TY - JOUR

T1 - Children with cancer and their cardiorespiratory fitness and physical function—the long-term effects of a physical activity program during treatment

T2 - a multicenter non-randomized controlled trial

AU - Fridh, Martin Kaj

AU - Schmidt-Andersen, Peter

AU - Andrés-Jensen, Liv

AU - Thorsteinsson, Troels

AU - Wehner, Peder Skov

AU - Hasle, Henrik

AU - Schmiegelow, Kjeld

AU - Larsen, Hanne Bækgaard

N1 - Funding Information: We thank all children and their parents for participating in the study. We also thank the health personnel at the Copenhagen University Hospital, Rigshospitalet, Odense University Hospital, and Aarhus University Hospital for their help. This work is part of the Childhood Oncology Network Targeting Research, Organization & Life expectancy (CONTROL), supported by the Danish Cancer Society (R-257-A14720) and the Danish Childhood Cancer Foundation (2019-5934). Furthermore, we thank Lis Adamsen for her tremendous support and insightful feedback throughout the study. Funding Information: Open access funding provided by Royal Library, Copenhagen University Library. This study received funding from the Novo Nordic Foundation, the Danish Child Cancer Foundation, Trygfonden, the Danish Cancer Society, Lundbeckfonden, Arvid Nilssons Foundation, Aase, and Ejnar Danielsen’s Foundation, Familien Hede Nielsens Foundations, ML Jørgensen & Gunnar Hansen Foundation, and the Toyota Foundation. Publisher Copyright: © 2023, The Author(s).

PY - 2024

Y1 - 2024

N2 - Purpose: We aimed to determine the effects of a classmate-supported, supervised, in-hospital physical activity program during treatment primarily on cardiorespiratory fitness and secondarily on physical function. Methods: A multicenter non-randomized controlled intervention study including children diagnosed with cancer, 6–18 years at diagnosis treated with chemo-/radiotherapy. The intervention comprised (i) an educational session on cancer in the child’s school class; (ii) selection of two “ambassadors”—classmates who were co-admitted, supporting the child’s everyday hospital life; and (iii) supervised in-hospital physical activity from diagnosis and throughout intensive treatment. One-year post-treatment, physical testing included cardiorespiratory fitness (primary outcome), Sit-to-Stand test, Timed-Up-and-Go, and Handgrip Strength. Results: The intervention group included 75 of 120 children (61% boys, 13.4 ± 3.1 years); the control groups included 33 of 58 children with cancer (58% boys, 13.5 ± 2.5 years), and 94 age- and sex-matched children without a cancer history. One-year post-treatment, cardiorespiratory fitness tended to be higher in the intervention group (37.0 ± 6.0 mL/kg/min) than in the patient control group with cancer (32.3 ± 9.7 mL/kg/min) (mean difference 4.7 [0.4 to 9.1], p = 0.034). The intervention group performed better in the secondary outcomes. Compared with community controls, both patient groups had lower cardiorespiratory fitness. The patient control group had lower Sit-to-Stand, Timed Up and Go, and Handgrip Strength, while the intervention group had strength comparable to that of the community controls. Conclusions: Peer-supported, supervised, in-hospital physical activity during treatment may improve cardiorespiratory fitness and muscle strength 1-year post-treatment in children with cancer; however, survivors continue to have lower cardiorespiratory fitness than community controls. Implications for Cancer Survivors: Children with cancer may benefit from in-hospital physical activity in improving long-term cardiorespiratory fitness and muscle strength.

AB - Purpose: We aimed to determine the effects of a classmate-supported, supervised, in-hospital physical activity program during treatment primarily on cardiorespiratory fitness and secondarily on physical function. Methods: A multicenter non-randomized controlled intervention study including children diagnosed with cancer, 6–18 years at diagnosis treated with chemo-/radiotherapy. The intervention comprised (i) an educational session on cancer in the child’s school class; (ii) selection of two “ambassadors”—classmates who were co-admitted, supporting the child’s everyday hospital life; and (iii) supervised in-hospital physical activity from diagnosis and throughout intensive treatment. One-year post-treatment, physical testing included cardiorespiratory fitness (primary outcome), Sit-to-Stand test, Timed-Up-and-Go, and Handgrip Strength. Results: The intervention group included 75 of 120 children (61% boys, 13.4 ± 3.1 years); the control groups included 33 of 58 children with cancer (58% boys, 13.5 ± 2.5 years), and 94 age- and sex-matched children without a cancer history. One-year post-treatment, cardiorespiratory fitness tended to be higher in the intervention group (37.0 ± 6.0 mL/kg/min) than in the patient control group with cancer (32.3 ± 9.7 mL/kg/min) (mean difference 4.7 [0.4 to 9.1], p = 0.034). The intervention group performed better in the secondary outcomes. Compared with community controls, both patient groups had lower cardiorespiratory fitness. The patient control group had lower Sit-to-Stand, Timed Up and Go, and Handgrip Strength, while the intervention group had strength comparable to that of the community controls. Conclusions: Peer-supported, supervised, in-hospital physical activity during treatment may improve cardiorespiratory fitness and muscle strength 1-year post-treatment in children with cancer; however, survivors continue to have lower cardiorespiratory fitness than community controls. Implications for Cancer Survivors: Children with cancer may benefit from in-hospital physical activity in improving long-term cardiorespiratory fitness and muscle strength.

KW - Cardiorespiratory fitness

KW - Childhood cancer

KW - Muscle strength

KW - Peer support intervention

KW - Physical activity intervention

U2 - 10.1007/s11764-023-01499-7

DO - 10.1007/s11764-023-01499-7

M3 - Journal article

C2 - 38057671

AN - SCOPUS:85178924021

JO - Journal of Cancer Survivorship

JF - Journal of Cancer Survivorship

SN - 1932-2259

ER -