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

Abstract

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.

Goal-directed therapeutic exercise for paediatric posterior fossa brain tumour survivors: a qualitative analysis of experiences

“…Physical activity of sufficient frequency, intensity and duration provide benefits to survivor’s cardiorespiratory fitness, muscle strength, cognitive functioning and fatigue [ 14 – 16 ]. In the last decade, there is emerging evidence that exercise is safe, feasible and potentially effective to improve the health and well-being of childhood brain tumour survivors [ 17 , 18 ]. Intervention types vary greatly, with most studies implementing adult-like exercise modalities (e.g., cycle ergometers, strength training), with a distinct lack of family-centred or goal-directed intervention approaches [ 17 ].…”

“…In the last decade, there is emerging evidence that exercise is safe, feasible and potentially effective to improve the health and well-being of childhood brain tumour survivors [ 17 , 18 ]. Intervention types vary greatly, with most studies implementing adult-like exercise modalities (e.g., cycle ergometers, strength training), with a distinct lack of family-centred or goal-directed intervention approaches [ 17 ]. Goal-directed therapeutic exercise is highly individualised, it promotes attention in and commitment to therapy, encourages autonomy and considers the patient’s interests, preferences, current level of function and environmental factors [ 19 ].…”

Goal-directed therapeutic exercise for paediatric posterior fossa brain tumour survivors: a qualitative analysis of experiences

“…Physical activity of su cient frequency, intensity, and duration, provide bene ts to survivor's cardiorespiratory tness, muscle strength, cognitive functioning and fatigue [5,22,38]. In the last decade, there is emerging evidence that exercise is safe, feasible and potentially effective to improve the health and well-being of childhood brain tumour survivors [15,34]. Intervention types vary greatly, with most studies implementing adult-like exercise modalities (e.g., cycle ergometers, strength training), with a distinct lack of familycentred or goal-directed intervention approaches [15].…”

“…In the last decade, there is emerging evidence that exercise is safe, feasible and potentially effective to improve the health and well-being of childhood brain tumour survivors [15,34]. Intervention types vary greatly, with most studies implementing adult-like exercise modalities (e.g., cycle ergometers, strength training), with a distinct lack of familycentred or goal-directed intervention approaches [15]. Goal-directed therapeutic exercise is highly individualised, it promotes attention in and commitment to therapy, encourages autonomy and considers the patient's interests, preferences, current level of function and environmental factors [19].…”