Exercise interventions in children with cancer: a review

Tseng-Tien Huang, Kirsten K Ness, Tseng-Tien Huang, Kirsten K Ness

Abstract

The purpose of this review is to summarize literature that describes the impact of exercise on health and physical function among children during and after treatment for cancer. Relevant studies were identified by entering the following search terms into Pubmed: aerobic training; resistance training; stretching; pediatric; children; AND cancer. Reference lists in retrieved manuscripts were also reviewed to identify additional trials. We include fifteen intervention trials published between 1993 and 2011 that included children younger than age 21 years with cancer diagnoses. Nine included children with an acute lymphoblastic leukemia (ALL) diagnosis, and six children with mixed cancer diagnoses. Generally, interventions tested were either in-hospital supervised exercise training or home based programs designed to promote physical activity. Early evidence from small studies indicates that the effects of exercise include increased cardiopulmonary fitness, improved muscle strength and flexibility, reduced fatigue and improved physical function. Generalizations to the entire childhood cancer and childhood cancer survivor populations are difficult as most of the work has been done in children during treatment for and among survivors of ALL. Additional randomized studies are needed to confirm these benefits in larger populations of children with ALL, and in populations with cancer diagnoses other than ALL.

References

    1. Smith MA, Seibel NL, Altekruse SF, et al. Outcomes for children and adolescents with cancer: challenges for the twenty-first century. Journal of Clinical Oncology. 2010;28(15):2625–2634.
    1. Hampton T. Cancer survivors need better care: new report makes recommendations. Journal of the American Medical Association. 2005;294(23):2959–2960.
    1. Bhatia SBJ, Meadows AT. Late effects of childhood cancer and its treatment. In: Pizzo Pa PD, editor. Principles and Practice of Pediatric Oncology. Philadelphia, Pa, USA: Lippincott Williams & Wilkins; 2006. pp. 1490–1514.
    1. Hudson MM, Mertens AC, Yasui Y, et al. Health status of adult long-term survivors of childhood cancer: a report from the childhood cancer survivor study. Journal of the American Medical Association. 2003;290(12):1583–1592.
    1. Mertens AC, Yasui Y, Neglia JP, et al. Late mortality experience in five-year survivors of childhood and adolescent cancer: the childhood cancer survivor study. Journal of Clinical Oncology. 2001;19(13):3163–3172.
    1. Oeffinger KC, Mertens AC, Sklar CA, et al. Chronic health conditions in adult survivors of childhood cancer. New England Journal of Medicine. 2006;355(15):1572–1582.
    1. Aznar S, Webster AL, San Juan AF, et al. Physical activity during treatment in children with leukemia: a pilot study. Applied Physiology, Nutrition and Metabolism. 2006;31(4):407–413.
    1. Jenney MEM, Faragher EB, Jones PHM, Woodcock A. Lung function and exercise capacity in survivors of childhood leukaemia. Medical and Pediatric Oncology. 1995;24(4):222–230.
    1. San Juan AF, Chamorro-Viña C, Maté-Muñoz JL, et al. Functional capacity of children with leukemia. International Journal of Sports Medicine. 2008;29(2):163–167.
    1. van Brussel M, Takken T, Lucia A, van der Net J, Helders PJM. Is physical fitness decreased in survivors of childhood leukemia? A systematic review. Leukemia. 2005;19(1):13–17.
    1. van Brussel M, Takken T, Van Der Net J, et al. Physical function and fitness in long-term survivors of childhood leukaemia. Pediatric Rehabilitation. 2006;(3):267–274.
    1. Warner JT, Bell W, Webb DKH, Gregory JW. Daily energy expenditure and physical activity in survivors of childhood malignancy. Pediatric Research. 1998;43(5):607–613.
    1. Adams MJ, Hardenbergh PH, Constine LS, Lipshultz SE. Radiation-associated cardiovascular disease. Critical Reviews in Oncology/Hematology. 2003;45(1):55–75.
    1. Argilés JM, López-Soriano FJ, Busquets S. Mechanisms to explain wasting of muscle and fat in cancer cachexia. Current Opinion in Supportive and Palliative Care. 2007;1(4):293–298.
    1. Courneya KS. Exercise in cancer survivors: an overview of research. Medicine and Science in Sports and Exercise. 2003;35(11):1846–1852.
    1. Duggan C, Bechard L, Donovan K, et al. Changes in resting energy expenditure among children undergoing allogeneic stem cell transplantation. American Journal of Clinical Nutrition. 2003;78(1):104–109.
    1. Kremer LCM, Van Dalen EC, Offringa M, Ottenkamp J, Voûte PA. Anthracycline-induced clinical heart failure in a cohort of 607 children: long-term follow-up study. Journal of Clinical Oncology. 2001;19(1):191–196.
    1. Lipshultz SE. Exposure to anthracyclines during childhood causes cardiac injury. Seminars in Oncology. 2006;33(3, supplement 8):S8–S14.
    1. Lipshultz SE, Lipsitz SR, Sallan SE, et al. Chronic progressive cardiac dysfunction years after doxorubicin therapy for childhood acute lymphoblastic leukemia. Journal of Clinical Oncology. 2005;23(12):2629–2636.
    1. Liu RDKS, Chinapaw MJM, Huijgens PC, Mechelen WV. Physical exercise interventions in haematological cancer patients, feasible to conduct but effectiveness to be established: a systematic literature review. Cancer Treatment Reviews. 2009;35(2):185–192.
    1. Marchese VG, Chiarello LA, Lange BJ. Effects of physical therapy intervention for children with acute lymphoblastic leukemia. Pediatric Blood and Cancer. 2004;42(2):127–133.
    1. San Juan AF, Chamorro-Vina C, Moral S, et al. Benefits of intrahospital exercise training after pediatric bone marrow transplantation. International Journal of Sports Medicine. 2008;29(5):439–446.
    1. San Juan AF, Fleck SJ, Chamorro-Viña C, et al. Effects of an intrahospital exercise program intervention for children with leukemia. Medicine and Science in Sports and Exercise. 2007;39(1):13–21.
    1. Juan AFS, Wolin K, Lucía A. Physical activity and pediatric cancer survivorship. Recent Results in Cancer Research. 2011;186:319–347.
    1. Jóhannsdóttir IM, Hjermstad MJ, Moum T, et al. Increased prevalence of chronic fatigue among survivors of childhood cancers: A population-based study. Pediatric Blood and Cancer. In press.
    1. Meeske KA, Patel SK, Palmer SN, Nelson MB, Parow AM. Factors associated with health-related quality of life in pediatric cancer survivors. Pediatric Blood and Cancer. 2007;49(3):298–305.
    1. Cox CL, Montgomery M, Oeffinger KC, et al. Promoting physical activity in childhood cancer survivors. Cancer. 2009;115(3):642–654.
    1. Wolin KY, Ruiz JR, Tuchman H, Lucia A. Exercise in adult and pediatric hematological cancer survivors: an intervention review. Leukemia. 2010;24(6):1113–1120.
    1. Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ, USA: Lawrence Erlbaum Associates; 1988.
    1. Blaauwbroek R, Bouma MJ, Tuinier W, et al. The effect of exercise counselling with feedback from a pedometer on fatigue in adult survivors of childhood cancer: a pilot study. Supportive Care in Cancer. 2008:1–8.
    1. Chamorro-Vina C, Ruiz JR, Santana-Sosa E, et al. Exercise during hematopoietic stem cell transplant hospitalization in children. Medicine and Science in Sports and Exercise. 2010;42(6):1045–1053.
    1. Gohar SF, Comito M, Price J, Marchese V. Feasibility and parent satisfaction of a physical therapy intervention program for children with acute lymphoblastic leukemia in the first 6 months of medical treatment. Pediatric Blood and Cancer. 2011;56(5):799–804.
    1. Hartman A, Te Winkel ML, Van Beek RD, et al. A randomized trial investigating an exercise program to prevent reduction of bone mineral density and impairment of motor performance during treatment for childhood acute lymphoblastic leukemia. Pediatric Blood and Cancer. 2009;53(1):64–71.
    1. Keats MR, Culos-Reed SN. A community-based physical activity program for adolescents with cancer (project TREK): program feasibility and preliminary findings. Journal of Pediatric Hematology/Oncology. 2008;30(4):272–280.
    1. Ladha AB, Courneya KS, Bell GJ, Field CJ, Grundy P. Effects of acute exercise on neutrophils in pediatric acute lymphoblastic leukemia survivors: a pilot study. Journal of Pediatric Hematology/Oncology. 2006;28(10):671–677.
    1. Moyer-Mileur LJ, Ransdell L, Bruggers CS. Fitness of children with standard-risk acute lymphoblastic leukemia during maintenance therapy: response to a home-based exercise and nutrition program. Journal of Pediatric Hematology/Oncology. 2009;31(4):259–266.
    1. Ruiz JR, Fleck SJ, Vingren JL, et al. Preliminary findings of a 4-month intrahospital exercise training intervention on IGFs and IGFBPs in children with leukemia. Journal of Strength and Conditioning Research. 2010;24(5):1292–1297.
    1. Sharkey AM, Carey AB, Heise CT, Barber G. Cardiac rehabilitation after cancer therapy in children and young adults. American Journal of Cardiology. 1993;71(16):1488–1490.
    1. Speyer E, Herbinet A, Vuillemin A, Briançon S, Chastagner P. Effect of adapted physical activity sessions in the hospital on health-related quality of life for children with cancer: a cross-over randomized trial. Pediatric Blood and Cancer. 2010;55(6):1160–1166.
    1. Takken T, van der Torre P, Zwerink M, et al. Development, feasibility and efficacy of a community-based exercise training program in pediatric cancer survivors. Psycho-Oncology. 2009;18(4):440–448.
    1. Yeh CH, Man Wai JP, Lin US, Chiang YC. A pilot study to examine the feasibility and effects of a home-based aerobic program on reducing fatigue in children with acute lymphoblastic leukemia. Cancer Nursing. 2011;34(1):3–12.
    1. Hinds PS, Hockenberry M, Rai SN, et al. Clinical Field Testing of an Enhanced-Activity Intervention in Hospitalized Children with Cancer. Journal of Pain and Symptom Management. 2007;33(6):686–697.
    1. San Juan AF, Fleck SJ, Chamorro-Viña C, et al. Early-phase adaptations to intrahospital training in strength and functional mobility of children with leukemia. Journal of Strength and Conditioning Research. 2007;21(1):173–177.
    1. American College of Sports Medicine. ACSM's Guidelines for Exercise Testing and Prescription. Philadelphia, Pa, USA: Williams & Wilkins; 2000.
    1. Golden E, Beach B, Hastings C. The pediatrician and medical care of the child with cancer. Pediatric Clinics of North America. 2002;49(6):1319–1338.
    1. Oude Nijhuis CSM, Daenen SMGJ, Vellenga E, et al. Fever and neutropenia in cancer patients: the diagnostic role of cytokines in risk assessment strategies. Critical Reviews in Oncology/Hematology. 2002;44(2):163–174.
    1. Skinner J, Finlay JL, Sondel PM, Trigg ME. Infectious complications in pediatric patients undergoing transplantation with T lymphocyte-depleted bone marrow. Pediatric Infectious Disease. 1986;5(3):319–324.
    1. Fairey AS, Courneya KS, Field CJ, Mackey JR. Physical exercise and immune system function in cancer survivors: a comprehensive review and future directions. Cancer. 2002;94(2):539–551.
    1. Chun DM, Corbin CB, Pangrazi RP. Validation of criterion-referenced standards for the mile run and progressive aerobic cardiovascular endurance tests. Research Quarterly for Exercise and Sport. 2000;71(2):125–134.
    1. Gerber LH, Hoffman K, Chaudhry U, et al. Functional outcomes and life satisfaction in long-term survivors of pediatric sarcomas. Archives of Physical Medicine and Rehabilitation. 2006;87(12):1611–1617.
    1. Marchese VG, Chiarello LA, Lange BJ. Strength and functional mobility in children with Acute Lymphoblastic Leukemia. Medical and Pediatric Oncology. 2003;40(4):230–232.
    1. Ness KK, Morris EB, Nolan VG, et al. Physical performance limitations among adult survivors of childhood brain tumors. Cancer. 2010;116(12):3034–3044.
    1. Clanton NR, Klosky JL, Li C, et al. Fatigue, vitality, sleep, and neurocognitive functioning in adult survivors of childhood cancer: a report from the childhood cancer survivor study. Cancer. 2011;117(11):2559–2568.
    1. Hockenberry MJ, Hooke MC, Gregurich M, McCarthy K, Sambuco G, Krull K. Symptom clusters in children and adolescents receiving cisplatin, doxorubicin, or ifosfamide. Oncology Nursing Forum. 2010;37(1):E16–27.

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅