Peak Oxygen Uptake and Exercise Capacity of Children Undergoing Leukemia Treatment (original) (raw)
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Is physical fitness decreased in survivors of childhood leukemia? A systematic review
Leukemia, 2005
The aim of this review is to determine whether physical fitness, assessed by peak oxygen uptake (VO 2peak ) measurement, is reduced in survivors of acute lymphoblastic leukemia (ALL) compared to healthy children. A systematic literature search (up to June 2004) was performed using Medline, Sportdiscus, Cinahl, Embase, Cochrane and PEDro database and reference tracking. The VO 2peak (ml kg À1 min À1 ) reached during a maximal exercise test until volitional exhaustion was used as the main outcome for this review. In all, 17 studies were identified in the literature. Data from three studies (102 ALL survivors, age ranging from 7 to 19 years) were pooled in a meta-analysis. Although there was a significant heterogeneity between the included studies (P ¼ 0.0006), the standardized mean difference (SMD) value of À0.61 (P ¼ 0.07) indicated that VO 2peak tended to be reduced in survivors of childhood ALL compared to healthy control subjects, that is, decrease of À5.97 ml kg À1 min À1 (95% confidence interval (CI): (À12.35, 0.41); P ¼ 0.07) or À13% (95 % CI: (À27, 0.004)). Physical fitness tends to be reduced in survivors of ALL during childhood, which suggests the need for this population group to engage in regular physical activities with the purpose of increasing their functional capacity. Although more research is needed, this functional improvement might ameliorate the quality of life of ALL survivors as physical and outdoors activities are an essential part of daily routine during childhood.
Supportive Care in Cancer, 2019
The aim of this study was to evaluate the effects of a home-exercise programme on physical fitness indicators and physical functioning after completion of chemotherapy in children and adolescents diagnosed with acute lymphoblastic leukaemia (ALL). Methods Twenty-four survivors of ALL were assigned to usual care (control group, n = 12, 11.0 ± 3.7 years) or to a homeexercise programme (intervention group, n = 12, 11.8 ± 4.3 years). Peak oxygen uptake (VO 2 peak ml/kg/min), minute ventilation (VE L/min), output of carbon dioxide (VCO 2 L/min), respiratory exchange ratio (RER), peak heart rate (beats/min), maximal load (W), VO 2 at anaerobic threshold (VO 2 at AT, ml/kg/min), pulse oxygen (PO 2 ml/beat), heart rate at anaerobic threshold (beats/min), handgrip test (pounds), flexibility (cm), Timed Up & Go test TUG (s), and Timed Up and Down Stairs test (TUDS s) were measured at baseline and over 16 weeks of intervention. Results Adjusted mixed linear models revealed a significant group-time interaction + 6.7 (95% CI = 0.6-12.8 ml/kg/min; η 2 partial = 0.046, P = 0.035) for VO 2 peak. Similarly, changes in mean values were observed after the home-exercise programme compared with baseline for VE (L/min) − 8.8 (3.0) (P = 0.035), VCO 2 − 0.2 (0.08), (P = 0.041), maximal load (W) − 35.5 (12.8) (P = 0.024), TUDS (s) 0.8 (2.6) (P = 0.010), and TUG (s) 0.6 (0.1) (P = 0.001); however, the group-time interaction was not significant. Conclusion The home-exercise programme resulted in changes in measures of VO 2 peak, VE, VCO 2 , and functional capacity during daily life activities (TUDS and TUG test). This is an interesting and important study that surely adds to the current body of knowledge/literature on the safety of exercise interventions, especially in children with haematological cancer.
International Journal of Environmental Research and Public Health, 2020
The aim of the study was to assess daily physical activity level and its influence on the physical efficiency of children after the treatment of leukemia. The study was comprised of 34 children (23 boys and 11 girls) after the treatment of acute lymphoblastic leukemia or myeloid leukemia (mean age of 11.29 ± 2.81 years, mean body height of 146.88 ± 16.11 cm, and mean body weight of 43.68 ± 13.93 kg). The mean time since treatment completion was 3.09 ± 1.80 years. The level of physical activity was assessed with the Health Behavior in School-Aged Children questionnaire (HBSC). Physical efficiency was assessed based on the palant ball throw (assessment of strength, coordination, and upper limb speed), the long jump (assessment of jumping ability, speed and coordination) and the 60 m run (assessment of speed). Measurements of motor skills were normalized, classified according to age and sex, and converted into grades. The mean values obtained in the run and the ball throw showed low pa...
Background: Acute lymphoblastic leukemia (ALL) is one type of childhood cancer. In the past decades, cure rates of ALL have increased and the survivor's quality of life and physical fitness have become a growing concern. Furthermore cancer-related fatigue (CRF) is reported to be the most distressing symptom in cancer. Objective: We aimed to examine the effect of aerobic exercise on the physical fitness and fatigue in children suffering from ALL. Methods: Thirty patients of 8 to 16 years with ALL participated in this study. Participants were randomized to study group (Group A), who participated in supervised aerobic exercise program in addition to home program, and control group (Group B), who were instructed to maintain their usual level of activity in addition to home program. Measurement of physical fitness and fatigue were done at the baseline and after 16 th weeks. Results: Post measurement results suggested that, there was significance difference between both groups (P< 0.05). The percentage of improvement of physical fitness and fatigue level for group A was 31.06% and 21.56% respectively, while the percentage of improvement for group B was 4.16 % and 2.78% respectively. Conclusion: Aerobic exercise is effective in improving physical fitness and management of CRF in children with ALL.
Functional Capacity of Children with Leukemia
International Journal of Sports Medicine, 2008
! Previous research has shown that adult cancer patients and/or survivors commonly exhibit poor physical capacity, i.e., peak oxygen uptake (V O 2peak ) levels considerably lower (~50 %) than predicted, which reflects, at least partly, the sedentary life habits of this population group . Less research has focused on the physical capacity (e.g., expressed as V O 2peak ) of children with cancer. This is, however, an important topic given that outdoor physical activities play an important role in the daily routine of children; thus, impaired physical capacity can have a direct detrimental effect on their quality of life (QOL) . Decreased QOL associated to a poor functional capacity has indeed been reported in survivors (i.e., who have successfully completed treatment) of childhood cancer, a fact that is attributable to various mechanisms related to the side effects of treatment as musculoskeletal and neuro-muscular complications, anthracycline-induced cardiotoxicity, sarcopenia and muscle weakness, or reduced ankle range of motion . To the best of our knowledge, however, little research is available on the exercise capacity (i.e., V O 2peak ) of children during treatment against cancer. Thus, it would be interesting to assess if functional capacity is also significantly decreased in this population. If this was indeed the case, exercise training prescription would seem necessary during treatment (not only after successfully completing treatment) to improve the physical condition and QOL of children with cancer. This would aid in preventing poor physical condition from becoming a chronic problem and a self-perpetuating condition in the years that follow the completion of treatment. It was therefore the purpose of this study to determine if the physical fitness (assessed with a number of measurements as V O 2peak , ventilatory threshold, functional mobility and ankle range of Abstract ! The purpose of this study was to determine if the functional capacity and quality of life of children receiving treatment against acute lymphoblastic leukemia (ALL) is decreased compared to healthy age and gender-matched children. Functional capacity was assessed with a number of measurements as the peak oxygen uptake (V O 2peak ) and ventilatory threshold determined during a ramp treadmill test, functional mobility (Timed Up and Down Stairs test [TUDS]) and ankle dorsiflexion passive and active range of motion (passive and active DF-ROM, respectively). Quality of life (QOL) was determined with the Spanish version of the Child Report Form of the Child Health and Illness Profile-Child Edition (CHIP-CE/CRF). Fifteen children (9 boys, 6 girls; mean [SD] age: 6.8 ± 3.1 years) receiving maintenance therapy against ALL were studied and fifteen, nonathletic healthy children (9 boys, 6 girls; 6.9 ± 3.3 years) were selected as controls. The mean values of V O 2peak and active DF-ROM were significantly (p < 0.05) lower in patients (25.3 ± 6.5 ml • kg -1 • min -1 vs. 31.9 ± 6.8 ml • kg -1 • min -1 in controls and 19.6 ± 8.08 vs. 24.1 ± 5.08, respectively). Children's self report of satisfaction (with self and health) (p < 0.05), comfort (concerning emotional and physical symptoms and limitations) (p < 0.01) and resilience (positive activities that promote health) (p < 0.01) were significantly decreased in patients with ALL. In summary, children receiving treatment against ALL have overall lower functional capacity and QOL than healthy children. However, their physical condition and health status are sufficiently high to allow them to participate in physical activities and supervised exercise programs.
The Effects of an Exercise Program in Leukemia Patients
Integrative Cancer Therapies, 2009
Purpose. To examine the feasibility of administering an inhospital exercise program to acute leukemia patients undergoing chemotherapy. A secondary purpose explored the impact of exercise on selected physiological, psychological, and inflammatory markers. Methods. Ten patients, aged 18 to 50 years, diagnosed with acute leukemia or newly relapsed were assessed for body weight, height, body composition (skinfolds), cardiorespiratory endurance (total minutes on bicycle ergometer at 60% heart rate reserve), dynamic muscular endurance (Rocky Mountain Cancer Rehabilitation Institute protocol), fatigue (Revised Piper Fatigue Scale), depression (Center for Epidemiologic Studies Depression scale, National Institute of Mental Health questionnaire), and quality of life (Functional Assessment of Cancer Therapy-General) at baseline (within 3 days of diagnosis) and at the end of induction phase of treatment. Blood draws were taken at baseline, midpoint, and at the end of induction for analyses of inflammatory markers (Linco Luminex assay). Combined aerobic and strength training exercises were administered 3 times per week, twice daily, for 30 minutes. Pairedsamples t-tests were used for the analyses of physiological and psychological parameters. One-way repeated measures analysis of variance was used for the analyses of inflammatory markers. Results. Significant improvements in cardiorespiratory endurance (P = .009, baseline 8.9 ± 8.8 minutes, postexercise intervention 17 ± 14.3 minutes) with significant reductions in total fatigue scores (P = .009, baseline 4.6 ± 1.7, postexercise intervention 1.8 ± 1.6) and depression scores (P = .023, baseline 19 ± 11.5, postexercise intervention 12 ± 8.2) were observed. Marginally significant decrease in interleukin-6 (IL-6; P = .059) with no significant changes in IL-10 (P = .223) or interferon-γ (P = .882) were observed. Conclusion. Administration of exercise to acute leukemia patients undergoing treatment is feasible. The exercise protocol used increased cardiovascular endurance, reduced fatigue and depression scores, and maintained quality of life. Although no significant change in inflammation was observed, a trend demonstrating a reduction in IL-6 and an increase in IL-10 warrants further investigation.
This study aimed to assess the physical activity levels of pediatric patients with acute leukemia undergoing chemotherapy. Thirty-eight pediatric patients and matched controls, aged 3-12 years old, were measured for weight, height, and other anthropometric parameters. Physical activity was assessed using actical accelerometer and activity log book. Patients recorded significantly lower mean total activity counts (26.2 ± 30.2 cpm vs. 192.2 ± 68.8 cpm; p < 0.01) and spent more time in sedentary activities (1301 ± 121 min vs. 1020 ± 101 min; p < 0.001) compared to controls. They also achieved fewer 1-5-min bouts of moderate-vigorous physical activity (MVPA) compared to controls (1.50 ± 5.95 vs. 37.38 ± 40.36; p < 0.001). In conclusion, patients had lower physical activity level and intensity; and simple exercise intervention programs may be needed to minimize the detrimental effects of prolonged sedentary behaviors.
Journal of Pediatric Hematology/Oncology, 2019
Background: Most childhood acute lymphoblastic leukemia (ALL) survivors develop chronic treatment-related adverse effects several years after the end of therapy. A regular practice of physical activity and a good cardiorespiratory fitness have the potential to reduce the risk of chronic disease and improve quality of life. The aim of this study was to evaluate in a cohort of ALL survivors, the association between a good cardiorespiratory fitness or the respect of physical activity guidelines and major long-term health outcomes. Methods: In total, 247 ALL survivors underwent a cardiopulmonary exercise test, completed a physical activity questionnaire and a battery of clinical examinations. We calculated the odds ratio to obtain the preventive fraction (PF) to evaluate the effects of the cardiorespiratory fitness and physical activity levels on health outcomes (ie, obesity, metabolic health, cardiac health, cognitive health and mood, bone health). Results: Despite their young age, 88%...
Journal of maternal and child health, 2022
Background: Acute lymphoblastic leukemia is one of the most common malignancies in children with the highest incidence aged 3-7 years. Management and treatments such as chemotherapy and radiotherapy have musculoskeletal and neuromuscular side effects which can significantly reduce the physical activity of leukemia patients and survivors. This study aims to determine the profile of the physical activity level of children with acute lymphoblastic leukemia as assessed by the Global Physical Activity Questionnaire (GPAQ) in Surakarta, Indonesia. Subjects and Method: This was a study with a cross-sectional design. Children who survived acute lymphoblastic leukemia who had completed chemotherapy at Dr. Moewardi Hospital and met the inclusion criteria were included in this study. A sample of 26 patients was selected through purposive sampling. Demographic data were obtained through interviews and the profile of the patient's physical activity level was assessed using the GPAQ questionnaire. Data analysis was performed using a Pearson Correlation test with SPSS 22.0. Results: The total sample in this study was 26 children with acute lymphoblastic leukemia. As many as 11.5% of children with acute lymphoblastic leukemia experienced decreased physical activity. There was a significant relationship between length of stay (p=0.001), age (p=0.004), gender (p=0.031), and the degree of risk of acute lymphoblastic leukemia (p=0.004) with the category of physical activity based on the GPAQ score. Conclusion: As many as 11.5% of children with acute lymphoblastic leukemia experienced decreased physical activity. The length of time being a survivor, the degree of risk of acute lymphoblastic leukemia, the age of the survivor, and gender are risk factors for decreased physical activity in children.