Testing physical function in children undergoing intense cancer treatment—a RESPECT feasibility study

Nielsen, Martin; Christensen, Jesper; Frandsen, Thomas Leth; Thorsteinsson, Troels; Andersen, Lars Bo; Christensen, Karl Bang; Nersting, Jacob; Faber, Mette Tuxen; Schmiegelow, Kjeld; Larsen, Hanne Bækgaard

doi:10.1002/pbc.27100

Cited by 21 publications

(25 citation statements)

References 34 publications

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“…While posturography was only performed after medical treatment, two studies conducted balance tests during treatment. 114 , 148 Bone tumor patients were only included in one study, 103 while CNS cancer cohorts were the population of main interest. In terms of age, a wide spectrum including very young children, as well as older adult survivors of childhood cancer (up to an age of 63 years) were analyzed.…”

Section: Resultsmentioning

confidence: 99%

Physical and functional performance assessment in pediatric oncology: a systematic review

et al. 2021

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Background Research indicates reduced physical performance from diagnosis into survivorship of pediatric cancer patients. However, there is no systematic information or guideline available on the methods to assess physical performance and function in this population. The purpose was to systematically compile and describe assessments of physical performance and function in patients and survivors of pediatric cancer, including cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait and motor performance test batteries. Methods We searched the databases PubMed, SPORTDiscus, and Cochrane Database and performed abstract and full-text selection of 2619 articles according to the Cochrane Handbook of Systematic Reviews. Information on patients characteristics, assessments, information on validity and reliability, and relevant references was extracted. Results In summary, 63 different assessments were found in 149 studies including 11639 participants. Most studies evaluated cardiorespiratory fitness and muscle strength with the majority conducted off treatment. Some outcomes (e.g. speed) and diagnoses (e.g. neuroblastoma) were severely underrepresented. With the exception of gait, leukemia patients represented the largest group of individuals tested. Conclusions Insufficient data and patient heterogeneity complicate uniform recommendations for assessments. Our results support researchers and practitioners in selecting appropriate assessment to meet their specific research questions or individual daily practice needs. Impact This systematic review includes 149 studies and provides a comprehensive summary of 63 assessments to evaluate cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait or motor performance test batteries in patients and survivors of pediatric cancer. We present the most studied fields within the pediatric cancer population, which are cardiorespiratory fitness and muscle strength, off treatment phase, and leukemia patients. We propose research priorities by identification of subgroups in terms of cancer type, phase of treatment, and outcome of interest that are underrepresented in studies currently available.

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Section: Resultsmentioning

confidence: 99%

Physical and functional performance assessment in pediatric oncology: a systematic review

et al. 2021

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“…Our intervention was likely to be too early, at least without supervision and personalized guidance, which might be one reason for poor fidelity. Nonetheless, recent evidence is reasoning early PA interventions since Nielsen et al found 24% reduction at 3 months in physical function in children with ALL [18]. Motivating children to be physically active from the beginning of the treatment with the existing resources remains a challenge.…”

Section: Discussionmentioning

confidence: 99%

“…Acceptability of the intervention was evaluated based on Bowen et al [17] and similarly than Nielsen et al [18] by reporting the participation rate from the eligible patients and by reporting the retention rate of the participants during follow-up. We also gained information about the acceptability from the interviews.…”

Section: Methodsmentioning

confidence: 99%

The effect of an active video game intervention on physical activity, motor performance, and fatigue in children with cancer: a randomized controlled trial

et al. 2019

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ObjectiveTo evaluate the effect of active video games in promoting physical activity and motor performance, and reducing fatigue in children with cancer. A randomized controlled trial was conducted. The intervention included playing Nintendo Wii™Fit (Nintendo Co., Ltd., Kyoto, Japan) for 30 min/day for 8 weeks. Physical activity was estimated with accelerometers, physical activity diaries and questionnaires. Movement-ABC2 and PedsQL™ were used to examine motor performance and fatigue. Intervention experiences and fidelity were examined with an interview.ResultsParticipants (n = 36 children with cancer, 3–16 years-old) were randomly assigned to the intervention and control groups. The median [min–max] accelerometer counts/h (500 [131–1130] vs 385 [116–1012], p = 0.63) and physical activity min/day (34 [0–150] vs 23 [0–260], p = 0.95) did not differ between the groups. Change between the pre-test and post-test regarding motor performance and fatigue was similar in both groups (motor performance p = 0.77; fatigue p = 1.00). Participants experienced playing active video games meaningful, but the intervention was not followed completely as instructed. Overall, the physical activity levels were low and one fourth of the children had or were at risk of having movement difficulties.Trial registration: ClinicalTrials.gov identifier: NCT01748058 (October 15, 2012)

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“…The INTERACT study is a national multicenter, two-arm parallel-group, randomized controlled superiority trial based on empirical evidence within the research group ( 13 , 18 , 43 , 62 ) and methodical recommendations from current evidence ( 27 ). The primary endpoint is at 6 months after inclusion, and follow-up will be 12 months after ended treatment.…”

Section: Methods and Analysismentioning

confidence: 99%

“…Further, it is based on several years of experience with exercising children and adolescents with cancer through the RESPECT project (REhabilitation including Social and Physical activity and Education in Children and Teenagers with cancer), based at Copenhagen University Hospital, Rigshospitalet. The RESPECT project has shown how children can and will perform safe, in-hospital exercise and how this counteracts side effects resulting from cancer treatment, including loss of fitness and muscle strength, compared with children in pediatric wards in other Danish hospitals ( 13 , 18 , 29 , 43 ). Two key principles of RESPECT are early rehabilitation from treatment initiation and supervised exercise, hypothesizing that: (1) Maintaining children's physical function and fitness is easier during treatment than recovering deficits and developing new relationships post-treatment and (2) supervised exercise is more effective than unsupervised exercise.…”

Section: Methods and Analysismentioning

confidence: 99%

Integrative Neuromuscular Training in Adolescents and Children Treated for Cancer (INTERACT): Study Protocol for a Multicenter, Two-Arm Parallel-Group Randomized Controlled Superiority Trial

et al. 2022

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BackgroundImproved survival rates for children and adolescents diagnosed with cancer call for novel strategies for reducing short- and long-term treatment-related side effects. These include the physical and metabolic sequelae that are exacerbated by sedentary behavior and treatment-induced toxicities. We aim to investigate the effect of an integrative neuromuscular training intervention during the first 6 months of anti-cancer treatment primarily on muscle strength, and secondarily on exercise capacity, physical function, markers of metabolic syndrome, dysmetabolism, and health-related quality of life during and after ended treatment.MethodsOne hundred and twenty-seven children and adolescents, newly diagnosed with malignant and benign neoplasia, aged 6–17 years, and treated with chemotherapy or radiation will be randomized to either the intervention or the control arm of the study. The intervention group will, in addition to usual care, be offered a combination of 6 months of supervised physical exercise (integrative neuromuscular training) and home-based exercise. The active control group will, in addition to usual care, receive information along an unsupervised written home-based training program. All participants, including parents, will receive information about the importance of physical exercise during the course of cancer treatment, at the start of treatment, and in 5 monthly sessions. The primary outcome is measured in terms of isometric quadriceps muscle strength. Secondary outcomes include muscle strength and endurance, markers of metabolic syndrome and dysmetabolism, exercise capacity, physical function and activity, days of hospitalization, and health-related quality of life. Assessment will be conducted at treatment initiation (baseline), at 3 and 6 months after inclusion, and 1 month and 1 year after ended treatment. The primary endpoint for lower-body muscle strength is at 6 months after treatment initiation. The effects of the intervention will be evaluated through a constrained linear mixed model.DiscussionThis national randomized controlled study has the potential to provide new knowledge concerning the short- and long-term effects of a novel, inclusive approach for youth exercise programming (integrative neuromuscular exercise) in children and adolescents during anti-cancer treatment. Using a pragmatic, low-cost, and time-efficient training design, this intervention can be easily adapted to both hospital and home settings.Clinical Trial RegistrationClinicalTrials.gov (NCT04706676), first released January 5, 2021.

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Testing physical function in children undergoing intense cancer treatment—a RESPECT feasibility study

Abstract: Children with cancer are generally motivated to participate in physical function tests. Future studies should address diagnosis specific obstacles and design testing modalities that facilitate physical function tests in this target group.

Cited by 21 publications

References 34 publications

Physical and functional performance assessment in pediatric oncology: a systematic review

Physical and functional performance assessment in pediatric oncology: a systematic review

The effect of an active video game intervention on physical activity, motor performance, and fatigue in children with cancer: a randomized controlled trial

Integrative Neuromuscular Training in Adolescents and Children Treated for Cancer (INTERACT): Study Protocol for a Multicenter, Two-Arm Parallel-Group Randomized Controlled Superiority Trial

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