Synthesizing the literature on physical activity among children and adolescents affected by cancer: evidence for the international Pediatric Oncology Exercise Guidelines (iPOEG)

Abstract

Physical activity (PA), including exercise, is safe and beneficial for children and adolescents affected by cancer. Yet, no efforts have been made to collate the breadth of review and experimental articles exploring the effects of PA in this cohort. Thus, a scoping review of review and experimental articles reporting on the effects of PA for children and adolescents affected by cancer was undertaken. Review and experimental articles published in English, summarizing or reporting on the effects of PA interventions for children and adolescents affected by cancer were included. Articles were identified through prior literature, systematic searching, reference list scanning, stakeholder engagement, and a database update. Data were extracted, collated, assessed for quality (reviews) or risk of bias (experimental articles), and summarized narratively. A total of 1,380 articles were identified; 20 review and 69 experimental articles were included. Articles explored PA behavior, physical, psychosocial, cognitive, and “other” outcomes. Improvements, no change, or mixed results were reported across the majority of outcomes explored. Two PA-related adverse events (e.g., a treatable injury, fatigue) were described. Included articles varied greatly in quality and risk of bias. Findings confirm that PA for children and adolescents affected by cancer is a rapidly growing field. More adequately powered research, focused on priority outcomes, adopting appropriate study designs, and adhering to reporting standards is required. Addressing these gaps will enable a better understanding of the effects of PA. Nevertheless, the literature confirms moving more is beneficial and safe for children and adolescents affected by cancer.

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

“…( 31 ) and Morales et al., 2020b ( 30 ) reported no differences in transplantation outcomes such as complications or GvHD for children undergoing HSCT. The effects on physical and/or functional performance as well as body composition have been reviewed in other studies in depth ( 13 , 14 , 35 ). Hence, this study focused on effects directly related to the immune system.…”

“…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 ).…”

The international Pediatric Oncology Exercise Guidelines (iPOEG)

“…Nevertheless, more adequately powered research adhering to reporting standards is required. The full literature synthesis, including all methods and results, has been published elsewhere [ 43 ].…”

Advancing the Field of Pediatric Exercise Oncology: Research and Innovation Needs

“…Experimental articles show that PA interventions can increase PA behaviors (e.g., time spent engaging in PA) and improve physical (e.g., strength), psychosocial (e.g., quality of life), cognitive (e.g., reaction time), and other (e.g., health behavior) outcomes among children and adolescents from cancer diagnosis onward [3,4]. This evidence has been summarized in systematic reviews (e.g., [5]), meta-analyses (e.g., [6]), and, most recently, a comprehensive literature synthesis [7], which collectively suggest that PA is safe and beneficial for children and adolescents affected by cancer.…”

“…To identify the research and innovation needs, the iPOEG network was presented with a list of needs that was drafted based on results from a series of surveys, a literature synthesis, and an in-person meeting, which was attended by article authors [7,8]. Closed-ended questions asked the iPOEG network whether they agreed or disagreed with each need.…”