Abstract
BackgroundChildhood cancer and its treatment have considerable impact on a child's physical and mental wellbeing. Especially long-term administration of chemotherapy and/or radiotherapy impairs physical fitness both during and after therapy, when children often present with muscle weakness and/or low cardiorespiratory fitness. Physical exercise can improve these two elements of physical fitness, but the positive effects of physical exercise might be further increased when a child's wellbeing is simultaneously enhanced by psychosocial training. Feeling better may increase the willingness and motivation to engage in sports activities. Therefore, this multi-centre study evaluates the short and long-term changes in physical fitness of a child with a childhood malignancy, using a combined physical exercise and psychosocial intervention program, implemented during or shortly after treatment. Also examined is whether positive effects on physical fitness reduce inactivity-related adverse health problems, improve quality of life, and are cost-effective.MethodsThis multi-centre randomized controlled trial compares a combined physical and psychosocial intervention program for children with cancer, with care as usual (controls). Children with cancer (aged 8-18 years) treated with chemotherapy and/or radiotherapy, and who are no longer than 1 year post-treatment, are eligible for participation. A total of 100 children are being recruited from the paediatric oncology/haematology departments of three Dutch university medical centres. Patients are stratified according to pubertal stage (girls: age ≤10 or >10 years; boys: ≤11 or >11 years), type of malignancy (haematological or solid tumour), and moment of inclusion into the study (during or after treatment), and are randomly assigned to the intervention or control group.DiscussionChildhood cancer patients undergoing long-term cancer therapy may benefit from a combined physical exercise and psychosocial intervention program since it may maintain or enhance their physical fitness and increase their quality of life. However, the feasibility, patient need, and effectiveness of such a program should be established before the program can be implemented as part of standard care.Trial registration numberNTR1531 (The Netherlands National Trial Register)
Highlights
Childhood cancer and its treatment have considerable impact on a child’s physical and mental wellbeing
The number of childhood cancer survivors (CCS) is growing and it is evident that the disease and its treatment can significantly impair long-term health [1]
One study reported that about 75% of CCS has at least one late adverse health effect after a median follow-up of 17 years [1]
Summary
Childhood cancer and its treatment have considerable impact on a child’s physical and mental wellbeing. Feeling better may increase the willingness and motivation to engage in sports activities This multi-centre study evaluates the short and long-term changes in physical fitness of a child with a childhood malignancy, using a combined physical exercise and psychosocial intervention program, implemented during or shortly after treatment. Physical inactivity with subsequent muscle atrophy and reduced strength is probably the most prominent cause of this reduced state of physical fitness [6,7,8,9] This low physical fitness may lead to fatigue, obesity and a poor skeletal and/or mental health [7,9,10,11,12,13,14]. These factors may further reduce physical activity and physical fitness making these health outcomes a self-perpetuating condition if the cycle is not reversed
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