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Telemedicine-based adapted physical activity programs for pediatric oncology patients in active oncological care: a
Linda Peli1, Elisa Inselvini1, Marta Cogliati2
1Lega Italiana Lotta Tumori (LILT), Brescia, Italy.
Insights
Telemedicine-based adapted physical activity (APA) programs show promise for improving quality of life and function in pediatric cancer survivors. High adherence suggests feasibility for long-term survivorship care.
Area of Science:
- Pediatric Oncology
- Rehabilitation Medicine
- Digital Health
Background:
- Pediatric cancer survivors face long-term challenges like musculoskeletal issues and reduced physical activity, impacting quality of life (QoL) and cardiovascular health.
- Traditional rehabilitation programs present access barriers, highlighting the need for innovative solutions like telemedicine.
- Adapted Physical Activity (APA) is crucial for managing these long-term health challenges.
Purpose of the Study:
- To assess the feasibility and adherence of a telemedicine-integrated APA program for pediatric oncology patients.
- To explore the program's effectiveness on functional and psychosocial outcomes as a secondary objective.
Main Methods:
- Included children and adolescents (5-18 years) with onco-hematological conditions.
- Assessed participants pre- and post-intervention using functional tests and QoL tools (PedsQL™).
- Implemented personalized exercise regimens (strength, aerobic, flexibility, balance) with in-person and remote telemedicine supervision.
Main Results:
- High adherence (median 77.08%) was observed in the 18 participants.
- Preliminary improvements noted in QoL (PedsQL™ child, p=0.007), fatigue (p=0.035), and functional performance (chair stand test, p=0.033).
- Remote training frequency positively correlated with QoL improvement (p=0.027), and influenced flexibility; parental perceptions also improved.
Conclusions:
- Telemedicine-integrated APA programs are feasible and potentially effective for improving QoL and function in pediatric oncology patients.
- These findings support the integration of digital health solutions in survivorship care.
- Larger studies are required to confirm the effectiveness of these interventions.
Background:
Survival rates for pediatric hematological malignancies have significantly improved over the last 50 years. However, children undergoing cancer treatment face long- term health challenges, including musculoskeletal impairments and reduced physical activity levels, which contribute to poorer quality of life (QoL) and elevated cardiovascular risks. Barriers to accessing traditional physical activity and rehabilitation programs necessitate innovative approaches like telemedicine-based interventions.
Objective:
The primary objective was to evaluate the feasibility and adherence of a telemedicine-integrated adapted physical activity (APA) program in pediatric oncology patients. Effectiveness, in terms of functional and psychosocial outcomes, was considered as an exploratory secondary endpoint. Although some statistically significant findings were observed, these results should be interpreted as supportive evidence and not as definitive proof of effectiveness.
Methods:
The study included children and adolescents (5-18 years) with onco-hematological conditions. Participants underwent baseline (Pre-APA) and six-month (post-APA) assessments using different functional tests and validated QoL evaluation tools (PedsQLTM). The intervention comprised personalized exercise regimens targeting strength, aerobic capacity, flexibility, and balance. Supervised training sessions were conducted both in-person and remotely via telemedicine solutions. Secondary outcomes included quadriceps muscle and hand- grip strength, balance, fatigue, and health-related QoL. Statistical analyses utilized mixed regression models to evaluate pre-post intervention changes and the impact of remote training.
Results:
Eighteen subjects (8 female, median age 12 years) were included. The APA program demonstrated high adherence (median 77.08%). Preliminary improvements were observed in QoL (PedsQLTM child, p=0.007), fatigue (p=0.035), and functional performance (chair stand test, p=0.033). Regression analysis indicated a positive correlation between remote training frequency and QoL improvement (p=0.027, R²=0.235). Although strength measures showed no significant improvement, remote training influenced flexibility outcomes. Parental perceptions of fatigue and QoL also improved (p=0.049).
Conclusion:
Telemedicine-based APA programs are a feasible and effective approach for enhancing QoL and functional capacity in pediatric oncology patients. These preliminary findings support the integration of digital health solutions in long-term survivorship care, though larger studies are needed to confirm these results.
