Occupational Therapy Interventions for Pediatric Cancer: A Systematic Review and Meta-Analysis

To examine the effects of occupational therapy (OT) interventions on physical, psychosocial, physical activity, and health-related quality of life outcomes in children with cancer.

This systematic review and meta-analysis followed the PRISMA guidelines. The eight databases searched were Academic Search Complete, CINAHL Complete, MasterFILE Complete, PubMed, Psychology and Behavioral Sciences Collection, SPORTDiscus, MEDLINE, and ProQuest. Reference lists of relevant articles were hand-searched, and the methodological quality of each study was assessed using the Cochrane Risk of Bias 2 tool for randomized controlled trials (RCTs).

30 RCTs comprising 1,808 children undergoing cancer treatment were included in the review. Interventions included creative arts (n = 3), exercise (n = 11), combined physical and psychosocial training (n = 3), web- and technology-based approaches (n = 4), animal-assisted interventions (n = 4), cognitive interventions (n = 3), and play-based OT and wish-granting programs (n = 2). Overall, OT interventions improved physical and psychosocial outcomes. Meta-analyses demonstrated significant post-intervention effects on pain, fatigue, upper- and lower-body muscle strength, anxiety/depression, communication, psychosocial functioning, physical activity, and health-related quality of life (Standardized Mean Differences ranging from -0.49 to -0.96; p ≤ 0.04).

OT interventions have the potential to enhance physical and psychosocial well-being and support functional outcomes in children undergoing cancer treatment. Future research should examine interventions by specific cancer types and occupation-based outcomes, such as daily living skills.