Effects of a combined physical and psychosocial training for children with cancer: a randomized controlled trial

Abstract

BackgroundPhysical fitness and psychosocial function is often reduced in children during or shortly after cancer treatment. This study evaluates the effect of a combined physical exercise and psychosocial intervention on cardiorespiratory fitness, muscle strength, body composition, psychosocial function and health-related quality of life (HrQoL). In addition, intervention mediators, applicability and adherence were examined.MethodsThis multicenter randomized controlled trial included 68 children with cancer [mean age 13.2 (SD: 3.1) years; 54% male] during treatment or within 12-months post-treatment. The 12-week intervention consisted of 24 individual physical exercise sessions supervised by a physiotherapist, and 6 psychosocial training sessions for children and 2 for parents. Physical fitness and psychosocial function were assessed at baseline, directly post-intervention and at 12 months’ post-baseline. Generalized estimating equations were used to simultaneously assess intervention effects at short and long-term. Additionally, we evaluated within-group differences over time. Potential physical and psychosocial mediators in the intervention effect on HrQoL were examined using the product-of-coefficient test. Applicability and adherence were assessed by trainer-report.ResultsThis study was able to compare 26 children who received the study intervention, with 33 children who received usual care. No significant differences in the effects of the intervention were found on physical fitness and psychosocial function at short-term. At 12-months follow-up, significantly larger improvements in lower body muscle strength (β = 56.5 Newton; 95% CI: 8.5; 104.5) were found in the intervention group when compared to the control group. Within-group changes showed significant improvements over time in HrQoL and bone density in both groups. Intervention effects on HrQoL were not significantly mediated by physical fitness and psychological function. Intervention applicability was satisfactory with an average session attendance of 67% and 22% dropout (mainly due to disease recurrence).ConclusionsThis 12-week physical exercise and psychosocial training intervention for children with cancer was applicable and showed satisfactory adherence. We found no significant between-group differences in effect, except for a significant improvement in lower body muscle strength at long-term in the intervention group compared to the control group. Yet, both the intervention and the control group showed improvements in bone mineral density and HrQoL over time.Trial registrationThe trial was registered at the Dutch Trial Registry (NTR1531). Registered 12 November 2008.

Longitudinal development of cancer‐related fatigue and physical activity in childhood cancer patients

“…There were no significant beneficial effects of the QLIM intervention on physical fitness, physical and psychosocial function at 4 and 12 months, except for a larger improvement in lower body muscle strength at 12 months in the intervention group. [26][27][28] Therefore, patients were evaluated together for the purpose of the present study, irrespective of the QLIM study group they were originally assigned to.…”

Behavioural interventions targeting physical activity and diet behaviours in pediatric oncology: A Scoping Review

“…The age of the participants ranged from three to 34 years old. Four studies targeted adolescents and/or young adults (11-34 years old) [21][22][23][24], seven included children and adolescents (4-20 years old) [25][26][27][28][29][30][31] and three were designed for the caregivers of younger children (3-13 years old) [32][33][34]. No studies included families of children younger than 3 years of age.…”

Primary Care: How to Increase Physical Activity in Your Patients

“…В ряде исследований было продемонстрировано, что риск развития злокачественных новообразований различной локализации, в частности, молочной железы и толстой кишки, уменьшается при нали-чии активного образа жизни [5][6][7][8][9][33][34][35][36]. ФА в сочетании с правильной диетой (метод тушения против метода глубокой жарки) снижает риск развития рака молочной железы [37] и простаты [38,39] и играет первостепенную роль в их профилактике [37,40].…”

“…Именно поэтому Американский фонд артрита рекомендует ФН в части тренировок гибкости и мышечной силы как важную составляющую терапии у пациентов с артри тами [26,43]. Регулярные ФН способствуют увеличению минеральной плотности костной ткани, снижают скорость потери костного кальция, предупреждая развитие остеопороза [43][44][45]. Анализ результатов ряда исследований показал, что при наличии ФА снижен риск перелома костей, в том числе тазобедренного сустава и позвоночника [45].…”

“…Всемирная организация здравоохранения в числе таких ФР преждевременной смертности населения в мире на четвертом месте выделила низкую физическую активность (ФА) [4]. При наличии гиподинамии на 20-30% увеличивается риск смерти от всех причин [1,5], в числе которых ведущие позиции занимают сердечно-сосудистые заболевания (ССЗ): повышаются риски возникновения артериальной гипертензии на 35-53%, ишемической болезни сердца (ИБС) -на 30%, сахарного диабета (СД) -на 27%, рака молочной железы и толстой кишки -на 21-25% [5][6][7][8][9]. В России около 40% взрослого населения имеют низкую ФА [4,5], что негативно влияет на производительность труда и продолжительность трудоспособной жизни, а следовательно, на общественное здоровье и социально-экономическую ситуацию [10], увеличивая прямые и косвенные затраты на здравоохранение [10,11].…”