Feasibility Study: The Effect of Therapeutic Yoga on Quality of Life in Children Hospitalized With Cancer Exercise Interventions in Children with Cancer: A Review Exercise during hematopoietic stem cell transplant hospitalization in children. Effects of Acute Exercise on Neutrophils in Pediatric Acute Lymphoblastic Leukemia Survivors: A Pilot Study Preliminary Findings of a 4-Month Intrahospital Exercise Training Intervention on IGFs and IGFBPs in Children with Leukemia Benefits of intrahospital exercise training after pediatric bone marrow transplantation. Feasibility and parent satisfaction of a physical therapy intervention program for children with acute lymphoblastic leukemia in the first 6 months of medical treatment. Fitness of Children With Standard-risk Acute Lymphoblastic Leukemia During Maintenance Therapy: Response to a Home-based Exercise and Nutrition Program A randomized trial investigating an exercise program to prevent reduction of bone mineral density and impairment of motor performance during treatment for childhood acute lymphoblastic leukemia. Implementation of structured physical activity in the pediatric stem cell transplantation. Effects of physical therapy intervention for children with acute lymphoblastic leukemia. Clinical field testing of an enhanced-activity intervention in hospitalized children with cancer.
Purpose : To describe the effect of therapeutic yoga on child and parental reports of quality of life in children hospitalized with oncological diagnoses . Methods : Six children participated in 5 yoga sessions  over 2 months . The PedsQL 4.0 was administered to each child and participating parent/caregivers at baseline and after completion of the yoga intervention . The Wilcoxon nonparametric rank test measured individual differences over time . Results : Statistically significant differences ( P < .05 ) were found in child perception of gross motor function . Conclusion : These feasibility study data suggest that therapeutic yoga positively affected child perception of gross motor function measured on the PedsQL 4.0 . Further studies are needed , including a r and omized control trial and with a larger number of participants , to clarify and confirm the effect of therapeutic yoga The purpose of this review is to summarize literature that describes the impact of exercise on health and physical function among children during and after treatment for cancer . Relevant studies were identified by entering the following search terms into Pubmed : aerobic training ; resistance training ; stretching ; pediatric ; children ; AND cancer . Reference lists in retrieved manuscripts were also review ed to identify additional trials . We include fifteen intervention trials published between 1993 and 2011 that included children younger than age 21 years with cancer diagnoses . Nine included children with an acute lymphoblastic leukemia ( ALL ) diagnosis , and six children with mixed cancer diagnoses . Generally , interventions tested were either in-hospital supervised exercise training or home based programs design ed to promote physical activity . Early evidence from small studies indicates that the effects of exercise include increased cardiopulmonary fitness , improved muscle strength and flexibility , reduced fatigue and improved physical function . Generalizations to the entire childhood cancer and childhood cancer survivor population s are difficult as most of the work has been done in children during treatment for and among survivors of ALL . Additional r and omized studies are needed to confirm these benefits in larger population s of children with ALL , and in population s with cancer diagnoses other than ALL PURPOSE The purpose of this controlled trial was to assess the effect of an approximately 3-wk intrahospital exercise intervention performed during inpatient hospitalization for pediatric allogeneic hematopoietic stem cell transplant ( HSCT ) on ( i ) immune cell recovery and ( ii ) body composition . METHODS Immune ( i.e. , blood counts of leukocytes , monocytes , lymphocytes , and lymphocyte sub population s ) and anthropometric variables ( i.e. , body mass , body mass index , and estimated fat-free mass ) were measured before and after ( + 15 and 30 d ) HSCT . Seven children ( 5 boys and 2 girls ; age ( mean + /- SD ) = 8 + /- 4 yr ) with high-risk cancer performed an individualized training program ( aerobic + resistance exercises ) in their isolated hospital rooms . We also assessed a control group ( n = 13 ; 9 boys and 4 girls ; age = 7 + /- 3 yr ) with similar medical conditions and following the same transplant protocol . RESULTS In both groups , the dendritic cell count decreased from pre-HSCT to + 15 d post-HSCT and thereafter ( up to + 30 d ) remained stabile ; however , the posttransplant decrease was more abrupt in the control group than that in the intervention group ( -87 % vs -63 % , respectively , from pre-HSCT to + 15 d ) . The rest of the immune cell parameters measured showed a similar response from pre-HSCT to post-HSCT in both groups . We found a significant effect of the interaction group x time for all anthropometric variables ( weight , body mass index , body fat , and fat-free mass ) , indicating an increase over the hospitalization period only in the intervention group , for example , body mass increased from 32.9 + /- 18.7 kg pre-HSCT to 35.4 + /- 18.6 kg at + 30 d in the intervention group versus a decrease from 30.2 + /- 16.6 to 29.3 + /- 6.3 kg in the control group . CONCLUSION Our findings support the feasibility of exercise training interventions during hospitalization , including immunocompromised children Purpose This nonr and omized controlled trial was design ed to investigate the effects of acute exercise on neutrophil count and function in children and adolescents receiving maintenance treatment for acute lymphoblastic leukemia ( ALL ) compared to matched controls . Methods Participants ( n=10 ; 4 ALL patients and 6 healthy matched controls ) were males between the ages of 7 to 18 years . On visit 1 , participants completed an incremental exercise test to volitional exhaustion on a treadmill to determine peak aerobic fitness ( VO2peak ) . On visit 2 , participants completed a 30-minute exercise session consisting of an intermittent run-walk on a treadmill at 70 % to 85 % of VO2 peak with blood sampling completed at 5 time points : fasting , preexercise , postexercise , 1-hour postexercise , and 2-hour postexercise . Results A significant increase in absolute neutrophil count from preexercise to postexercise was observed in both groups ( P=0.011 ) . Neutrophil oxidative capacity was significantly depressed in the ALL group at the basal level ( P=0.029 ) , however , it increased in both groups after exercise and stimulation . Conclusions This preliminary study suggests that 30 minutes of moderate intensity exercise in ALL patients receiving maintenance therapy provides a similar neutrophil response to that of healthy age and sex-matched controls Ruiz , JR , Fleck , SJ , Vingren , JL , Ramírez , M , Madero , L , Fragala , MS , Kraemer , WJ , and Lucia , A. Preliminary findings of a 4-month intrahospital exercise training intervention on IGFs and IGFBPs in children with leukemia . 24(5 ) : 1292 - 1297 , 2010-The aim of this study was to determine the effect of a 16-week intrahospital supervised , conditioning program including both resistance and aerobic type training on insulin-like growth factors 1 and 2 ( IGF-1 , IGF-2 ) , several IGF-binding proteins ( IGFBPs ) , and growth hormone ( GH ) in children receiving treatment against acute lymphoblastic leukemia ( ALL ) . We also analyzed the effects of a 20-week detraining period on these hormones . Seven children ( 3 girls and 4 boys ) aged 4 - 7 years in the maintenance phase of treatment against ALL performed 3 training sessions per week for 16 weeks of resistance ( 1 set of 8 - 15 repetitions of 11 exercises ) and aerobic training ( 30 minutes at ≥50 % heart rate max ) followed by 20 weeks of detraining where no structured exercise program was performed . Levels of IFG-1 and IFG-2 did not significantly change after the intervention period or after the detraining phase . Likewise , levels of GH , IGFBP-2 , and IGFBP-3 remained stable pre and posttraining and after the detraining period . IGFBP-1 levels significantly decreased after training ( −43.8 % , p = 0.014 ) , whereas there were no significant differences between pretraining vs. detraining ( −17.8 % , p = 0.108 ) nor between posttraining vs. detraining ( 17.7 % , p = 0.251 ) . Exercise training did not have major effects on the IGFs , IGFBPs , and GH in children with ALL . Although the importance of these findings to long-term cancer prognosis and /or recurrence remains to be determined , the present data ( particularly those on IGF-1 and IGFBP-3 ) support the idea that exercise training can be safely undergone during treatment against ALL with no major adverse effect The purpose of this study was to determine if an eight-week intrahospital supervised , conditioning program improves functional capacity and quality of life ( QOL ) in children ( 4 boys , 4 girls ) ( mean [ SD ] age : 10.9 [ 2.8 ] years [ range : 8 - 16 ] ) who have undergone bone marrow transplantation ( BMT ) for leukemia treatment within the last 12 months . A group of 8 age and gender-matched healthy children served as controls . The experimental group performed 3 weekly sessions of resistance and aerobic training inside an intra-hospital gymnasium . A significant combined effect of group and time ( p < 0.05 ) was observed for muscle functional capacity ( Timed Up and Down Stairs [ TUDS ] test ) and peak oxygen uptake ( V.O(2peak ) ) , i.e. , with BMT children showing greater improvements than controls ( V.O(2peak ) at pre- and post-training of 25.9 ( 8.2 ) and 31.1 ( 7.6 ) mL/kg/min in diseased children ) . Muscle strength ( 6 RM test for bench and leg press and seated row ) also improved after training ( p < 0.05 ) in the BMT group . Concerning QOL , a significant combined effect of group and time ( p < 0.05 ) was also observed for children 's self-report of comfort and resilience and for parents ' report of their children 's satisfaction and achievement . In summary , children who have received BMT  experience physical and overall health benefits after a relatively short-term ( 8 weeks ) supervised exercise training program BACKGROUND Children with acute lymphoblastic leukemia ( ALL ) are at risk for developing musculoskeletal complications during and after their medical treatment . The objective of this study was to examine the feasibility of an in-hospital physical therapy- and home exercise program during the first four phases of medical treatment , for children with newly diagnosed ALL . PROCEDURE Nine patients , between the ages of 2 - 14 years old were enrolled within 2 weeks of diagnosis in the study . Each patient was evaluated at study entry , after each of the first four phases of therapy and each time patients were re-admitted to the hospital . Following the initial physical therapy evaluation an individualized home exercise program was developed , consisting of stretching , strengthening , and aerobic exercises . The following end points were measured at each evaluation : gross motor assessment as measured by gross motor function measure ( GMFM ) , health-related quality of life as measured by the PedsQL and parent satisfaction question naire . RESULTS This study was feasible with 98 % of the evaluation sessions completed . The GMFM and PedsQL improved steadily throughout the study ; however , the PedsQL slightly decreased from interim maintenance to delayed intensification . The parents reported being satisfied with the physical therapy program . CONCLUSION We demonstrated that an in-hospital- and home exercise physical therapy program during the first four phases of medical treatments is feasible for children with ALL . Future r and omized studies are needed to confirm whether an initial physical therapy program at diagnosis in children with ALL will limit functional impairments , improve overall fitness and increase health-related quality of life Background Altered nutrient intake and decreased exercise in response to cancer therapies and their side effects , particularly corticosteroids , may be key factors in the increased body weight and differences in physical fitness reported in survivors of childhood acute lymphoblastic leukemia ( ALL ) . Purpose To assess ( 1 ) the effect of a home-based nutrition and exercise intervention program on cardiovascular fitness , strength , and flexibility in children with ALL during maintenance therapy and ( 2 ) the feasibility of conducting and evaluating a home-based exercise and nutrition program in this patient population . Design Children ages 4 to 10 years with st and ard-risk ALL were r and omized when starting maintenance therapy to a 12-month home-based exercise and nutrition program ( n=6 , 3 males/3 females ) or control ( n=7 , 4 males/3 females ) group . Assessment of anthropometrics , dietary intake , physical activity , and fitness was performed at baseline and 6 and 12 months of study . Results Although age , body size , and nutrient intakes were similar between both subject groups at 0 , 6 , and 12 months , exercise and nutrition program children had greater improvement in physical activity and cardiovascular fitness between 6 and 12 months than control children . Conclusions These results suggest that a home-based exercise intervention during maintenance therapy encouraged greater physical activity and improved cardiovascular fitness in children with st and ard-risk ALL . Further investigation involving larger population s of children with ALL is warranted BACKGROUND Reduced bone mineral density ( BMD ) , altered body composition , impaired motor performance and passive ankle dorsiflexion are side effects of acute lymphoblastic leukemia ( ALL ) treatment . We performed a r and omized study investigating whether an exercise program could prevent these side effects . PROCEDURE At diagnosis we r and omized 51 ALL patients ( median age : 5.4 years ) into a group receiving a 2-year exercise program or a control group receiving st and ard care .  BMD of total body ( BMD(TB ) ) , lumbar spine ( BMD(LS ) ) and body composition were measured using dual energy X-ray absorptiometry , motor performance with Bayley Scales of Infant Development or Movement-ABC , and passive ankle dorsiflexion with a goniometer . The investigator was blinded to the r and omization . RESULTS Body fat increased equally during treatment in both groups . One year after cessation of therapy more rapid decline of excessive body fat was observed in the intervention group than in the controls ( P = 0.01 ) . Lean body mass , BMD(TB ) and BMD(LS ) of both groups decreased equally during treatment and increased equally thereafter . Both groups showed a similar decrease in passive ankle dorsiflexion and motor performance during treatment . Adherence to the intervention program varied considerably . Adherence to intervention : 11 % of children exercised daily , 37 % > once a week , 16 % once weekly , 36 % < once a week . CONCLUSIONS The exercise program was not more beneficial than st and ard care in preventing reduction in BMD , motor performance and passive ankle dorsiflexion than st and ard care , most likely due to unsatisfactory compliance . Increased BMI and body fat in the intervention group normalized faster after cessation of chemotherapy The peripheral blood stem cell transplantation ( PBSCT ) represents a specific , but stressful therapy for hemato-oncological diseases . While for adults , data suggest positive eff ects for a supportive sport therapy , this question is not evaluated sufficiently for children . The objective of this study was to examine the integration of sports activity into pediatric PBSCT and to indicate attainable results . This 2-step case-control- study included 23 children and adolescents from the PBSCT : During the isolation phase 13 patients trained 3 times per week on a cycle ergometer and passed a course with different sports equipment . Apart from recording physiologic adaptations , quality of live was inquired in a pre-post design using question naires . Guided interviews according to necessity and requirements for sports activity at the PBSCT unit completed the evaluation and were used for the intervention as well as for the control group ( n = 10 ) without sports therapy . On the ergometer , patients trained average 25 min with 0.6 watt / kg . In the majority , a loss of muscular power could be avoided . Quality of life and fatigue symptoms improved by trend . Interview analysis showed general acceptance of physical activity during PBSCT . After initial skepticism due to the additional burden , our implementation study showed the feasibility of  supportive sports therapy  in PBSCT . Quality and flexibility of the equipment should be higher than normal and different physical and psychological conditions of the patients should be anticipated and integrated into the training program BACKGROUND The purpose of this study was to examine the effects of physical therapy intervention in children with acute lymphoblastic leukemia ( ALL ) . PROCEDURE Twenty-eight children aged 4 - 15 years were r and omly assigned to an intervention or control group . The intervention group received five sessions of physical therapy and was instructed to perform an individualized home exercise program consisting of ankle dorsiflexion stretching , lower extremity strengthening , and aerobic exercise . RESULTS After 4 months children who received physical therapy intervention had significantly improved ankle dorsiflexion active range of motion and knee extension strength ( P < 0.01 ) . Differences were not found between the two groups for any of the other dependent variables . CONCLUSIONS Physical therapy intervention for children with ALL receiving maintenance chemotherapy improved two body functions important for normal gait .  Physical therapy programs initiated earlier in treatment and with greater emphasis on endurance activities may also improve stamina and quality of life ( QOL ) This prospect i ve , two-site , r and omized , controlled pilot study assessed the feasibility of an enhanced physical activity ( EPA ) intervention in hospitalized children and adolescents receiving treatment for a solid tumor or for acute myeloid leukemia ( AML ) , and assessed different statistical techniques to detect the intervention 's sleep and fatigue outcomes .  Twenty-nine patients ( 25 with a solid tumor and 4 with AML ) participated . Data were collected from actigraph ; patient , parent , and staff nurse reports of patient fatigue ; parent sleep diaries ; and patient charts . The intervention was successfully implemented 85.4 % of the scheduled times . We used two different statistical methods to analyze the longitudinal data . Using an ANOVA model , sleep was significantly more efficient in the experimental arm than in the control arm when daily differences from baseline sleep efficiency values were averaged and compared ( F=4.17 , P=0.053 ) . However , in a mixed model ( repeated measures ) analysis , sleep duration ( F=0.54 , P=0.47 ) and sleep efficiency ( F=0.04 , P=0.85 ) were not seen to differ between study arms . We conclude that an inpatient intervention of EPA can be delivered to children and adolescents receiving chemotherapy . Our findings identify design and statistical considerations for a future effectiveness study of the EPA intervention in hospitalized pediatric oncology patients
Studies in pediatric oncology have shown a positive effect of physical activity on disease- and treatment-related side effects .
Although several review s have approved the benefits of therapeutic exercise for adult cancer patients , no systematic review exists summarizing the evidence of physical activity in pediatric oncology .