This study describes skeletal, neuromuscular and fitness impairments among 109 children (median age 10 (range 4–18) years, 65.1% male, 63.3% white) with acute lymphoblastic leukemia (ALL), enrolled on a physical activity trial from 2009 to 2013. Outcomes were measured 7-10 days after diagnosis and compared to age- and sex-specific expected values. Associations between function and HRQL were evaluated with logistic regression. Children low values for BMD z-scores/height (mean±standard error: −0.53±0.16 vs. 0.00±0.14, p <0.01), body mass index percentile (57.6±3.15 vs. 50.0±3.27%, p=0.02), quadriceps strength (201.9±8.3 vs. 236.1±5.4 Newtons, p<0.01), six minute walk distance (385.0±13.1 vs. 628.2±7.1 meters, p < 0.001), and Bruininks-Oseretsky Test of Motor Proficiency (23±2.5 vs. 50±3.4%, p < 0.001). Quadriceps weakness was associated with a 20.9-fold (95% CI 2.5–173.3) increase in poor physical HRQL. Children with newly diagnosed ALL have weakness and poor endurance and may benefit from early rehabilitation that includes strengthening and aerobic conditioning.

Background. Resistance training research has demonstrated positive effects for persons with Parkinson's disease (PD), but the number of acute training variables that can be manipulated makes it difficult to determine the optimal resistance training program. Objective. The purpose of this investigation was to examine the effects of an 8-week resistance training intervention on strength and function in persons with PD. Methods. Eighteen men and women were randomized to training or standard care for the 8-week intervention. The training group performed 3 sets of 5–8 repetitions of the leg press, leg curl, and calf press twice weekly. Tests included leg press strength relative to body mass, timed up-and-go, six-minute walk, and Activities-specific Balance Confidence questionnaire. Results. There was a significant group-by-time effect for maximum leg press strength relative to body mass, with the training group significantly increasing their maximum relative strength (P < .05). No other significant interactions were noted (P > .05). Conclusions. Moderate volume, high-load weight training is effective for increasing lower-body strength in persons with PD.

• Elimination of cranial radiation from therapy for childhood acute lymphoblastic leukemia has improved bodycomposition outcomes.• Survivors of childhood acute lymphoblastic leukemia treated without cranial radiation remain at risk for impaired fitness.There is limited information on body composition, energy balance, and fitness among survivors of childhood acute lymphoblastic leukemia (ALL), especially those treated without cranial radiation therapy (CRT). This analysis compares these metrics among 365 ALL survivors with a mean age of 28.6 6 5.9 years (149 treated with and 216 without CRT) and 365 age-, sex-, and race-matched peers. We also report risk factors for outcomes among survivors treated without CRT. Male survivors not exposed to CRT had abnormal body composition when compared with peers (% body fat, 26.2 6 8.2 vs 22.7 6 7.1). Survivors without CRT had similar energy balance but had significantly impaired quadriceps strength (221.9 6 6.0 Newton-meters [Nm]/kg, 60°/s) and endurance (211.4 6 4.6 Nm/kg, 300°/s), exercise capacity (22.0 6 2.1 ml/kg per minute), low-back and hamstring flexibility (24.7 6 1.6 cm), and dorsiflexion range of motion (23.1 6 0.9°) and higher modified total neuropathy scores (11.6 6 1.1) than peers. Cumulative asparaginase dose ‡120 000 IU/m 2 was associated with impaired flexibility, vincristine dose ‡39 mg/m 2 with peripheral neuropathy, glucocorticoid (prednisone equivalent) dose ‡8000 mg/m 2 with hand weakness, and intrathecal methotrexate dose ‡225 mg with dorsiflexion weakness. Physical inactivity was associated with hand weakness and decreased exercise capacity. Smoking was associated with peripheral neuropathy. Elimination of CRT from ALL therapy has improved, but not eliminated, body-composition outcomes. Survivors remain at risk for impaired fitness. (Blood. 2015;125(22):3411-3419)

Short-term resistance training may be associated with reduced oxidative stress in subjects with PD. Future studies with larger samples, inclusive of a higher volume of resistance exercise, are needed to extend these findings.

Background Childhood cancer survivors (CCS) are at risk for obesity. The purpose of this project was to determine which clinical measures of body composition are most accurate among CCS when compared to dual energy x-ray absorptiometry (DXA). Methods We evaluated agreement between body mass index (BMI), skinfolds percent body fat, and waist to height ratio (WHtR), with DXA among 1361 CCS (mean age 32.4±7.7), ≥10 years from diagnosis. We calculated sensitivity and specificity of BMI, skinfolds, and WHtR obesity classifications compared to DXA. Log-binomial regression, stratified by sex, was used to evaluate treatment-related factors for misclassification as non-obese by BMI, skinfolds, and WHtR. Results Mean body fat values for skinfolds were 23.3±7.7% (males) and 32.3±8.1% (females), and for DXA, 26.9±7.4% (males) and 38.4±7.7% (females). Pearson correlations between skinfolds and DXA were high: R=0.83 males, R=0.84 female. Skinfolds incorrectly classified 34.5% of obese males and 27.3% of obese females. BMI measures were the least sensitive with false negative rates of 46.4% (males) and 53.1% (females). Males exposed to abdominal/pelvic radiation were at increased risk for misclassification as non-obese by BMI (RR 1.57; 95% CI 1.25–1.95). The percentages classified as obese were highest when using DXA (63.1%, males; 84.8%, females) and lowest when using BMI (35.7%, males; 39.7%, females). Although skinfolds and WHtR underestimated the percentage classified as obese compared to DXA, the differences were not as large. Conclusion Findings suggest that skinfolds and WHtR are better than BMI for obesity classification in CCS. Clinicians should be aware of the high risk of misclassifying obese CCS as non-obese.