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Physical Activity, the Childhood Cancer Symptom Cluster-Leukemia, and Cognitive Function: A Longitudinal Mediation

Mary C Hooke1, Cheryl Rodgers, Olga Taylor

  • 1Author Affiliations: School of Nursing, University of Minnesota, Minneapolis (Dr Hooke); School of Nursing, Duke University, Durham, North Carolina (Drs Rodgers, Pan, and Hockenberry); Texas Children's Cancer and Hematology Centers/Baylor College of Medicine, Houston (Ms Taylor and Dr Scheurer); College of Nursing, University of Arizona, Tucson (Ms Koerner and Dr Moore); Children's Minnesota Cancer and Blood Disorders Program, Minneapolis (Ms Mitby and Dr Hooke).

Cancer Nursing
|August 21, 2018
PubMed

Insights

Physical activity (PA) influences symptom clusters and cognitive function in children with leukemia. Symptom management may protect cognitive function during treatment.

Area of Science:

  • Pediatric Oncology
  • Child Psychology
  • Rehabilitation Medicine

Background:

  • Children undergoing leukemia treatment often experience a cluster of symptoms including fatigue, sleep disturbances, pain, nausea, and depression.
  • Physical activity (PA) is crucial for child development and may impact the severity of these co-occurring symptoms.
  • Children with leukemia face risks of cognitive impairments, particularly from central nervous system therapies.

Purpose of the Study:

  • To investigate the longitudinal mediation effects of physical activity (PA) on cognitive function through a symptom cluster in children undergoing leukemia treatment.
  • To explore how changes in PA and symptom severity over time influence cognitive outcomes.

Main Methods:

  • A longitudinal parallel-process model was used, tracking 327 children (aged 3-18) over four intervals in their first year of leukemia treatment.
  • Data on symptoms, PA, and cognitive function were collected through self-reports (for children 7+) and parent reports (for younger children and cognitive measures).
  • Statistical analyses examined the influence of initial PA and changes in PA on the symptom cluster, and whether the symptom cluster mediated the relationship between PA and cognition over time.

Main Results:

  • Higher initial physical activity (PA) was associated with reduced symptom cluster severity over time.
  • Conversely, increases in PA during treatment correlated with increased symptom cluster severity.
  • A more severe symptom cluster at baseline predicted lower cognitive function, with cognitive function declining as symptoms worsened over time.

Conclusions:

  • The symptom cluster significantly mediated the relationship between physical activity (PA) and cognitive function in children undergoing leukemia treatment.
  • Symptom management strategies during cancer treatment may serve as a crucial method for preserving cognitive function in pediatric patients.
Abstract

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