What are the effects of exercise training in childhood cancer survivors? A systematic review

Morales, Javier S.; Herrera-Olivares, Alba M.; Rincón‐Castanedo, Cecilia; Martín-Ruiz, Asunción; Castillo‐García, Adrián; Fiuza‐Luces, Carmen; Lucía, Alejandro

doi:10.1007/s10555-020-09852-3

Cited by 20 publications

(22 citation statements)

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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%

“…Distance-delivered physical activity interventions for childhood cancer survivors did not significantly increase ( p -value not reported) self-reported physical activity levels, according to Mizrahi et al [ 20 ] (heterogeneity not reported). Morales et al [ 21 ] reported an increase ( p -value not reported) in activity levels in childhood cancer survivors after exercise training programs (heterogeneity not reported). Activity levels were assessed by means of a questionnaire and an accelerometer.…”

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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

et al. 2023

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“…Owing to their disease and treatment exposure, they are at risk of chronic medical conditions such as cardiovascular and pulmonary diseases, secondary cancers, metabolic syndrome and obesity, osteoporosis, fatigue, neurocognitive complaints, and psychological distress, all of which can negatively affect PF and function and, thereby, the survivors’ ability to participate in everyday and social activities [ 3 , 4 , 8 ]. Options for preventing late effects are currently limited; however, a few small-scale intervention studies indicate promising effects of PA on promoting physical functioning, health, and QoL [ 10 - 13 ]. However, important knowledge gaps and methodological shortcomings remain, including heterogeneity of the samples, lack of controls, quality of assessment methods, and outcome measures used, limiting the generalizability of the results [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

The Physical Activity and Fitness in Childhood Cancer Survivors (PACCS) Study: Protocol for an International Mixed Methods Study

Lie¹,

Anderssen²,

Rueegg³

et al. 2022

JMIR Res Protoc

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Background Survivors of childhood cancer represent a growing population with a long life expectancy but high risks of treatment-induced morbidity and premature mortality. Regular physical activity (PA) may improve their long-term health; however, high-quality empirical knowledge is sparse. Objective The Physical Activity and Fitness in Childhood Cancer Survivors (PACCS) study comprises 4 work packages (WPs) aiming for the objective determination of PA and self-reported health behavior, fatigue, and quality of life (WP 1); physical fitness determination (WP 2); the evaluation of barriers to and facilitators of PA (WP 1 and 3); and the feasibility testing of an intervention to increase PA and physical fitness (WP 4). Methods The PACCS study will use a mixed methods design, combining patient-reported outcome measures and objective clinical and physiological assessments with qualitative data gathering methods. A total of 500 survivors of childhood cancer aged 9 to 18 years with ≥1 year after treatment completion will be recruited in follow-up care clinics in Norway, Denmark, Finland, Germany, and Switzerland. All participants will participate in WP 1, of which approximately 150, 40, and 30 will be recruited to WP 2, WP3, and WP 4, respectively. The reference material for WP 1 is available from existing studies, whereas WP 2 will recruit healthy controls. PA levels will be measured using ActiGraph accelerometers and self-reports. Validated questionnaires will be used to assess health behaviors, fatigue, and quality of life. Physical fitness will be measured by a cardiopulmonary exercise test, isometric muscle strength tests, and muscle power and endurance tests. Limiting factors will be identified via neurological, pulmonary, and cardiac evaluations and the assessment of body composition and muscle size. Semistructured, qualitative interviews, analyzed using systematic text condensation, will identify the perceived barriers to and facilitators of PA for survivors of childhood cancer. In WP 4, we will evaluate the feasibility of a 6-month personalized PA intervention with the involvement of local structures. Results Ethical approvals have been secured at all participating sites (Norwegian Regional Committee for Medical Research Ethics [2016/953 and 2018/739]; the Oslo University Hospital Data Protection Officer; equivalent institutions in Finland, Denmark [file H-19032270], Germany, and Switzerland [Ethics Committee of Northwestern and Central Switzerland, project ID: 2019-00410]). Data collection for WP 1 to 3 is complete. This will be completed by July 2022 for WP 4. Several publications are already in preparation, and 2 have been published. Conclusions The PACCS study will generate high-quality knowledge that will contribute to the development of an evidence-based PA intervention for young survivors of childhood cancer to improve their long-term care and health. We will identify physiological, psychological, and social barriers to PA that can be targeted in interventions with immediate benefits for young survivors of childhood cancer in need of rehabilitation. International Registered Report Identifier (IRRID) DERR1-10.2196/35838

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“…This was an intentional choice given other systematic reviews have examined exercise interventions in childhood cancer survivors. 109,110 Furthermore, most of the interventions focus on improving physical fitness as an outcome, with some including early CVD risk factors. Synthesizing the observational research allowed us to examine more late effects, such as clinically evident CVD, and mortality, in an older cohort.…”

Section: Discussionmentioning

confidence: 99%

Physical activity and fitness in childhood cancer survivors: A scoping review

et al. 2021

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Background: Estimates indicate that nearly 8% of the over 500,000 survivors of childhood cancer living in the United States are frail in their fourth and fifth decades of life, a phenotype typically seen in geriatric populations. Participation in regular physical activity to improve physical fitness in healthy and diseased populations reduces risk for frail health by increasing physiologic reserve. However, physical activity may not have the same effects on fitness in childhood cancer survivors as it does among their peers with no cancer history. Aims: This scoping review seeks to describe associations between physical activity, physical fitness, chronic disease, and mortality in childhood cancer survivors. Methods: Relevant literature was identified through a comprehensive search in the PubMed, Web of Science, CINAHL, and Cochrane databases. A narrative synthesis was performed on observational studies that had physical activity or physical fitness clearly defined and compared with chronic disease outcomes. Results: A total of 595 studies were screened, and results from 11 studies are presented. Childhood cancer survivors who participate in regular physical activity have improved markers of cardiovascular health, decreased risk of overt cardiovascular disease, and decreased risk of all-cause mortality compared to survivors who are not physically active. Childhood cancer survivors who are physically fit have increased neurocognition, and decreased risk of all-cause mortality compared to survivor's who are not fit. The differential effects of physical activity on fitness and health among childhood cancer survivors when compared to peers is potentially related to treatment exposures that damage cardiovascular tissue and impact regenerative potential. Conclusion:Research is needed to determine the optimal timing, frequency, intensity, and duration of physical activity necessary to optimize fitness in childhood cancer survivors.

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What are the effects of exercise training in childhood cancer survivors? A systematic review

Cited by 20 publications

References 40 publications

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

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

The Physical Activity and Fitness in Childhood Cancer Survivors (PACCS) Study: Protocol for an International Mixed Methods Study

Physical activity and fitness in childhood cancer survivors: A scoping review

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