Whole-body vibration (WBV) is a feasible and potentially beneficial exercise strategy for managing neuromuscular impairments like decreased strength or flexibility, mobility limitations and bone health in pediatric cancer survivors. However, as starting rehabilitation as early as possible is recommended to preserve physical function, this study investigated the feasibility of WBV for patients receiving cancer treatment for first cancer diagnosis. Eleven patients (various types of cancer, ages 7–17) participated in the supervised WBV intervention concomitant to acute cancer treatment, which involved chemotherapy. Training was implemented as part of a general exercise program and offered 3 days per week during hospitalization (warm-up, four progressive training exercises comprising 60–120 s, 21–27 Hz, 2 mm peak-to-peak-displacement). Feasibility, which was defined as the absence of WBV-related serious adverse events leading to study dropout, was primarily evaluated. Training documentation was additionally analyzed. As a main result, no serious adverse events leading to study dropout were reported. However, two incidents of bleeding (adverse events) were observed in patients with bleeding tendencies and low platelets (thrombocytes < 30,000/μL). After adjusting the platelet count threshold for WBV participation to 30,000/μL, no further incidents occurred. Moreover, due to WBV-related side effects like physical exhaustion, 11% of all training sessions had to be stopped and another 11% required reductions in the vibration load. Patients participated in 48% of the planned sessions. While main reasons for non-attendance were medical issues (35%), only few WBV sessions were missed, not completed or needed modifications due to motivational issues. Consequently, WBV seems to be feasible for inpatient pediatric patients receiving chemotherapy for first cancer diagnosis, given a sufficiently high platelet count of at least 30,000/μL. Although WBV tolerance and training motivation appear high, patient’s reduced medical condition during hospitalization can negatively impact training progression and attendance. Future research is required to confirm our findings on feasibility and to assess efficiency of WBV training for pediatric cancer patients receiving cancer treatment.

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Background Exercise interventions in pediatric oncology include primarily traditional types of physical activity (PA) such as endurance and strength training, while there is a growing interest in recreational types of PA for pediatric cancer survivors, as well. One of these motivating and fun activities is indoor wall climbing. Therefore, this exploratory study aims to evaluate the feasibility and beneficial effects of a 10-week indoor wall climbing intervention in pediatric oncology. Patients Thirteen childhood cancer survivors aged 6–21 years were included after cessation of their inpatient medical treatment of whom eleven completed the study. Methods Study participants completed measurements of physical functioning at baseline (t0) and post-intervention (t1), as well as a questionnaire on program satisfaction at t1. Results Survivors participated in 57.43±31.77% of the climbing sessions and no adverse events occurred. Most study participants evaluated the climbing experience to be fun and motivational. One child stated that the climbing intervention was too exhausting/overstraining. Significant positive effects were found in terms of ankle DF-ROM and ankle DF strength. Discussion Indoor wall climbing seems feasible with childhood cancer survivors and suggests beneficial potentials on physical functioning. However, some preconditions (i. e. close supervision; slow increase of intensity; sufficient breaks) must be ensured. Conclusion Indoor wall climbing could be a motivational adjunct to traditional types of exercise in pediatric oncology.

ZusammenfassungBei einem Sensomotoriktraining (SMT), hier konkret einem Gleichgewichtstraining als Unterform des SMT, werden Übungen auf unterschiedlich stabilen Untergründen und in verschiedenen Standpositionen durchgeführt. Es hat das Potenzial, Regenerations- und Anpassungsmechanismen anzuregen und so zur Plastizität des Nervensystems beizutragen. Das Training ermöglicht eine individuelle und an die Tagesform angepasste Umsetzung und zeichnet sich durch einen geringen Material- und Zeitaufwand sowie eine gute Reproduzierbarkeit aus. Das SMT findet schon lange Anklang in der Rehabilitation sowie der Verletzungs- und Sturzprophylaxe. In den vergangenen Jahren wurde es auch vermehrt im Bereich der Erwachsenenonkologie zur Verbesserung der oftmals weitreichenden therapiebedingten Beeinträchtigungen der unteren Extremitäten, wie z. B. eine verminderte Gleichgewichtsfähigkeit, umgesetzt. Auch an Krebs erkrankte Kinder und Jugendliche sind häufig, u. a. infolge einer Chemotherapie-induzierten Polyneuropathie (CIPN), von den genannten Beeinträchtigungen in der unteren Extremität betroffen. Diese können sie auch noch lange nach der medizinischen Therapie daran hindern, ausreichend körperlich aktiv zu sein. SMT hat in diesem Kontext das Potenzial, adäquate sensorische und motorische Voraussetzungen für ein ausreichendes Aktivitätsniveau zu schaffen.Mit dem Ziel einer kindgerechten, motivierenden und individuellen Umsetzung des SMT wurde am Departement für Sport, Bewegung und Gesundheit der Universität Basel ein spezielles Trainingskonzept für die Kinderonkologie entwickelt. Mit einer Drehscheibe können die Kinder die Übungen kreativ und spielerisch zusammensetzen und so die Schwierigkeit individuell an ihre Tagesform nach der Therapie anpassen. Die Umsetzbarkeit des Trainingskonzepts wurde in einer 4-wöchigen Pilotstudie im Rahmen eines etablierten pädiatrisch-onkologischen Nachsorgesportprogramms der Deutschen Sporthochschule Köln im Kinderkrankenhaus Amsterdamer Straße Köln erprobt. Es nahmen 6 Kinder und Jugendliche teil. Die vorläufigen Ergebnisse der Pilotstudie und ein Fallbeispiel zeigen, dass das kindgerechte und spielerische SMT nach einer Krebserkrankung im Kindesalter ohne Zwischenfälle umsetzbar ist und eine spezifische und wertvolle Ergänzung der pädiatrisch-onkologischen Bewegungstherapie darstellen kann.

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.