Balance training during acute medical treatment for pediatric cancer - subjective benefits and preliminary effects on selected physical abilities.

BACKGROUND: As balance training seems to be a promising training method to improve physical limitations of the lower limbs, this study aims to evaluate feasibility, subjective benefits and preliminary effects on physical abilities of balance training in pediatric cancer patients. PATIENTS: 11 pediatric cancer patients (5-21 years) undergoing acute medical treatment were included in the study. METHOD: Participants took part in a 4-week balance training intervention. 3 trainings/week were conducted either supervised or self-administered. Subjective benefits were evaluated using a questionnaire, effects on selected physical abilities were assessed using functional-motor assessments. RESULTS: Participants completed 71.21+37.34% of balance training sessions, no adverse events occurred. Participants were satisfied with the intervention and described various subjective benefits. Significant improvements were found in functional strength of the lower limbs as well as positive trends in balance. DISCUSSION: Balance training seems feasible with pediatric cancer patients undergoing acute medical treatment potentially improving functions of the lower limbs relevant for daily physical activity. CONCLUSION: Balance training can be a valuable conjunct to general exercise programs in pediatric oncology. HINTERGRUND: Da ein Gleichgewichtstraining eine vielversprechende Trainingsmethode zur Verbesserung körperlicher Beeinträchtigungen der unteren Extremitäten darstellt, untersucht die vorliegende Studie die Machbarkeit, subjektive und erste objektive Effekte eines Gleichgewichtstrainings auf körperliche Fähigkeiten bei onkologisch erkrankten Kindern. PATIENTEN: 11 Kinder und Jugendliche (5-21 Jahre) während der akutmedizinischen Behandlung einer onkologischen Erkrankung wurden in die Studie eingeschlossen. METHODIK: Die Patient*innen nahmen an einem 4-wöchigen Gleichgewichtstraining teil. 3 Trainingseinheiten/Woche wurden entweder supervidiert oder selbstständig umgesetzt. Subjektive Effekte wurden mit einem Fragebogen und die Effekte auf ausgewählte körperliche Fähigkeiten mittels funktionell-motorischer Testungen evaluiert. ERGEBNISSE: Die Teilnehmer*innen absolvierten 71.21+37.34% der Trainingseinheiten und es traten keine trainingsbedingten Zwischenfälle auf. Die Kinder waren zufrieden mit der Intervention und beschrieben verschiedene subjektive Effekte. Positive Veränderungen zeigten sich im Bereich der funktionellen Kraft der unteren Extremitäten und des Gleichgewichts. DISKUSSION: Ein Gleichgewichtstraining während der akutmedizinischen Behandlung in der Kinderonkologie scheint machbar und zeigt potenziell positive Effekte auf relevante Funktionen der unteren Extremitäten. SCHLUSSFOLGERUNG: Ein Gleichgewichtstraining kann eine wertvolle Ergänzung allgemeiner Bewegungsprogramme in der pädiatrischen Onkologie darstellen.

Physical activity programs for children diagnosed with cancer: an international environmental scan.

BACKGROUND: Physical activity programs for children diagnosed with cancer may enhance health and quality of life. However, it is unknown where and in what capacity such programs are being offered internationally. PURPOSE: To identify physical activity programs for children diagnosed with cancer and summarize program characteristics. METHODS: Five data sources were searched to identify physical activity programs offered to children diagnosed with cancer. Following confirmation of eligibility, correspondents were sent a series of open-ended questions via email. Data were extracted from responses and summarized descriptively and narratively. RESULTS: Of the 140 unique correspondents contacted, 46 programs, in 10 countries, met eligibility criteria. Responses to open-ended follow-up questions were obtained from 36 programs and were subsequently included in the content analysis. Internationally, the majority of programs are being offered to children in Europe, with mixed cancer types, at different stages of the cancer trajectory. There is relatively equal distribution with regard to the setting in which programs are offered (i.e., community, hospital, combination). All correspondents reported that their program is professionally supervised, and most require that children obtain medical clearance prior to participating. There is considerable variability in terms of other key program (e.g., funding) and physical activity characteristics (e.g., frequency). CONCLUSIONS: Findings from this environmental scan highlight where and in what capacity physical activity programs are being offered, providing guidance for those seeking to develop/implement physical activity programs themselves. Moreover, results highlight the current state of practice, underscoring the necessity of international networks, multi-site collaborations, and public relations to ensure all children diagnosed with cancer have access to physical activity programs.

Limited Walking Abilities and Impaired Ankle Dorsiflexion Function in Children After Intense Cancer Treatment.

BACKGROUND: With improved survival rates in pediatric oncology, the detection of adverse side- and late-effects is gaining increased interest. This cross-sectional study investigated walking abilities and ankle dorsiflexion function in children with cancer. PATIENTS: Study participants included 16 children with various cancers (4-20 years, patient group) after completion of the intense treatment and 16 age- and gender-matched healthy peers (comparison group). METHOD: Walking speed (10-meter-walking-test, treadmill test assessing preferred transition speed), walking capacity (2-minute-walk-test), walking balance (Timed-Up-And-Go-Test), active/passive ankle dorsiflexion range of motion (ROM) (goniometer) and ankle dorsiflexion strength (hand-held dynamometer) were comprehensively assessed. RESULTS: Significant lower values in the patient group were found for walking capacity, maximum walking speed, ankle dorsiflexion ROM and strength. No significant differences between the groups were found for preferred walking speed and walking balance. DISCUSSION: Limited walking abilities and ankle dorsiflexion dysfunctions are prominent in children with cancer; having the potential to impact children's community mobility and physical activity. CONCLUSIONS: To provide holistic care, the development of specific supportive strategies such as exercise interventions and its translation into clinical practice needs to be accelerated.

Whole-Body Vibration Training Designed to Improve Functional Impairments After Pediatric Inpatient Anticancer Therapy: A Pilot Study.

PURPOSE: To assess a whole-body vibration (WBV) intervention for children after cancer treatment. METHODS: Eleven children after inpatient anticancer therapy participated in a 12-week supervised WBV intervention, which consisted of one 9- to 13-minute WBV session per week, with 5 to 9 minutes' overall vibration time. Feasibility was defined as the ability to participate in WBV training without reporting adverse events. The number of offered and completed training sessions, program acceptance, and measures of function were assessed. RESULTS: Nine participants completed the WBV intervention without any WBV-related adverse events. The adherence rate was 87.96%. Only minor side effects were reported and there was general program acceptance. We found indications that WBV has positive effects on knee extensor strength and active ankle dorsiflexion range of motion. CONCLUSIONS: WBV was feasible, safe, and well received among children after inpatient anticancer therapy. No health deteriorations were observed. Positive effects need to be confirmed in future trials.

Exercise interventions for patients with pediatric cancer during inpatient acute care: A systematic review of literature.

Physical inactivity has been shown to exacerbate negative side effects experienced by pediatric patients undergoing cancer therapy. Exercise interventions are being created in response. This review summarizes current exercise intervention data in the inpatient pediatric oncology setting. Two independent reviewers collected literature from three databases, and analyzed data following the PRISMA statement for systematic reviews and meta-analyses. Ten studies were included, representing 204 patients. Good adherence, positive trends in health status, and no adverse events were noted. Common strategies included individual, supervised, combination training with adaptability to meet fluctuating patient abilities. We recommend that general physical activity programming be offered to pediatric oncology inpatients.