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

Abstract

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.

Effect of Early Physical Therapy on Children of School Age With Hematological Cancer: A Quasi-Randomized Controlled Pilot Study

“…Previous studies have reported that most children with cancer experience a decline in exercise tolerability during treatment, resulting in low HRQOL, 11,16,25 and they often refuse PT due to various reasons, including fatigue. 19,27 In this study, the rate of early PT implementation was high, and no adverse events were observed.…”

“…It is hypothesized that exercise training has a positive effect on physical fitness among childhood cancer survivors. [7][8][9][10][11][12][13][14][15][16] High-intensity exercise after treatment is associated with a lower psychological burden and cognitive impairment in childhood cancer survivors. 30 Our study showed that controlled, relatively low-intensity exercise under the guidance of a physical therapist improved HRQOL during intensive cancer treatment.…”

“…4 As such, children with hematological cancers experience reduced physical function, including neuromuscular deficits secondary to neuropathy [4][5][6] or poor physical fitness 7,8 and are at increased risk of developing cardiovascular disease, 9,10 obesity, 7,10 and negative psychosocial functioning (depression and anxiety). 11 Children with and survivors of childhood hematological cancer often experience muscle weakness, 7,8 decreased functional capacity, [8][9][10][11][12] and diminished health-related quality of life (HRQOL). 10,11 This decreased HRQOL negatively affects the motivation of children with hematological cancer and can result in poor self-esteem regarding the ability to perform physical activity.…”

“…11 Children with and survivors of childhood hematological cancer often experience muscle weakness, 7,8 decreased functional capacity, [8][9][10][11][12] and diminished health-related quality of life (HRQOL). 10,11 This decreased HRQOL negatively affects the motivation of children with hematological cancer and can result in poor self-esteem regarding the ability to perform physical activity. 7 Current therapies focus more on overcoming late effects as the long-term survival outcomes have improved.…”

“…Exercise can help improve physical fitness and minimize late negative physical and psychological effects. 11,14,15 Exercise capacity and HRQOL are important outcome measures for physical therapy (PT) in children with cancer. 16 Furthermore, children with hematological cancers typically have more strength deficits than children with other cancer types, such as brain or bone tumors.…”