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Marmol-Perez A, Gil-Cosano JJ, Ubago-Guisado E, Llorente-Cantarero FJ, Pascual-Gázquez JF, Ness KK, Martinez-Vizcaino V, Ruiz JR, Gracia-Marco L. Muscle strength deficits are associated with low bone mineral density in young pediatric cancer survivors: The iBoneFIT project. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:419-427. [PMID: 38219958 PMCID: PMC11117007 DOI: 10.1016/j.jshs.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/16/2023] [Accepted: 12/18/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Pediatric cancer survivors are at increased risk of muscle weakness and low areal bone mineral density (aBMD). However, the prevalence of muscle strength deficits is not well documented, and the associations of muscle strength with aBMD are unknown in this population. Therefore, this study aimed to investigate the prevalence of upper- and lower-body muscle strength deficits and to examine the associations of upper- and lower-body muscle strength with age-, sex, and race-specific aBMD Z-scores at the total body, total hip, femoral neck, and lumbar spine. METHODS This cross-sectional study included 116 pediatric cancer survivors (12.1 ± 3.3 years old, mean ± SD; 42.2% female). Upper- and lower-body muscle strength were assessed by handgrip and standing long jump test, respectively. Dual‑energy X‑ray absorptiometry was used to measure aBMD (g/cm2). Associations between muscle strength and aBMD were evaluated in multivariable linear regression models. Logistic regression was used to evaluate the contribution of muscle strength (1-decile lower) to the odds of having low aBMD (Z-score ≤ 1.0). All analyses were adjusted for time from treatment completion, radiotherapy exposure, and body mass index. RESULTS More than one-half of survivors were within the 2 lowest deciles for upper- (56.9%) and lower- body muscle strength (60.0%) in comparison to age- and sex-specific reference values. Muscle strength deficits were associated with lower aBMD Z-scores at all sites (B = 0.133-0.258, p = 0.001-0.032). Each 1-decile lower in upper-body muscle strength was associated with 30%-95% higher odds of having low aBMD Z-scores at all sites. Each 1-decile lower in lower-body muscle strength was associated with 35%-70% higher odds of having low aBMD Z-scores at total body, total hip, and femoral neck. CONCLUSION Muscle strength deficits are prevalent in young pediatric cancer survivors, and such deficits are associated with lower aBMD Z-scores at all sites. These results suggest that interventions designed to improve muscle strength in this vulnerable population may have the added benefit of improving aBMD.
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Affiliation(s)
- Andres Marmol-Perez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18011, Spain; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Jose J Gil-Cosano
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18011, Spain; Department of Communication and Education, Loyola University Andalusia, Seville 41704, Spain
| | - Esther Ubago-Guisado
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18011, Spain; Biosanitary Research Institute, ibs.Granada, Granada 18012, Spain
| | - Francisco J Llorente-Cantarero
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba 14004, Spain; CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid 28029, Spain; Department of Specific Didactics, Faculty of Education, University of Cordoba, Cordoba 14071, Spain
| | - Juan Francisco Pascual-Gázquez
- Pediatric and adolescent hematology and oncology service, Pediatrics and Pediatric Surgery Clinical Management Unit, Virgen de las Nieves University Hospital, Granada 18014, Spain
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | | | - Jonatan R Ruiz
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18011, Spain; Biosanitary Research Institute, ibs.Granada, Granada 18012, Spain; CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid 28029, Spain
| | - Luis Gracia-Marco
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18011, Spain; Biosanitary Research Institute, ibs.Granada, Granada 18012, Spain; CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid 28029, Spain.
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Kowaluk A, Siewierska K, Choniawkova M, Sedlacek P, Kałwak K, Malicka I. Physical Activity Level and Quality of Life of Children Treated for Malignancy, Depending on Their Place of Residence: Poland vs. the Czech Republic: An Observational Study. Cancers (Basel) 2023; 15:4695. [PMID: 37835387 PMCID: PMC10571542 DOI: 10.3390/cancers15194695] [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: 08/02/2023] [Revised: 09/16/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
This study aimed to assess the level of physical activity (PA) and quality of life of cancer-treated children, depending on their place of residence (Poland vs. the Czech Republic, where incidence and mortality rates of childhood malignancies are similar). A total of 68 school-age children (7-18 years) undergoing oncological treatment were included in this study. This study used the quality of life questionnaire (KIDSCREEN-10) and the HBSC questionnaire. This study showed statistically significant differences in the level of PA between Polish and Czech children. In Poland, 93.75% of children exhibited no weekly physical effort at the level of moderate to vigorous PA. In the Czech Republic, 69.44% of children engaged in PA lasting at least 60 min per day, or at least 1 day weekly. Physically active children engaging in more frequent effort, at least 60 min daily, reported higher physical performance (rho = 0.41), higher energy levels (rho = 0.41), and less mood disturbance (rho = -0.31). Children with good relationships with parents were more likely to engage in submaximal PA and spend less time on stationary games. Our study showed that an appropriate level of PA improves well-being and quality of life. It is crucial to promote attractive PA programs tailored for cancer-treated children.
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Affiliation(s)
- Aleksandra Kowaluk
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland (I.M.)
- Supraregional Center of Paediatric Oncology “Cape of Hope”, Wroclaw University Clinical Hospital, 50-556 Wroclaw, Poland;
| | - Katarzyna Siewierska
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland (I.M.)
| | - Marie Choniawkova
- Department of Paediatric Haematology and Oncology, University Hospital Motol, 150 06 Prague, Czech Republic (P.S.)
| | - Petr Sedlacek
- Department of Paediatric Haematology and Oncology, University Hospital Motol, 150 06 Prague, Czech Republic (P.S.)
| | - Krzysztof Kałwak
- Supraregional Center of Paediatric Oncology “Cape of Hope”, Wroclaw University Clinical Hospital, 50-556 Wroclaw, Poland;
| | - Iwona Malicka
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland (I.M.)
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