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Published on: July 21, 2023
Effects of a Bone-Strengthening Exercise Intervention on Bone Health in Pediatric Cancer Survivors: A Randomized
Andres Marmol-Perez1, Esther Ubago-Guisado2, Jose J Gil-Cosano3
1Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN.
Objectives:
To investigate the effects of a 9-month online bone-strengthening exercise intervention on the femoral neck areal bone mineral density (aBMD) z score and other bone health parameters.
Design:
Assessor-blinded randomized controlled trial with 2 parallel arms.
Setting:
Sport and Health University Research Institute (iMUDS), Granada, Spain.
Participants:
A total of 116 pediatric cancer survivors (N=116) aged 6-18 years (12.1±3.3y; 42% girls).
Interventions:
Before the intervention, all participants received dietary counseling on calcium and vitamin D intake. The exercise group performed a 9-month periodized video-recorded bone-strengthening exercise intervention based on squats and jumps (3-4 d/wk for 10-20 min/session) at home.
Main Outcome Measures:
Primary (femoral neck aBMD [g/cm2]) and secondary outcomes (aBMD and bone mineral content [g]) were measured using dual-energy x-ray absorptiometry at the hip regions (femoral neck and total hip), total body, and lumbar spine (mean of L1-L4) at baseline and 9-month postintervention.
Results:
No between-group differences in femoral neck aBMD z score (Cohen d=-0.08; P=.706) and aBMD z score outcomes were observed after the intervention. However, the intervention showed small effect sizes on the total hip, with a borderline nonsignificant improvement in aBMD z score (Cohen d=0.35; P=.054) and a significant improvement in bone mineral content z score (Cohen d=0.38; P=.039).
Conclusions:
The 9-month online bone-strengthening exercise intervention did not increase the femoral neck aBMD z score; however, it improved the overall bone mineral content z score at the hip in young pediatric cancer survivors.
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