The importance of specific exercise therapy in pediatric oncology

Abstract

Introduction Modern therapy has improved survival for children with cancer. However, treatment has unintended consequences. More and more studies are showing that children have persisting motor and sensory dysfunctions, such as loss of sensation, numbness, pain, absent reflexes as well as loss of balance control. Developmental milestones such as walking, running, jumping or climbing are delayed which negatively impacts their quality of life and social reintegration (Bjornard et al. 2018). Consequently, survivors are less inclined to participate in physical education at school and experience difficulties when engaging in sport activities with their peers. The beneficial effects of movement interventions have been documented in numerous studies. However, despite this potential, the promotion of physical activity (PA) within pediatric oncology is still a largely overlooked area of practice. The international Pediatric Oncology Exercise Guidelines (iPOEG) highlight PA and exercise as safe, beneficial and recommended for all children and adolescents with cancer (Wurz et al. 2021).

Methods We are therefore currently trying to increase awareness regarding the importance of movement therapy in pediatric oncology. In addition to the PrepAir study, the development of specific training manuals and materials will facilitate the long-term and sustainable integration of exercise therapy into the field of paediatric oncology. With this crowdfunding project (www.prepAIR.ch), we strive to equip children's hospitals with specially trained specialists and age-appropriate training material.

Results Our goal is to support the reintegration of children into daily life through therapeutic exercise, aimed at preventing a vicious cycle of inactivity caused by a cancer diagnosis. This approach not only improves quality of life but also contributes positively to the optimal course of treatment.

Discussion/Conclusion We hypothesized that children who maintain their motor and sensory functions (e.g. balance, jumping) through physical activity will maintain age-appropriate development, improve their quality of life and facilitate social reintegration after therapy. They will be motivated to engage in lifelong physical activity through school and sports clubs. Exercise therapy should be accessible to all affected children and adolescents.

References

Bjornard, K. L., Gilchrist, L., Inaba, H., Diouf, B., Hockenberry, M. J., Kadan-Lottick, N. S., Bowers, D. C., Dolan, M. E., Ullrich, N. J., Evans, W. E., & Ness, K. K. (2018). Peripheral neuropathy in children and adolescents treated for cancer. The Lancet Child & Adolescent Health, 2(10), 744–754. https://doi.org/10.1016/S2352-4642(18)30236-0

Wurz, A., McLaughlin, E., Lategan, C., Chamorro Vina, C., Grimshaw, S. L., Hamari, L., Götte, M., Kesting, S., Rossi, F., van der Torre, P., Guilcher, G. M. T., McIntyre, K., & Culos-Reed, N. (2021). The international pediatric oncology exercise guidelines (iPOEG). Translational Behavioral Medicine, 11(10), 1915–1923. https://doi.org/10.1093/tbm/ibab028