Effects of Physical Exercise During Hospitalization in Children and Adolescents With Cancer: A Systematic Review

Santos, Scárlat da Silva; Moussalle, Luciane Dalcanale; Heinzmann‐Filho, João Paulo

doi:10.1590/1984-0462/2021/39/2019313

Cited by 8 publications

(19 citation statements)

References 31 publications

(124 reference statements)

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“…Of note, in healthy adults a recent systematic review highlights that aerobic/endurance training has a greater influence on NK cell cytotoxicity compared to strength training ( 45 ). Nevertheless, exercise programs during cancer therapy seem to be a useful and safe tool for children to keep their level of physical or functional performance or to improve muscle strength, physical fitness, body composition and functionality ( 12 , 13 , 35 , 50 ). In this regard, guidelines regarding physical activity of pediatric cancer patients have recently been published ( 51 ) or are currently under development ( 52 ).…”

Section: Discussionmentioning

confidence: 99%

Effects of Exercise Interventions on Immune Function in Children and Adolescents With Cancer and HSCT Recipients - A Systematic Review

2021

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BackgroundPediatric cancer patients are at high risk for life-threatening infections, therapy associated complications and cancer-related side effects. Exercise is a promising tool to support the immune system and reduce inflammation. The primary objective of this systematic review was to evaluate the effects of exercise interventions in pediatric cancer patients and survivors on the immune system.MethodsFor this systematic review (PROSPERO ID: CRD42021194282) we searched four databases (MEDLINE, Cochrane Library, ClinicalTrials.gov, SPORTDiscus) in June 2021. Studies with pediatric patients with oncological disease were included as main criterion. Two authors independently performed data extraction, risk of bias assessment, descriptive analysis and a direction ratio was calculated for all immune cell parameters.FindingsOf the 1448 detected articles, eight studies with overall n = 400 children and adolescents with cancer and n = 17 healthy children as controls aged 4-19 years met the inclusion criteria. Three randomized, four non-randomized controlled trials and one case series were analyzed descriptively. The exercise interventions had no negative adverse effects on the immune system. Statistically significant results indicated enhanced cytotoxicity through exercise, while changes in immune cell numbers did not differ significantly. Interventions further reduced days of in-hospitalization and reduced the risk of infections. Several beneficial direction ratios in immune parameters were identified favoring the intervention group.InterpretationExercise interventions for pediatric cancer patients and survivors had no negative but promising beneficial effects on the immune system, especially regarding cytotoxicity, but data is very limited. Further research should be conducted on the immunological effects of different training modalities and intensities, during various treatment phases, and for different pediatric cancer types. The direction ratio parameters given here may provide useful guidance for future clinical trials.Systemic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021194282, Prospero ID: CRD42021194282.

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Section: Discussionmentioning

confidence: 99%

Effects of Exercise Interventions on Immune Function in Children and Adolescents With Cancer and HSCT Recipients - A Systematic Review

2021

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“…One more systematic review was removed because it was duplicated in a second journal. Therefore, the total number of systematic reviews included in this umbrella review is 13 [ 5 , 6 , 8 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ] (PRISMA flow diagram, Figure 1 ). The number of studies and participants included in the 13 eligible systematic reviews is 145 and 3914, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Eight systematic reviews assessed muscle strength after exercise and physical activity interventions [ 5 , 6 , 17 , 19 , 20 , 22 , 23 , 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, the inspiratory training program did not improve inspiratory muscle strength (heterogeneity not reported). In the study by Santos et al [ 22 ], the muscle strength of upper and lower limbs of hospitalized children and adolescents with cancer was assessed after exercise programs. These programs mainly combined aerobic and strength training.…”

Section: Resultsmentioning

confidence: 99%

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Effects of Exercise and Physical Activity Levels on Childhood Cancer: An Umbrella Review

et al. 2023

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Patients and survivors of childhood cancer experience adverse effects related to the disease and its treatment. These adverse effects are associated with both physiological and psychological health. Exercise helps manage the side effects and improve the health outcomes. The objective of this umbrella review is to search the current literature in the context of exercise and physical activity as complementary interventions on pediatric cancer and to provide comprehensive information about the derived health outcomes. A literature search was conducted on the Cochrane, PubMed, and Embase databases for systematic reviews published up to January 2023. Moreover, a hand search of reference lists was performed. We included participants under 19 years of age at diagnosis of any type of childhood cancer, without restriction on the type or phase of treatment, who participated in exercise interventions. The results showed a beneficial impact on fatigue, muscle strength, aerobic capacity, activity and participation levels, psychosocial health, cardiovascular/cardiorespiratory fitness, physical function, bone mineral density, and brain volume and structure, with limited and not serious adverse effects. These findings documented that exercise interventions had a positive effect on many physiological and psychological health outcomes in pediatric cancer patients and survivors.

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“…Physical activity is beneficial for outcomes in both healthy and disease-burdened populations ( 14 ). Previous reviews have summarized the research literature on exercise training for mixed pediatric cancer diagnoses ( 15 – 18 ), the combination of adolescent and young adult cancer groups ( 19 , 20 ), and exercise interventions during the treatment phase ( 21 – 23 ). The results indicate that therapeutic exercise training of sufficient frequency, intensity, and duration can improve cardiorespiratory fitness, muscular strength, fatigue and cognitive functioning ( 15 – 17 ).…”

Section: Introductionmentioning

confidence: 99%

Therapeutic exercise interventions in pediatric survivors of brain cancer and other solid tumors: A scoping review

et al. 2022

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BackgroundImproved survival rates for children with solid tumors presents an ongoing challenge of how to maximize quality of survivorship and effectively manage the short- and long-term complications of disease and treatment. To gain an understanding of the extent and nature of research pertaining to therapeutic exercise interventions and identify knowledge gaps, we conducted a scoping review of exercise training studies conducted in pediatric survivors of brain cancer and other solid tumors.MethodA systematic literature search was performed across four electronic databases. Papers were selected for full-text review if they included participants treated for brain cancer or other solid tumors, with at least 50% of participants aged ≤ 21 years, evaluated an exercise intervention ≥2-weeks in duration, and were published in an English, peer-reviewed journal. We included the following quantitative study designs; randomized controlled trials, non-randomized trials, and single-arm pre-test-post-test.ResultsOf the 7,482 citations identified, 17 papers met the inclusion criteria (presenting findings from eleven studies). Two studies were randomized controlled trials, five studies were non-randomized controlled trials, and four studies were a single-arm pre-test post-test design. Average age of participants ranged from 7.3–15.5 years, and time since diagnosis ranged from 3 to 70 months. Five studies included participants with brain tumors exclusively, three studies included other solid tumors, and three studies included a mixed sample (brain and other solid tumors). A wide range of exercise modalities were employed, including cycle ergometry, resistance training, sport, yoga, and active gaming. The length of the exercise program ranged from 3–40 weeks and frequency from 3–11 sessions per week. Exercise session duration ranged from 15–180 min, with most studies reporting 30–90-min sessions. Adherence ranged from 77 to 100%, with none of the studies reporting adverse events. Studies reported improvements in cardiorespiratory fitness, functional strength, physical activity, and quality of life.ConclusionsA small number of mostly low methodological quality studies have examined the effects of therapeutic exercise in pediatric survivors of solid tumors. Although limited, the extant literature supports the feasibility and safety of therapeutic exercise interventions for pediatric survivors of brain cancer and other solid tumors.

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Effects of Physical Exercise During Hospitalization in Children and Adolescents With Cancer: A Systematic Review

Cited by 8 publications

References 31 publications

Effects of Exercise Interventions on Immune Function in Children and Adolescents With Cancer and HSCT Recipients - A Systematic Review

Effects of Exercise Interventions on Immune Function in Children and Adolescents With Cancer and HSCT Recipients - A Systematic Review

Effects of Exercise and Physical Activity Levels on Childhood Cancer: An Umbrella Review

Therapeutic exercise interventions in pediatric survivors of brain cancer and other solid tumors: A scoping review

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