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Exercise Intervention in Pediatric Patients with Solid Tumors: The Physical Activity in Pediatric Cancer Trial
Carmen Fiuza-Luces1, Julio R Padilla, Luisa Soares-Miranda
11Research Institute of the Hospital '12 de Octubre' (i + 12), Madrid, SPAIN; 2Spanish Network for Biomedical Research in Rare Diseases (CIBERER), U723, SPAIN; 3School of Doctorate Studies and Research, European University, Madrid, SPAIN; 4Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, PORTUGAL; 5Innate Immune Research Group, IdiPAZ, Madrid, SPAIN; 6Department of Health Sciences, GIDFYS, European University Miguel de Cervantes, Valladolid, SPAIN; 7Department of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital Niño Jesús, Madrid, SPAIN; 8Andrews Research and Education Foundation, Gulf Breeze, FL; and 9Department of Pediatric Hemato-Oncology and Stem Cell Transplantation, University Hospital La Paz, Madrid, SPAIN.
Insights
Pediatric cancer patients undergoing chemotherapy showed improved muscle strength with an in-hospital exercise program. This physical activity intervention enhanced strength without adverse events, benefiting patients with solid tumors.
Area of Science:
- Oncology
- Exercise Physiology
- Pediatrics
Background:
- Pediatric cancer patients undergoing neoadjuvant chemotherapy often experience decreased physical function.
- Maintaining muscle strength is crucial for recovery and quality of life in these patients.
Purpose of the Study:
- To evaluate the impact of an in-hospital exercise intervention on muscle strength and other physical parameters in pediatric cancer patients with solid tumors receiving neoadjuvant chemotherapy.
Main Methods:
- A randomized controlled trial was conducted with pediatric cancer patients.
- Participants were assigned to either an exercise group (aerobic and strength training) or a control group.
- Muscle strength (five-repetition-maximum tests) and secondary endpoints were assessed at baseline, end of treatment, and 2 months post-treatment.
Main Results:
- The exercise intervention group demonstrated significant increases in leg press, bench press, and lateral row strength compared to the control group (P < 0.001).
- Muscle strength gains were maintained or further improved at the 2-month follow-up.
- No significant adverse events were reported, and adherence averaged 68%.
Conclusions:
- An in-hospital exercise program effectively increases muscle strength in pediatric cancer patients with solid tumors undergoing neoadjuvant chemotherapy.
- This intervention is safe and feasible, offering a potential strategy to mitigate treatment-related physical decline.
Introduction:
The randomized controlled trial "Physical Activity in Pediatric Cancer" determined the effects of an inhospital exercise intervention combining aerobic and muscle strength training on pediatric cancer patients with solid tumors undergoing neoadjuvant chemotherapy.
Methods:
Participants were allocated to an exercise (n = 24, 17 boys; mean ± SEM age, 10 ± 1 yr) or control group (n = 25, 18 boys; 11 ± 1 yr). Training included three sessions per week for 19 ± 2 wk. Participants were assessed at treatment initiation, termination, and 2 months after end treatment. The primary endpoint was muscle strength (as assessed by upper and lower-body five-repetition-maximum tests). Secondary endpoints included cardiorespiratory fitness, functional capacity during daily life activities, physical activity, body mass and body mass index, and quality of life.
Results:
Most sessions were performed in the hospital's gymnasium. Adherence to the program averaged 68% ± 4% and no major adverse events or health issues were noted. A significant interaction (group-time) effect was found for all five-repetition maximum tests (leg/bench press and lateral row; all P < 0.001). Performance significantly increased after training (leg press: 40% [95% confidence interval [CI], 15-41 kg); bench press: 24% [95% CI, 6-14 kg]; lateral row 25% [95% CI, 6-15 kg]), whereas an opposite trend was found in controls. Two-month post values tended to be higher than baseline for leg (P = 0.017) and bench press (P = 0.014). In contrast, no significant interaction effect was found for any of the secondary endpoints.
Conclusion:
An inhospital exercise program for pediatric cancer patients with solid tumors undergoing neoadjuvant treatment increases muscle strength despite the aggressiveness of such therapy.
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