, Germany.,Dr. von Hauner Children's Hospital, Pediatric Hematology and Oncology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Bernhard Haller
- Institute of AI and Informatics in Medicine, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Irene von Luettichau
- Kinderklinik München Schwabing, Department of Pediatrics and Children's Cancer Research Centre, TUM School of Medicine, Technical University of Munich, Munich, Germany.,Pediatric Oncology Network, KIONET Bavaria, Erlangen, Germany
| | - Sabine Kesting
- Kinderklinik München Schwabing, Department of Pediatrics and Children's Cancer Research Centre, TUM School of Medicine, Technical University of Munich, Munich, Germany.,Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.,Pediatric Oncology Network, KIONET Bavaria, Erlangen, Germany
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22
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Hoag JA, Bingen K, Karst J, Palou A, Yan K, Zhang J. Playing With a Purpose: The Impact of Therapeutic Recreation During Hospitalization. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:6-14. [PMID: 35722870 DOI: 10.1177/27527530211059437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: Youth undergoing cancer treatment and hematopoietic stem cell transplant (HSCT) spend significant time in the hospital, which is disruptive to their physical, social, and emotional development. Therapeutic recreation (TR) can help individuals with an illness maintain or improve their health, quality of life, and physical functioning. TR is an understudied intervention, particularly with youth in the hospital setting. Methods: Forty-nine children (median age = 12 years, interquartile range [IQR] 11-15 years) hospitalized for cancer treatment or HSCT were assigned to participate in either the historical control or TR intervention. Participants wore a Fitbit charge HR for three days to measure movement. At the end of the study participation, they completed self-report measures of mood, social connectedness, and health-related quality of life. Results: Compared with historical controls, the TR intervention group had improved positive affect and decreased mood disturbance (p = 0.03); had better sleep quality (p = 0.003); and was more satisfied with the leisure activities offered in the hospital (p = 0.01). There were no differences in the number of steps taken per day, somatic distress, cooperation with cares, or interaction with medical personnel or caregivers. Both groups reported poor availability and support of peer companions. Discussion: TR is one avenue to increase leisure activities and positively impact mood. More thought needs to be given to how TR programs can be leveraged to increase physical activity and social connectedness.
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Affiliation(s)
| | | | - Jeffrey Karst
- 5506Medical College of Wisconsin, Milwaukee, WI, USA
| | - Akasha Palou
- 5506Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ke Yan
- 5506Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jian Zhang
- 5506Medical College of Wisconsin, Milwaukee, WI, USA
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Bewegungsförderung während der kinderonkologischen Akuttherapie. Monatsschr Kinderheilkd 2021. [DOI: 10.1007/s00112-021-01279-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Zusammenfassung
Hintergrund
Obwohl Studien zeigen, dass Bewegungsinterventionen während der stationären kinderonkologischen Akuttherapie sicher durchführbar sind und positive Effekte haben, fehlt es an einer flächendeckenden sporttherapeutischen Versorgung.
Ziel der Arbeit
Die vorliegende Publikation analysiert Daten zur Teilnahme, zu Hindernissen und zur Gestaltung eines stationären Sportprogramms mit den Zielen, Hinweise für die Etablierung weiterer Sportangebote zu generieren und die Bewegungsförderung während der pädiatrisch-onkologischen Akuttherapie zu verbessern.
Material und Methoden
Die Daten wurden zwischen September 2015 und August 2019 im Rahmen eines stationären Sportprogramms für onkologisch erkrankte Kinder und Jugendliche im Alter zwischen 2 und 22 Jahren erhoben.
Ergebnisse
In das Sportprogramm wurden 63 Kinder und Jugendliche für durchschnittlich 26 Wochen eingebunden. Die Teilnehmer*innen absolvierten 14,83 ± 12,25 von 28,17 ± 20,05 angebotenen Einheiten (Teilnahmequote: 56 %). Medizinische Gründe waren die häufigste Ursache, weshalb eine Trainingseinheit nicht wahrgenommen wurde. Nur 10 % der Einheiten wurden aus mangelnder Motivation abgelehnt. Die Dauer der Trainingseinheiten betrug ca. 25 min. Die Intensität lag im leichten bis moderaten Bereich.
Diskussion
Die Ergebnisse belegen das Interesse der Betroffenen an einem stationären Bewegungsangebot. Die Vielfalt der Trainingsinhalte unterstreicht die Bedeutung einer individuellen Adaptation der Sporttherapie. Gleichzeitig wird die Notwendigkeit eines „Minimalprogramms“ mit sehr leichten Intensitäten hervorgehoben. Optimierungsmöglichkeiten bestehen u. a. in einer höheren zeitlichen Flexibilität des Angebotes sowie der Ergänzung um ein selbstständiges Training mithilfe eines Bewegungsplanes.
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Koenders N, Marcellis L, Nijhuis-van der Sanden MW, Satink T, Hoogeboom TJ. Multifaceted interventions are required to improve physical activity behaviour in hospital care: a meta-ethnographic synthesis of qualitative research. J Physiother 2021; 67:115-123. [PMID: 33753014 DOI: 10.1016/j.jphys.2021.02.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 02/04/2021] [Accepted: 02/23/2021] [Indexed: 12/17/2022] Open
Abstract
QUESTION What are the views of patients, close relatives and healthcare professionals on physical activity behaviour in hospital care? METHODS A meta-ethnographic synthesis of qualitative studies was conducted with a lines-of-argument analysis. The methodological quality of included studies was evaluated using the Critical Appraisal Skills Programme (CASP) checklist. The lines of argument were synthesised and mapped in an existing theoretical model. The confidence of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach. RESULTS Eleven studies were included and provided data from 290 participants (145 patients, 0 close relatives and 145 healthcare professionals). We have synthesised six lines of argument that explained the (intention of) physical activity behaviour of patients during their hospital stay: patients and healthcare professionals perceive benefits and risks of physical activity for patients' health (high confidence); physical activity gives a sense of freedom, confidence in recovery and mental wellbeing (high confidence); all healthcare professionals should offer timely and tailored physical activity promotion (high confidence); patient motivation to be physically active may be contingent upon encouragement (moderate confidence); family members can influence physical activity behaviour favourably or unfavourably (low confidence); and hospital culture has a negative influence on physical activity behaviour of patients (high confidence). CONCLUSIONS Physical activity behaviour of patients during their hospital stay is a complex phenomenon with multiple interactions at the level of patients, healthcare professionals and hospital culture. Considering the results of this synthesis, multifaceted implementation strategies are needed to improve physical activity intention and behaviour of patients during their hospital stay.
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Affiliation(s)
- Niek Koenders
- Department of Rehabilitation, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.
| | - Laura Marcellis
- Department of Rehabilitation, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Maria Wg Nijhuis-van der Sanden
- Department of Allied Healthcare Sciences of IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Ton Satink
- Neurorehabilitation Research Group, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Thomas J Hoogeboom
- Department of Allied Healthcare Sciences of IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
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Exercise Trials in Pediatric Brain Tumor: A Systematic Review of Randomized Studies. J Pediatr Hematol Oncol 2021; 43:59-67. [PMID: 32604333 DOI: 10.1097/mph.0000000000001844] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/29/2020] [Indexed: 12/29/2022]
Abstract
In pediatric brain tumor patients, treatment advances have increased survival rates to nearly 70%, while consequently shifting the burden of disease to long-term management. Exercise has demonstrated potential in improving multiple health impairments secondary to brain tumor treatment. However, these effects have not been consolidated through review. Therefore, we performed a systematic review of 6 health sciences databases (Medline, Embase, PsychINFO, CINAHL, SPORTDiscus, and Cochrane Central Database). Two reviewers screened studies against predefined inclusion criteria, namely that the study must: (i) be pediatric-specific; (ii) examine the effects of an exercise intervention; and (iii) employ a randomized or quasi-randomized trial design. The same 2 reviewers performed data extraction and analyses. From a pool of 4442, 5 articles-based on 2 independent trials-were included in our review (N=41). Exercise interventions were primarily aerobic, but included balance or muscle building components. Exercise had a positive effect on volumetric or diffusion-based neuroimaging outcomes, as well as motor performance and cardiorespiratory fitness. The effects of exercise on cognition remains unclear. Exercise did not worsen any of the outcomes studied. This review captures the state of the science, suggesting a potential role for exercise in children treated for brain tumor.
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Huang YJ, Lee SL, Wu LM. Health-Promoting Lifestyle and Its Predictors in Adolescent Survivors of Childhood Cancer. J Pediatr Oncol Nurs 2021; 38:233-241. [PMID: 33595358 DOI: 10.1177/1043454221992322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Cancer survivors are at increased risk of long-term adverse effects related to the disease or treatment. Thus, it is important for cancer survivors to adopt a health-promoting lifestyle (HPL). This study aims to: (1) describe health behavior self-efficacy (HBSE) and HPL of adolescent survivors of childhood cancer, (2) examine the relationships between HBSE, HPL, and various demographic factors, and (3) identify determinants of HPL among adolescent survivors of childhood cancer. Method: A descriptive cross-sectional study was conducted with adolescent survivors of childhood cancer, ranged in age from 11 to 19 years (n = 82). Participants were recruited from pediatric oncology follow-up clinics at two medical centers in southern Taiwan. Data for each participant were collected from questionnaires assessing HBSE and HPL. Results: Only 61% of the adolescent survivors were considered as normal weight. The exercise was the lowest scoring HBSE subscale. Factors associated with better HPL included: education level, HBSE, well-being, and a healthy diet. Specifically, survivors diagnosed with cancer during adolescence exhibited significantly greater self-efficacy with stress management (F = 3.20, p = .04) compared with those diagnosed at pre-school ages. HBSE scores for well-being and a healthy diet were significant predictors of HPL, accounting for 43.8% of the total variance observed. Discussion: Our findings suggest that the age of diagnosis of childhood cancer significantly modulates the frequency of health-promoting behaviors of adolescent survivors. Thus, interventions designed to enhance adolescents' well-being and the management of a healthy diet may enhance HPL in survivors of childhood cancer.
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Affiliation(s)
- Yi-Jung Huang
- Kaohsiung Municipal Sinsing Senior High School, Kaohsiung City, Taiwan (R.O.C.)
| | - Shu-Li Lee
- School of Nursing, 38023Kaohsiung Medical University, Kaohsiung City, Taiwan (R.O.C.)
| | - Li-Min Wu
- School of Nursing, 38023Kaohsiung Medical University, Kaohsiung City, Taiwan (R.O.C.).,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan (R.O.C.)
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Self-efficacy in symptom management for adolescents and young adults with cancer: a systematic review. Support Care Cancer 2021; 29:2851-2862. [PMID: 33403400 DOI: 10.1007/s00520-020-05960-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/16/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Adolescents and young adults (AYAs) have more frequent and intense adverse effects from cancer therapy than other age groups. Self-efficacy, the ability for persons to maintain health-related behavior change, may assist with symptom management but the role it plays in AYAs with cancer has not been thoroughly investigated. This review explores the role that self-efficacy has in symptom management for AYAs with cancer and provides guidance for clinicians to utilize self-efficacy as a means to reduce side effects of therapy. METHODS A systematic review of peer-reviewed literature was conducted to identify works discussing self-efficacy and symptom management for AYAs with cancer. Five databases were searched with key terms and articles that discussed relationships between self-efficacy and cancer therapy symptoms were retained for analysis. FINDINGS Twelve manuscripts representing 1180 individuals age 12 to 43 years were identified. Self-efficacy was found to be related to (1) health management behaviors, (2) psychosocial health, (3) sexual and reproductive health, and (4) physical symptoms. Self-efficacy had direct correlations with physical activity, nutritional intake, symptom regulation, mental health, sexual health, and fertility preservation. The included studies did not find significant relationships with medication adherence or pain management. DISCUSSION Self-efficacy is an attribute that impacts behavior change, health maintenance, and overall wellness and can be changed over time and through interventions to improve symptoms of cancer therapy. Self-efficacy should be evaluated as a construct in relevant studies aimed at improving side effects of cancer therapy to better understand outcomes from interventions. Symptoms, toxicities, and adverse effects of cancer therapy may be improved by increasing self-efficacy of patients.
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Marchese V, Rock K, York T, Creath R, Gray V. Neuromuscular mechanisms that contribute to gross motor performance in survivors of childhood acute lymphoblastic leukemia. J Pediatr Rehabil Med 2021; 14:415-423. [PMID: 33935120 PMCID: PMC9299748 DOI: 10.3233/prm-200784] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE This study explored neuromuscular mechanisms and clinical measures that contribute to countermovement jump performance in survivors of childhood acute lymphoblastic leukemia (ALL CCS) compared to age- and sex-matched peers. METHODS This exploratory cross-sectional observational study examined 12 participants, six ALL CCS and six age- and sex-matched peers (7-16 years). During a countermovement jump, rates of muscle activation of lower leg muscles were measured with electromyography, and joint torques and peak jump height with force plates and a motion capture system. Clinical measures included muscle extensibility, balance, and mobility measured by active ankle dorsiflexion, Bruininks-Oseretsky Motor Proficiency (BOT-2), and Timed Up and Go (TUG) tests. RESULTS Compared to peers, ALL CCS demonstrated reduced gastrocnemius muscle extensibility and tibialis anterior rate of muscle activation, decreased jump height, and poorer performance on the BOT-2 and TUG. Jump height was significantly correlated with clinical measures of the BOT-2 and TUG. CONCLUSION These ALL CCS demonstrated neuromuscular impairments that may impact jump performance, an essential childhood physical activity. Further research is needed to explore intervention strategies to improve the neuromuscular mechanisms that contribute to high-level gross motor skills in ALL CCS.
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Affiliation(s)
- Victoria Marchese
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kelly Rock
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Teresa York
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Robert Creath
- Department of Exercise Science, Lebanon Valley College, Annville, PA, USA
| | - Vicki Gray
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA
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Schulte F, Forbes C, Wurz A, Patton M, Russell KB, Pluijm S, Krull KR. Childhood Cancer Survivorship: Daily Challenges. Pediatr Clin North Am 2020; 67:1083-1101. [PMID: 33131536 DOI: 10.1016/j.pcl.2020.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Survivors of childhood cancer are at risk of experiencing fatigue, pain, lower levels of physical activity, increased engagement in risky health behavior, and poor social adjustment, after finishing treatment. Risks are more pronounced for survivors of specific diagnoses or receiving specific treatment protocols. Interventions to address these outcomes are in their infancy. Future research should focus on exploring the antecedents and consequences of these outcomes. In the meantime, researchers and cancer centers should attempt to provide high-quality and accessible health information to survivors through various media outlets to encourage healthy behaviors.
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Affiliation(s)
- Fiona Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hematology, Oncology and Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada.
| | - Caitlin Forbes
- University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Amanda Wurz
- University of Calgary, Calgary, Alberta, Canada
| | | | | | - Saskia Pluijm
- Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Kevin R Krull
- St. Jude Children's Research Hospital, Memphis, TN, USA
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Children's physical activity behavior following a supervised physical activity program in pediatric oncology. J Cancer Res Clin Oncol 2020; 146:3037-3048. [PMID: 32583234 DOI: 10.1007/s00432-020-03294-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 06/20/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND The theory of planned behavior (TPB) model and its components have been applied to comprehend the adoption of physical activity along with informational and motivational parameters. Thus, the first aim of this exploratory study was to explore the evolution of children's physical activity levels over a supervised physical activity program. The second aim was to describe the evolution of TPB measures, self-reported fitness and self-esteem in the physical domain to better understand children's physical activity behavior over the course of the physical activity program. METHODS A total of 16 children (8 boys and 8 girls) with cancer answered psychosocial questionnaires before and after a supervised physical activity program to explore the TPB measures, self-reported fitness, self-esteem in the physical domain and their daily physical activities. RESULTS A significant increase of 13.8 min/day [95% CI (16.7; 10.8); p < 0.0001; d = 1.4] of daily MVLPA was observed between the time before (9.3 ± 9.1 min/day) and after (23.1 ± 10.8 min/day) the physical activity program. We found that the physical activity program positively impacted children's TPB measures (mean in attitude, identity, facilitating factors, self-confidence and intention) and MVLPA levels. The TPB model explained 36.2% of the variance in MVLPA by injunctive norms after the physical activity program. CONCLUSION This study highlighted the need to provide children with physical activity support as soon as the cancer is diagnosed and showed that children's physical activity behaviors were facilitated by familial support measured by injunctive norms.
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The impact of cancer on theory of planned behavior measures and physical activity levels during the first weeks following cancer diagnosis in children. Support Care Cancer 2020; 29:823-831. [PMID: 32495031 DOI: 10.1007/s00520-020-05541-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The theory of planned behavior (TPB) is used to document children's health behaviors linked to their physical activity. The TPB model and its components have been applied to comprehend the adoption of physical activity along informational and motivational parameters. Thus, this exploratory study aims to assess the evolution of children's physical activity levels (MVLPA) during the first weeks of their cancer, in addition to documenting the evolution of the TPB measures, self-reported fitness, and self-esteem in the physical domain to better understand children's physical activity behavior. METHODS A total of 16 children (8 boys and 8 girls) with cancer answered psychosocial questionnaires at the diagnosis of cancer (time 1) and at 6 to 8 weeks (time 2) to assess the TPB measures, self-reported fitness, self-esteem in the physical domain, and their daily physical activities. RESULTS A significant decrease of 41.2 min/days of daily MVLPA was observed between the time at cancer diagnosis (50.5 ± 32.8 min/days) and 6 to 8 weeks after the first interview (9.3 ± 9.1 min/days). We found that the time after the diagnosis of cancer negatively impacted children's TPB measures (mean in attitude, injunctive norms, identity, facilitating factors, self-confidence, and intention) and MVLPA levels. The TPB model explains 40% of the variance in MVLPA by the injunctive norms during the first weeks following cancer diagnosis in children. CONCLUSION The findings of this study highlight the negative impacts of cancer on children's TPB measures, self-reported fitness, and self-esteem in the physical domain and self-reported MVLPA levels over 4 to 6 weeks following the diagnosis. These findings help to better understand the effect of cancer diagnosis on children's physical activity behavior.
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Investigation of the effect of task-orientated rehabilitation program on motor skills of children with childhood cancer: a randomized-controlled trial. Int J Rehabil Res 2020; 43:167-174. [PMID: 32097140 DOI: 10.1097/mrr.0000000000000400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Problems have been reported in the execution and development of motor skills and its treatment as a cause of cancer in children. The purpose of this study was to examine the effect of the task-orientated rehabilitation program (ToRP) on motor skills of children with childhood cancer. Following the consort guideline, 93 children (49 males and 44 females) with pediatric cancer were randomized to either study (n = 52; 12.35 ± 3.43 years) or control (n = 41; 11.89 ± 3.56 years) groups. The study group received ToRP, and the control group received a home-based therapeutic strategies program for 20 sessions. Motor skill outcomes were assessed with Bruininks-Oseretsky Test of Motor Proficiency, Short Form (BOTMP-SF) by assessor who was blind to group allocation and interventions. The groups were homogenous in terms of demographic characteristics and motor skills. The study group showed a significant increase in both gross and fine motor skills (P values for all subtests: P < 0.001), whereas running speed, bilateral coordination, strength, response speed and visual motor control did not show significant improvement with the control group (P > 0.05). The ToRP appears to provide beneficial effects in improving motor skills at the early stages of rehabilitation for children with childhood cancer.
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Pugh G, Hough R, Gravestock H, Fisher A. The health behaviour status of teenage and young adult cancer patients and survivors in the United Kingdom. Support Care Cancer 2020; 28:767-777. [PMID: 31144171 PMCID: PMC6954124 DOI: 10.1007/s00520-019-04719-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 02/26/2019] [Indexed: 01/21/2023]
Abstract
PURPOSE The primary aim of this study was to investigate the health behaviour status of teenage and young adult (TYA) cancer patients and survivors; the secondary aim was to determine if TYA cancer patients and survivors health behaviour differs to general population controls. METHODS Two hundred sixty-seven young people with cancer (n =83 cancer patients receiving active treatment: n =174 cancer survivors, 57.1% >1 year since treatment completion) and 321 controls completed a health and lifestyle questionnaire which included validated measures of physical activity (PA) (Godin Leisure Time Exercise Questionnaire), diet (Dietary Instrument for Nutrition Education, DINE), smoking status, and alcohol consumption (AUDIT-C). RESULTS General population controls and cancer survivors were more likely to meet current (PA) recommendations (p <0.001) than TYA cancer patients undergoing treatment (54.8% vs 52.3% vs 30.1%, respectively). Less than 40% of young people with cancer and controls met fat intake, sugar intake, fibre intake or current fruit and vegetable recommendations. TYA cancer survivors were more likely to report binge drinking than controls (OR=3.26, 95% CI 2.12-5.02, p <0.001). Very few young people with in the study were current smokers. The majority of TYA cancer patients and survivors reported a desire to make positive changes to their health behaviour. CONCLUSION Consideration should be given to whether existing health behaviour change interventions which have demonstrated positive effects among the general TYA population could be adapted for young people with cancer.
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Affiliation(s)
- G. Pugh
- Centre for Sports & Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, Bancroft Road, London, E1 4DG UK
- Department of Behavioural Science & Health, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
| | - R. Hough
- Department of Haematology, University College London Hospital, London, UK
| | - H. Gravestock
- CLIC Sargent, No.1 Farriers Yard, L77-85 Fulham Palace Road, London, W6 8JA UK
| | - A. Fisher
- Department of Behavioural Science & Health, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
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Keiser T, Gaser D, Peters C, Oberhoffer-Fritz R, Kesting S, von Luettichau I. Short-Term Consequences of Pediatric Anti-cancer Treatment Regarding Blood Pressure, Motor Performance, Physical Activity and Reintegration Into Sports Structures. Front Pediatr 2020; 8:463. [PMID: 32850561 PMCID: PMC7431623 DOI: 10.3389/fped.2020.00463] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/02/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Cardiovascular diseases in childhood cancer survivors are known late sequelae following treatment. Arterial stiffness, pulse wave velocity (PWV) and central systolic blood pressure (cSBP) are potential predictors to assess the status of cardiovascular health. Frequent inpatient stays and reduced physical activity (PA) during treatment can lead to noticeable impairments regarding motor skills and physical performance. The present study examined parameters of cardiovascular health, motor performance and the status of integration into sports structures shortly after cessation of treatment. Methods: A cross-sectional, monocentric study was conducted from April to June 2019. Participants (6-18 yrs, mixed cancer entities) during maintenance therapy and follow-up care were recruited. Peripheral and central systolic/diastolic blood pressure (pSBP, pDBP, cSBP) and PWV were assessed using the Mobil-O-Graph®. The MOON test (MOtor performance in pediatric ONcology) was used to scale motor performance. PA levels and status of integration into sports structures were assessed with a questionnaire referring to the KiGGS study. All measured data were compared to published reference values. Results: Forty participants (11.3 ± 3.8 years, 50% female) were recruited 1.6 ± 1.8 years post-treatment. PSBP (z-score: 0.87 ± 0.67, p = 0.003), pDBP (0.83 ± 1.94, p = 0.033) and cSBP (≥8 years: 0.60 ± 1.29, p = 0.011) were significantly increased compared to reference values. PWV was also elevated, but not significantly. Motor performance was reduced in almost all motor abilities. Thirty-six percent of the examined group did not participate in physical education at school to the full extent. Only 17% reported 1 hour of daily moderate-to-vigorous PA as recommended for children and adolescents by the World Health Organization. Half of the participants were active sports club members before treatment, but one third did not resume their former membership. Conclusion: Increased cardiovascular parameters and impaired motor performance shortly after cessation of treatment, physical inactivity, and low rates of integration into regular sports programs highlight the support needed. Young cancer patients should receive early support in coping with physical limitations preferably soon after diagnosis. Motor deficits could be reduced by applying targeted interventions. Furthermore, a regular sports therapy program during in- and outpatient care could increase engagement in PA to possibly counteract risk factors and improve cardiovascular health.
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Affiliation(s)
- Tina Keiser
- Department of Sports Medicine and Exercise, Justus-Liebig University Gießen, Gießen, Germany
| | - Dominik Gaser
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany.,Department of Pediatrics and Children's Cancer Research Center, Kinderklinik München Schwabing, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Christiane Peters
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Renate Oberhoffer-Fritz
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Sabine Kesting
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany.,Department of Pediatrics and Children's Cancer Research Center, Kinderklinik München Schwabing, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Irene von Luettichau
- Department of Pediatrics and Children's Cancer Research Center, Kinderklinik München Schwabing, TUM School of Medicine, Technical University of Munich, Munich, Germany
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Exercise and Physical Activity in Patients with Osteosarcoma and Survivors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1257:193-207. [PMID: 32483741 DOI: 10.1007/978-3-030-43032-0_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Exercise has the potential to positively affect patients with osteosarcoma by improvement of function, mitigation of disability, and maintenance of independence and quality of life. Exercise may also directly impact cancer treatment efficacy. This chapter examines the feasibility and use of exercise or physical activity as therapy in the treatment of osteosarcoma and its survivors. It additionally presents the benefits of physical activity as treatment and rehabilitation both preoperatively (prehabilitation) and postoperatively. This chapter will also discuss barriers to exercise and physical activity for patients with osteosarcoma and its survivors, emphasizing the need for a comprehensive and cohesive support system to promote its incorporation into patient treatment plans and ensure compliance.
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Lin B, Gutman T, Hanson CS, Ju A, Manera K, Butow P, Cohn RJ, Dalla‐Pozza L, Greenzang KA, Mack J, Wakefield CE, Craig JC, Tong A. Communication during childhood cancer: Systematic review of patient perspectives. Cancer 2019; 126:701-716. [DOI: 10.1002/cncr.32637] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/10/2019] [Accepted: 10/17/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Beryl Lin
- School of Public Health University of Sydney Sydney New South Wales Australia
- School of Women's and Children's Health University of New South Wales Sydney New South Wales Australia
| | - Talia Gutman
- School of Public Health University of Sydney Sydney New South Wales Australia
- Centre for Kidney Research The Children's Hospital at Westmead Westmead New South Wales Australia
| | - Camilla S. Hanson
- School of Public Health University of Sydney Sydney New South Wales Australia
- Centre for Kidney Research The Children's Hospital at Westmead Westmead New South Wales Australia
| | - Angela Ju
- School of Public Health University of Sydney Sydney New South Wales Australia
- Centre for Kidney Research The Children's Hospital at Westmead Westmead New South Wales Australia
| | - Karine Manera
- School of Public Health University of Sydney Sydney New South Wales Australia
- Centre for Kidney Research The Children's Hospital at Westmead Westmead New South Wales Australia
| | - Phyllis Butow
- Psycho‐oncology Co‐operative Research Group School of Psychology University of Sydney Sydney New South Wales Australia
| | - Richard J. Cohn
- School of Women's and Children's Health University of New South Wales Sydney New South Wales Australia
- Kids Cancer Centre Sydney Children's Hospital Randwick New South Wales Australia
| | - Luciano Dalla‐Pozza
- Cancer Centre for Children The Children's Hospital at Westmead Sydney New South Wales Australia
| | - Katie A. Greenzang
- Dana‐Farber/Boston Children's Cancer and Blood Disorders Center Dana‐Farber Cancer Institute Boston Massachusetts
| | - Jennifer Mack
- Dana‐Farber/Boston Children's Cancer and Blood Disorders Center Dana‐Farber Cancer Institute Boston Massachusetts
| | - Claire E. Wakefield
- School of Women's and Children's Health University of New South Wales Sydney New South Wales Australia
- Kids Cancer Centre Sydney Children's Hospital Randwick New South Wales Australia
| | - Jonathan C. Craig
- School of Public Health University of Sydney Sydney New South Wales Australia
- Centre for Kidney Research The Children's Hospital at Westmead Westmead New South Wales Australia
| | - Allison Tong
- School of Public Health University of Sydney Sydney New South Wales Australia
- Centre for Kidney Research The Children's Hospital at Westmead Westmead New South Wales Australia
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37
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Hooke MC, Hoelscher A, Tanner LR, Langevin M, Bronas UG, Maciej A, Mathiason MA. Kids Are Moving: A Physical Activity Program for Children With Cancer. J Pediatr Oncol Nurs 2019; 36:379-389. [DOI: 10.1177/1043454219858607] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Children undergoing cancer treatment are less active than healthy peers. Inactivity persists into survivorship, negatively influencing health and quality of life. Fatigue is one of the most prevalent symptoms during treatment yet children with increased physical activity (PA) have less fatigue. This pilot study evaluated the impact of coaching on PA and fatigue in children undergoing cancer treatment delivered by pediatric oncology nurse practitioners (NPs) during routine clinic visits. NPs used motivational interviewing during clinic visits to coach children and their families on strategies to increase PA at home. Self-report measures of PA and fatigue were completed at treatment months 2, 4, and 6. PA was also measured using actigraphy. Among 30 children ages 6 to 18 years, 7 had acute lymphoblastic leukemia (ALL), 11 had lymphoma, and 12 had solid tumors. Patterns of fatigue were different by disease group with trends to fatigue decreasing during treatment in the patients with ALL ( p = .09) and lymphoma ( p = .13) but increasing in those with solid tumors ( p = .06). Self-report PA was unchanged. Actigraph measurements remained stable for the group. NPs reported time challenges in implementing coaching during the clinic visit and in providing coaching continuity. The intensive, repeating chemotherapy cycles in solid tumor treatment may contribute to increasing fatigue. Treatment intensity decreases during ALL and lymphoma treatment, which may allow for improvement in fatigue. Inactivity persisted during treatment but did not progress. Future research is needed to evaluate more “dose-intensive” PA interventions in larger samples of specific disease groups.
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Affiliation(s)
- Mary C. Hooke
- University of Minnesota, Minneapolis, MN, USA
- Children’s Minnesota, Minneapolis, MN, USA
| | | | | | | | | | - Alexis Maciej
- University of Minnesota Masonic Children’s Hospital, Minneapolis, MN, USA
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Grimshaw SL. Critically appraised paper: A 6-month experiential training program with coaching is effective in reducing fatigue and promoting physical activity among children with cancer [commentary]. J Physiother 2019; 65:175. [PMID: 31175035 DOI: 10.1016/j.jphys.2019.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 04/29/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sarah L Grimshaw
- Department of Physiotherapy and Children's Cancer Centre, Royal Children's Hospital, Murdoch Children's Research Institute, La Trobe University, Melbourne, Australia
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Thorsteinsson T, Schmiegelow K, Thing LF, Andersen LB, Helms AS, Ingersgaard MV, Lindgren LH, Larsen HB. Classmates motivate childhood cancer patients to participate in physical activity during treatment: A qualitative study. Eur J Cancer Care (Engl) 2019; 28:e13121. [PMID: 31215079 DOI: 10.1111/ecc.13121] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 11/02/2018] [Accepted: 04/12/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Children with cancer experience reduced physical fitness and compromised social relationships during and following intensive treatment. This may negatively impact their quality of life. As part of the RESPECT study, we explored the motivations for participation in a physical activity programme during treatment. METHODS Thirteen semi-structured interviews were conducted with seven boys and six girls, diagnosed with paediatric cancer in 2013 and treated with chemotherapy (age 8-16 years; time from diagnosis to interview 6-16 months). Interviews were conducted in the children's homes. RESULTS The qualitative analysis showed that children's motivations for engaging in the physical activity programme during intensive medical treatment were primarily influenced by (a) opportunity for physical activity with a classmate; (b) participation in group physical activity sessions; (c) support from significant others; and (d) improvement of physical well-being. Main barriers included (a) poor physical well-being; (b) compliance with medical procedures and being treated in protective isolation; and (c) limited physical activity facilities. CONCLUSION Despite barriers, it is possible to motivate and engage children with cancer in physical activity during intensive treatment in a paediatric oncology ward. Physical exercise and activity should be recommended and promoted from diagnosis throughout the treatment period and should include psychosocial and professional support.
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Affiliation(s)
- Troels Thorsteinsson
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark
| | - Kjeld Schmiegelow
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen Ø, Denmark.,Division of Paediatric Haematology/Oncology, Perlmutter Cancer Centre, New York University Langone Medical Centre, New York, New York
| | - Lone Friis Thing
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen N, Denmark
| | - Lars Bo Andersen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Teacher Education and Sport, Western Norway University of Applied Sciences, Haugesun, Norway
| | - Anne Sofie Helms
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark
| | - Marianne Vie Ingersgaard
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark
| | - Lea Hjortshøj Lindgren
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark
| | - Hanne Baekgaard Larsen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen Ø, Denmark
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Antwi GO, Jayawardene W, Lohrmann DK, Mueller EL. Physical activity and fitness among pediatric cancer survivors: a meta-analysis of observational studies. Support Care Cancer 2019; 27:3183-3194. [PMID: 30993451 DOI: 10.1007/s00520-019-04788-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 03/28/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE The number of pediatric cancer survivors has increased dramatically over recent decades. Prior studies involving pediatric cancer survivors have reported reduced physical activity and fitness levels. Thus, the aim of this meta-analysis was to synthesize previous findings on physical activity and fitness levels of pediatric cancer survivors, who had completed cancer treatment and are in complete remission compared with age-matched, non-athletic healthy controls with no history of cancer diagnosis. METHODS Three electronic databases (PubMed, Web of Science, and EBSCO) were searched using a combination of 24 terms. Observational studies examining the post-treatment physical activity and/or fitness levels of pediatric cancer survivors compared with that of non-cancer controls and published in peer-reviewed, English-language journals before August 22, 2018 were eligible. Random-effect models were used in Comprehensive Meta-Analysis software for effect-size estimations of eight studies for physical activity and eight for fitness. RESULTS The studies included a total sample of 2628; 1413 pediatric cancer survivors and 1215 non-cancer controls. Both physical activity and fitness were significantly lower in childhood cancer survivors than in non-cancer controls (g = - 0.889; 95% confidence interval [CI] = - 1.648 - 0.130; p = 0.022) and (g = - 1.435; 95% CI = - 2.615 - 0.225; p = 0.017), respectively, with high heterogeneity. CONCLUSIONS Pediatric cancer sequelae and its treatment may limit participation in physical activity and fitness activities by survivors of pediatric cancer. Accentuating the need to incorporate physical activity and fitness into treatment protocols and post-treatment recommendations may improve pediatric cancer survivors' health and well-being.
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Affiliation(s)
- Godfred O Antwi
- School of Public Health, Applied Health Science, SPH 116, Indiana University, 1025 E 7th Street, Bloomington, IN, 47405, USA.
| | - Wasantha Jayawardene
- School of Public Health: Institute for Research on Addictive Behavior, Indiana University Bloomington, Bloomington, IN, USA
| | - David K Lohrmann
- School of Public Health, Applied Health Science, SPH 116, Indiana University, 1025 E 7th Street, Bloomington, IN, 47405, USA
| | - Emily L Mueller
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.,Center for Pediatric and Adolescent Comparative Effectiveness Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
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Wurz A, Daeggelmann J, Albinati N, Kronlund L, Chamorro-Viña C, Culos-Reed SN. Physical activity programs for children diagnosed with cancer: an international environmental scan. Support Care Cancer 2019; 27:1153-1162. [DOI: 10.1007/s00520-019-04669-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 01/21/2019] [Indexed: 12/31/2022]
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Götte M, Kesting SV, Gerss J, Rosenbaum D, Boos J. Feasibility and effects of a home-based intervention using activity trackers on achievement of individual goals, quality of life and motor performance in patients with paediatric cancer. BMJ Open Sport Exerc Med 2018; 4:e000322. [PMID: 29765699 PMCID: PMC5950644 DOI: 10.1136/bmjsem-2017-000322] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Supervised exercise interventions during inpatient care are feasible. The objective was to evaluate the usability of activity trackers and centralised monitoring to conduct a home-based exercise intervention during cancer treatment. The primary endpoint and confirmatory analysis was achievement of individual goals for daily steps, compared (A) in the intervention group (IG) over time and (B) between the IG and control group (CG). Secondary endpoints included achievement of goals for active minutes and effects on motor performance and health-related quality of life (hrQoL). METHODS Forty patients treated for paediatric cancer (14.7±3.9 years) were included. The IG received a 6-8 week intervention during acute treatment (T1) and a 2-week intervention in transition to aftercare (T2). The CG only received the intervention at T2. Baseline tests to assess motor performance and physical activity were conducted prior to every intervention. RESULTS In the primary confirmatory analysis, the IG significantly improved achievement of individual step goals (p=0.04) whereas group analyses did not reveal significant differences. Achievement of active minutes remained low (p=0.23). IG scored higher in hrQoL than CG (p<0.01) and percentage of children scoring below normative value in strength tests was higher in CG. Of all participants, 94% rated the intervention as meaningful and 80% as motivational. CONCLUSIONS Results of this study indicate that this intervention for home stays with centralised supervision is feasible and leads to increased achievement of individual step goals. Despite the positive effects on hrQoL, further strategies are needed to increase positive effects on motor performance.
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Affiliation(s)
- Miriam Götte
- Department of Pediatric Hematology/Oncology, Center for Child and Adolescent Medicine, University Hospital Essen, Essen, Germany
- Department for Pediatric Hematology and Oncology, University Hospital Münster, Münster, Germany
| | - Sabine Verena Kesting
- Department for Pediatric Hematology and Oncology, University Hospital Münster, Münster, Germany
- Department of Sport and Health Science, Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Comprehensive Cancer Center Munich, Kinderklinik München Schwabing, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Joachim Gerss
- Institute of Biostatistics and Clinical Research, University Hospital Münster, Münster, Germany
| | - Dieter Rosenbaum
- Institute of Experimental Musculoskeletal Medicine, University Hospital Münster, Münster, Germany
| | - Joachim Boos
- Department for Pediatric Hematology and Oncology, University Hospital Münster, Münster, Germany
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43
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Physical activity barriers, preferences, and beliefs in childhood cancer patients. Support Care Cancer 2018; 26:2177-2184. [DOI: 10.1007/s00520-017-4041-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/28/2017] [Indexed: 12/20/2022]
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44
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Bruggers CS, Baranowski S, Beseris M, Leonard R, Long D, Schulte E, Shorter A, Stigner R, Mason CC, Bedrov A, Pascual I, Bulaj G. A Prototype Exercise-Empowerment Mobile Video Game for Children With Cancer, and Its Usability Assessment: Developing Digital Empowerment Interventions for Pediatric Diseases. Front Pediatr 2018; 6:69. [PMID: 29686977 PMCID: PMC5900044 DOI: 10.3389/fped.2018.00069] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 03/08/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Medical advances continue to improve morbidity and mortality of serious pediatric diseases, including cancer, driving research addressing diminished physical and psychological quality of life in children with these chronic conditions. Empowerment enhances resilience and positively influences health, disease, and therapy understanding. We describe the development and usability assessment of a prototype Empower Stars! mobile video game grounded in behavioral and exercise theories with the purpose of coupling physical exercise with empowerment over disease in children with cancer. METHODS Academic faculty, health-care providers, and community video game developers collaborated in this project. The iPadAir was selected as a delivery platform for its accelerometer and gyroscope features facilitating exercise design. Unity multiplatform technology provided animation and audiovisual features for immediate player feedback. Javascript, C#, Photoshop, Flash, and SketchUp were used for coding, creating graphical assets, Sprite sheets, and printing files, respectively. 3D-printed handles and case backing were used to adapt the iPad for physical exercise. Game usability, engagement, and enjoyment were assessed via a multilevel study of children undergoing cancer chemotherapy, their parents, and pediatric cancer health-care providers. Feedback crucial for ongoing game development was analyzed. RESULTS A prototype Empower Stars! mobile video game was developed for children 7-14 years old with cancer. Active, sedentary, educational, and empowerment-centered elements intermix for 20 min of exercise within a 30 min "one-day treatment" gameplay session involving superheroes, space exploration, metaphorical cancer challenges, life restoration on a barren planet, and innumerable star rewards. No player "dies." Usability assessment data analyses showed widespread enthusiasm for integrating exercise with empowerment over cancer and the game itself. Favorite elements included collecting star rewards and planet terraforming. Traveling in space and the Healthy Food Choice game were least liked. The need for improved gameplay instructions was expressed by all groups. The usability study provided essential feedback for converting the prototype into alpha version of Empower Stars! CONCLUSION Adapting exercise empowerment-promoting video game technology to mobile platforms facilitates usability and widespread dissemination for children with cancer. We discuss broader therapeutic applicability in diverse chronic pediatric diseases, including obesity, asthma, cystic fibrosis, diabetes, and juvenile idiopathic arthritis.
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Affiliation(s)
- Carol S Bruggers
- Division of Hematology-Oncology, Department of Pediatrics, University of Utah, Salt Lake City, UT, United States.,Primary Children's Hospital, Salt Lake City, UT, United States
| | | | | | | | - Derek Long
- Spy Hop Youth Media, Salt Lake City, UT, United States
| | | | | | - Rowan Stigner
- Spy Hop Youth Media, Salt Lake City, UT, United States
| | - Clinton C Mason
- Division of Hematology-Oncology, Department of Pediatrics, University of Utah, Salt Lake City, UT, United States
| | - Alisa Bedrov
- Division of Hematology-Oncology, Department of Pediatrics, University of Utah, Salt Lake City, UT, United States.,Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
| | - Ian Pascual
- Division of Hematology-Oncology, Department of Pediatrics, University of Utah, Salt Lake City, UT, United States.,Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT, United States.,Juan Diego Catholic High School, Draper, UT, United States
| | - Grzegorz Bulaj
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
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Taylor MF, Pooley JA. Sarcoma survivors’ perspectives on their body image and functional quality of life post-resection/limb salvage surgery. Eur J Cancer Care (Engl) 2017; 26. [DOI: 10.1111/ecc.12667] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 01/09/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Myra F. Taylor
- School of Medical and Health Sciences; Edith Cowan University; Joondalup WA Australia
| | - Julie A. Pooley
- School of Psychology; Edith Cowan University; Joondalup WA Australia
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Description of a Community-Based Exercise Program for Children With Cancer: A Sustainable, Safe, and Feasible Model. REHABILITATION ONCOLOGY 2017. [DOI: 10.1097/01.reo.0000000000000051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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47
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Lam KKW, Ho Cheung William L, Ho KYE, Chung OKJ, Chan CFG. Factors contributing to the low physical activity level for Hong Kong Chinese children hospitalised with cancer: an exploratory study. J Clin Nurs 2016; 26:190-201. [DOI: 10.1111/jocn.13495] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Ka Yan Eva Ho
- School of Nursing; The University of Hong Kong; Hong Kong China
| | | | - Chi Fung Godfrey Chan
- Department of Paediatrics and Adolescent Medicine; LKS Faculty of Medicine; Queen Mary Hospital; The University of Hong Kong; Hong Kong China
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Grimshaw SL, Taylor NF, Shields N. The Feasibility of Physical Activity Interventions During the Intense Treatment Phase for Children and Adolescents with Cancer: A Systematic Review. Pediatr Blood Cancer 2016; 63:1586-93. [PMID: 27186955 DOI: 10.1002/pbc.26010] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/11/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND Physical activity may have benefits for children undergoing intense treatment for cancer, but such programmes are challenging to implement. This systematic review aimed to investigate the feasibly of physical activity interventions during intense cancer treatment for children and adolescents. PROCEDURE A systematic search of seven electronic databases (Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, Public/Publisher MEDLINE, Psychological Information Database, Sportsdiscuss, Excerpta Medica Database, Allied and Complementary Medicine Database) from 2005 to August 2015 was completed. The risk of bias was assessed using the Downs and Black Checklist and The Critical Review Form-Qualitative Studies. Results were summarised descriptively across eight domains of feasibility: acceptability, demand, implementation, adaptation, practicality, integration, expansion and limited efficiency testing (including effectiveness). RESULTS Eleven quantitative studies and one qualitative study were identified for inclusion. Physical activity interventions were typically supervised, individualised programmes that prescribed a variety of activity types for hospital inpatients. There was evidence that physical activity interventions during the intense phase of cancer treatment were acceptable to parents and children, safe and successfully implemented. A trend of positive effects across all aspects of functioning was noted. Data were unavailable documenting feasibility for the domains of integration, adaptation and expansion. CONCLUSION There is preliminary evidence that physical activity interventions are feasible, in that they are acceptable, safe and potentially beneficial for children with cancer but more work needs to be done to understand the most effective ways to implement these types of programmes.
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Affiliation(s)
- Sarah L Grimshaw
- School of Allied Health, La Trobe University, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia
| | - Nicholas F Taylor
- School of Allied Health, La Trobe University, Melbourne, Australia.,Allied Health Research Office, Eastern Health, Melbourne, Australia
| | - Nora Shields
- School of Allied Health, La Trobe University, Melbourne, Australia.,Department of Allied Health, Northern Health, Melbourne, Australia
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A Review of Cardiorespiratory Fitness in Adolescent and Young Adult Survivors of Childhood Cancer: Factors that Affect its Decline and Opportunities for Intervention. J Adolesc Young Adult Oncol 2016; 5:8-15. [DOI: 10.1089/jayao.2015.0031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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50
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Yelton L, Forbis S. Influences and Barriers on Physical Activity in Pediatric Oncology Patients. Front Pediatr 2016; 4:131. [PMID: 28066750 PMCID: PMC5165656 DOI: 10.3389/fped.2016.00131] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 11/21/2016] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES To determine the influence of family, peers, school, and physicians on exercise in pediatric oncology patients and evaluate the barriers to physical activity (PA) levels in this population. METHODS A search of PubMed and Google Scholar resulted in 12 related articles. The articles were assessed for the influence of school systems, family, peers, self-efficacy, and physicians on exercise. Additionally, barriers and interventions to PA were also assessed. Limitations and research methodologies of each article were also evaluated. RESULTS Many school systems were unsure of expectations in regards to PA for their returning students with cancer. Most schools acknowledged willingness to increase exercise for these students; however, there is a communication gap between the medical field and the school system on what expectations should be. Family is associated with increased PA levels and healthier diets in this population with children preferring mothers as exercise partners more than fathers. While physician interventions have been shown to positively impact PA, it has been reported that physicians are not engaging in exercise counseling with their patients. CONCLUSION Several issues and barriers related to PA in pediatric oncology population were identified. Studies have demonstrated that it is feasible to increase PA and self-efficacy in this population. Further research is needed to better understand and quantify these issues as well as further test the interventions that have been suggested in this review and have been successful in other pediatric populations.
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Affiliation(s)
- Larrilyn Yelton
- Boonshoft School of Medicine, Wright State University , Dayton, OH , USA
| | - Shalini Forbis
- Boonshoft School of Medicine, Wright State University , Dayton, OH , USA
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