About
Scope & Aims
Editorial office
Editorial board
Ethical standards and procedures
Abstracting and indexing
Contact
Articles & Issues
Current issue
Articles in press
Archive
For Authors
General rules
Ethics in publishing
Guide for authors
Templates
Publication charge
For Reviewers
Our reviewers
Ethics in publishing
Guide for reviewers
Books and Events
Books
Events
ORIGINAL PAPER
Effects of a structured exercise therapy on cancer-related fatigue during
and after paediatric stem cell transplantation: a randomized controlled trial
1
Fresenius University of Applied Sciences Frankfurt, Frankfurt am Main, Germany
2
Hospital of the Goethe University Frankfurt am Main, Frankfurt am Main, Germany
3
Fresenius University of Applied Sciences Idstein, Idstein, Germany
4
Goethe University Frankfurt am Main, Frankfurt am Main, Germany
Submission date: 2020-05-02
Acceptance date: 2020-08-26
Publication date: 2021-08-29
Physiother Quart. 2021;29(3):76-85
KEYWORDS
cancer-related fatiguepaediatric oncologychildhood cancerphysical therapystem cell transplantationrehabilitation
TOPICS
ABSTRACT
Introduction:
Exercise therapy is a frequently applied method in paediatric oncology but there is insufficient evidence for its effectiveness in paediatric stem cell transplantation.
Methods:
In a single-centre randomized controlled trial, the effect of exercise therapy (intervention group) was compared with concentration and relaxation techniques (control group). Overall, 72 children were recruited before transplantation and randomly assigned into these 2 groups. They received exercise therapy during and after their hospital stay. A total of 47 inpatient children (age: 6–18 years) were evaluated in phase I: 21 in the intervention and 26 in the control group. The expression of cancer-related fatigue before and after therapy was documented by using the PedsQL 3.0 Multidimensional Fatigue Scale.
Results:
All patients deteriorated with regard to fatigue during their hospital stay. A total of 23 outpatient children (stratified into 4 groups) who continued or started exercise therapy showed a significant improvement over 3 and 6 months (phase II) after discharge from hospital (total fatigue score: p < 0.001, general fatigue: p = 0.002, sleep and rest fatigue: p < 0.001).
Conclusions:
Inpatient children showed no positive effects of exercise therapy on cancer-related fatigue. After discharge, the children in exercise therapy attained better physical constitution. Exercise therapy is effective for successful rehabilitation and outpatient reintegration and therefore recommended to reduce cancer-related fatigue.
Exercise therapy is a frequently applied method in paediatric oncology but there is insufficient evidence for its effectiveness in paediatric stem cell transplantation.
Methods:
In a single-centre randomized controlled trial, the effect of exercise therapy (intervention group) was compared with concentration and relaxation techniques (control group). Overall, 72 children were recruited before transplantation and randomly assigned into these 2 groups. They received exercise therapy during and after their hospital stay. A total of 47 inpatient children (age: 6–18 years) were evaluated in phase I: 21 in the intervention and 26 in the control group. The expression of cancer-related fatigue before and after therapy was documented by using the PedsQL 3.0 Multidimensional Fatigue Scale.
Results:
All patients deteriorated with regard to fatigue during their hospital stay. A total of 23 outpatient children (stratified into 4 groups) who continued or started exercise therapy showed a significant improvement over 3 and 6 months (phase II) after discharge from hospital (total fatigue score: p < 0.001, general fatigue: p = 0.002, sleep and rest fatigue: p < 0.001).
Conclusions:
Inpatient children showed no positive effects of exercise therapy on cancer-related fatigue. After discharge, the children in exercise therapy attained better physical constitution. Exercise therapy is effective for successful rehabilitation and outpatient reintegration and therefore recommended to reduce cancer-related fatigue.
REFERENCES (30)
1.
Jung M, Zepf N, Fuchs B. Exercise therapy for children with cancer related fatigue [in German]. Klin Padiatr. 2016;228(3):157–163; doi: 10.1055/s-0042-105291.
2.
Repka CP, Hayward R. Effects of an exercise intervention on cancer-related fatigue and its relationship to markers of oxidative stress. Integr Cancer Ther. 2018;17(2):503–510; doi: 10.1177/1534735418766402.
3.
Hinds PS, Hockenberry M, Rai SN, Zhang L, Razzouk BI, Cremer L, et al. Clinical field testing of an enhanced-activity intervention in hospitalized children with cancer. J Pain Symptom Manage. 2007;33(6):686–697; doi: 10.1016/j.jpainsymman.2006.09.025.
4.
Yeh CH, Man Wai JP, Lin U-S, Chiang Y-C. A pilot study to examine the feasibility and effects of a home-based aerobic program on reducing fatigue in children with acute lymphoblastic leukemia. Cancer Nurs. 2011;34(1):3–12; doi: 10.1097/NCC.0b013e3181e4553c.
5.
Takken T, van der Torre P, Zwerink M, Hulzebos EH, Bierings M, Helders PJM, et al. Development, feasibility and efficacy of a community-based exercise training program in pediatric cancer survivors. Psychooncology. 2009;18(4):440–448; doi: 10.1002/pon.1484.
6.
Meneses-Echávez JF, González-Jiménez E, Ramírez-Vélez R. Effects of supervised exercise on cancer-related fatigue in breast cancer survivors: a systematic review and meta-analysis. BMC Cancer. 2015;15:77; doi: 10.1186/s12885-015-1069-4.
7.
Mustian KM, Alfano CM, Heckler C, Kleckner AS, Kleckner IR, Leach CR, et al. Comparison of pharmaceutical, psychological, and exercise treatments for cancer-related fatigue: a meta-analysis. JAMA Oncol. 2017;3(7):961–968; doi: 10.1001/jamaoncol.2016.6914.
8.
Bhardwaj T, Koffman J. Non-pharmacological interventions for management of fatigue among children with cancer: systematic review of existing practices and their effectiveness. BMJ Support Palliat Care. 2017;7(4):404–414; doi: 10.1136/bmjspcare-2016-001132.
9.
Morales JS, Valenzuela PL, Rincón-Castanedo C, Takken T, Fiuza-Luces C, Santos-Lozano A, et al. Exercise training in childhood cancer: a systematic review and meta-analysis of randomized controlled trials. Cancer Treat Rev. 2018;70:154–167; doi: 10.1016/j.ctrv.2018.08.012.
10.
Radossi AL, Taromina K, Marjerrison S, Diorio CJ, Similio R, Njuguna F, et al. A systematic review of integrative clinical trials for supportive care in pediatric oncology: a report from the International Society of Pediatric Oncology, T&CM collaborative. Support Care Cancer. 2018;26(2):375–391; doi: 10.1007/s00520-017-3908-0.
11.
Le A, Mitchell H-R, Zheng DJ, Rotatori J, Fahey JT, Ness KK, et al. A home‐based physical activity intervention using activity trackers in survivors of childhood cancer: a pilot study. Pediatr Blood Cancer. 2017;64(2):387–394; doi: 10.1002/pbc.26235.
12.
Lam KKW, Li WHC, Chung OK, Ho KY, Chiu SY, Lam HS, et al. An integrated experiential training programme with coaching to promote physical activity, and reduce fatigue among children with cancer: a randomised controlled trial. Patient Educ Couns. 2018;101(11):1947–1956; doi: 10.1016/j.pec.2018.07.008.
13.
Braam KI, van Dijk-Lokkart EM, Kaspers GJL, Takken T, Huisman J, Buffart LM, et al. Effects of a combined physical and psychosocial training for children with cancer: a randomized controlled trial. BMC Cancer. 2018;18(1):1289; doi: 10.1186/s12885-018-5181-0.
14.
Baker KS, Bresters D, Sande JE. The burden of cure: long-term side effects following hematopoietic stem cell transplantation (HSCT) in children. Pediatr Clin North Am. 2010;57(1):323–342; doi: 10.1016/j.pcl.2009.11.008.
15.
Mohty B, Mohty M. Long-term complications and side effects after allogeneic hematopoietic stem cell transplantation: an update. Blood Cancer J. 2011;1(4):e16; doi: 10.1038/bcj.2011.14.
16.
Ruble K, Krupski C, Chen A, Dandoy CE. Quality and safety in hematopoietic stem cell transplant patients. In: Dandoy CE, Hilden JM, Billett AL, Mueller BU (eds.), Patient safety and quality in pediatric hematology/oncology and stem cell transplantation. Cham: Springer; 2017; 297–324.
17.
Felder-Puig R, di Gallo A, Waldenmair M, Norden P, Winter A, Gadner H, et al. Health-related quality of life of pediatric patients receiving allogeneic stem cell or bone marrow transplantation: results of a longitudinal, multi-center study. Bone Marrow Transplant. 2006;38(2):119–126; doi: 10.1038/sj.bmt.1705417.
18.
Ness KK, Hudson MM, Ginsberg JP, Nagarajan R, Kaste SC, Marina N, et al. Physical performance limitations in the Childhood Cancer Survivor Study cohort. J Clin Oncol. 2009;27(14):2382–2389; doi: 10.1200/JCO.2008.21.1482.
19.
Tanzi EM. Health-related quality of life of hematopoietic stem cell transplant childhood survivors: state of the science. J Pediatr Oncol Nurs. 2011;28(4):191–202; doi: 10.1177/1043454211408100.
20.
Van Haren IEPM, Timmerman H, Potting CM, Blijlevens NMA, Staal JB, Nijhuis-van der Sanden MWG. Physical exercise for patients undergoing hematopoietic stem cell transplantation: systematic review and meta-analyses of randomized controlled trials. Phys Ther. 2013;93(4):514–528; doi: 10.2522/ptj.20120181.
21.
Streckmann F, Kneis S, Leifert JA, Baumann FT, Kleber M, Ihorst G, et al. Exercise program improves therapy-related side-effects and quality of life in lymphoma patients undergoing therapy. Ann Oncol. 2014;25(2):493–499; doi: 10.1093/annonc/mdt568.
22.
Wiskemann J, Dreger P, Schwerdtfeger R, Bondong A, Huber G, Kleindienst N, et al. Effects of a partly self-administered exercise program before, during, and after allogeneic stem cell transplantation. Blood. 2011;117(9):2604–2613; doi: 10.1182/blood-2010-09-306308.
23.
Braam KI, van der Torre P, Takken T, Veening MA, van Dulmen‐den Broeder E, Kaspers GJL. Physical exercise training interventions for children and young adults during and after treatment for childhood cancer. Cochrane Database Syst Rev. 2013;4:CD008796; doi: 10.1002/14651858.CD008796.pub2.
24.
Knols RH, de Bruin ED, Shirato K, Uebelhart D, Aaronson NK. Physical activity interventions to improve daily walking activity in cancer survivors. BMC Cancer. 2010;10:406; doi: 10.1186/1471-2407-10-406.
25.
Rosenhagen A, Bernhörster M, Vogt L, Weiss B, Senn A, Arndt S, et al. Implementation of structured physical activity in the pediatric stem cell transplantation. Klin Padiatr. 2011;223(3):147–151; doi: 10.1055/s-0031-1271782.
26.
Weiß B. Quality of life and tumour-related fatigue in relation to sports activity in paediatric supportive therapy [in German]. Master’s thesis. Darmstadt: TU Darmstadt; 2009.
27.
Jung M, Höhne A, Varni J, Klingebiel T, Landenberger M. The measurement of fatigue in paediatric oncology. The first German version of the “PedsQL 3.0 Multidimensional Fatigue Scale” [in German]. Kind Jugendmed. 2009;9(4):218–224; doi: 10.1055/s-0038-1629061.
28.
Oberoi S, Robinson PD, Cataudella D, Culos-Reed SN, Davis H, Duong N, et al. Physical activity reduces fatigue in patients with cancer and hematopoietic stem cell transplant recipients: a systematic review and meta-analysis of randomized trials. Crit Rev Oncol Hematol. 2018;122:52–59; doi: 10.1016/j.critrevonc.2017.12.011.
29.
Witlox L, Hiensch AE, Velthuis MJ, Steins Bisschop CN, Los M, Erdkamp FLG, et al. Four-year effects of exercise on fatigue and physical activity in patients with cancer. BMC Med. 2018;16(1):86; doi: 10.1186/s12916-018-1075-x.
30.
Chamorro-Viña C, Valentín J, Fernández L, González-Vicent M, Pérez-Ruiz M, Lucía A, et al. Influence of a moderate-intensity exercise program on early NK cell immune recovery in pediatric patients after reduced-intensity hematopoietic stem cell transplantation. Integr Cancer Ther. 2017;16(4):464–472; doi: 10.1177/1534735416679515.
Share
RELATED ARTICLE
| eISSN: | 2544-4395 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
