Physical and functional performance assessment in pediatric oncology: a systematic review

Area of Science:

• Pediatric Oncology
• Rehabilitation Medicine
• Exercise Science

Background:

• Pediatric cancer patients experience reduced physical performance from diagnosis through survivorship.
• Existing research lacks systematic guidelines for assessing physical performance and function in this population.
• This gap hinders effective clinical practice and research.

Purpose of the Study:

• To systematically compile and describe assessments of physical performance and function in pediatric cancer patients and survivors.
• To cover a range of assessments including cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait, and motor performance test batteries.
• To provide a foundation for developing standardized assessment protocols.

Main Methods:

• Conducted a systematic search of PubMed, SPORTDiscus, and Cochrane databases.
• Screened 2619 articles based on the Cochrane Handbook of Systematic Reviews.
• Extracted data on patient characteristics, assessments, validity, reliability, and references from 149 included studies.

Main Results:

• Identified 63 distinct assessments across 149 studies involving 11,639 participants.
• Cardiorespiratory fitness and muscle strength were the most frequently evaluated outcomes, primarily in the off-treatment phase.
• Certain outcomes (e.g., speed) and diagnoses (e.g., neuroblastoma) were significantly underrepresented; leukemia patients were the most studied group.

Conclusions:

• Patient heterogeneity and limited data complicate uniform assessment recommendations.
• The findings support researchers and clinicians in selecting appropriate assessments for specific research questions or clinical needs.
• Highlights the need for research on underrepresented subgroups and outcomes to inform future assessment guidelines.