Implementing exercise interventions in pediatric oncology: an expert consensus framework from the FORTEe project

Area of Science:

• Pediatric Oncology
• Exercise Science
• Implementation Science

Background:

• Exercise therapy is gaining recognition in pediatric oncology supportive care.
• Implementation of structured exercise programs remains inconsistent across Europe.
• The FORTEe project, funded by the EU, aims to address this gap.

Purpose of the Study:

• To provide practical, resource-adapted recommendations for implementing exercise therapy in pediatric oncology.
• To support multidisciplinary teams in establishing and sustaining precision-based exercise programs.
• To facilitate the integration of exercise into routine childhood cancer care.

Main Methods:

• Expert consensus derived from a multinational trial preparation and implementation process.
• Recommendations based on the collaborative experience of the FORTEe trial (NCT05289739).
• Focus on resource-adapted strategies for diverse settings.

Main Results:

• Recommendations cover key implementation domains: human resources, staff training, medical clearance, complication monitoring, program delivery, and legal requirements.
• Guidance is provided for diverse resource settings.
• Addresses interprofessional role distribution and exercise adaptation.

Conclusions:

• Offers practical, context-specific guidance for stepwise implementation of exercise therapy.
• Aims to facilitate safe and sustainable integration of exercise into pediatric oncology care.
• Applicable across heterogeneous pediatric oncology settings with varying resource availability.