Thorsteinsson Troels, Larsen Hanne Baekgaard, Schmiegelow Kjeld, Thing Lone Friis, Krustrup Peter, Pedersen Mogens Theisen, Christensen Karl Bang, Mogensen Pernille Rudebeck, Helms Anne Sofie, Andersen Lars Bo
Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
BMJ Open Sport Exerc Med. 2017 May 12;3(1):e000179. doi: 10.1136/bmjsem-2016-000179. eCollection 2017.
Children with cancer experience severe reductions in physical fitness and functionality during and following intensive treatment. This may negatively impact their quality of life.
To describe the physical capacity and functionality of children with cancer during and after treatment as well as the feasibility of physical activity intervention in the Rehabilitation including Social and Physical activity and Education in Children and Teenagers with Cancer study.
The study included children diagnosed from January 2013 to April 2016 with paediatric cancer or Langerhans cell histiocytosis, all treated with chemotherapy. Seventy-five of 78 consecutively eligible children (96.2%) were included. Median age was 11 years (range 6‒18). The physical capacity and function were assessed based on testing of physical strength, balance and cardiorespiratory fitness. Children were tested at diagnosis, 3 and 6 months after diagnosis and 1 year after cessation of treatment. The feasibility evaluation was inspired by the criteria for reporting the development and evaluation of complex interventions in healthcare.
All children participated in the physical intervention programme with no dropouts. Strenuous physical exercise and physiological testing during paediatric cancer treatment was safe and feasible, with only five minor adverse events during the intervention. Cardiorespiratory fitness was significantly lower in children with cancer than norms for healthy age-matched children at diagnosis (difference 19.1 mL/kg/min, 95% CI 15.4 to 22.7; p <0.0001), during treatment 3 and 6 months from diagnosis (difference 21.0 mL/kg/min, 95% CI 17.4 to 24.6; p <0.0001 and difference 21.6 mL/kg/min, 95% CI 17.3 to 25.8; p <0.0001, respectively) and 1 year after cessation of treatment (difference 6.9 mL/kg/min, 95% CI 1.1 to 12.7; p <0.0072). Furthermore, children with cancer experienced a pronounced decline in physical function.
This study shows that it is safe and feasible to perform strenuous physical exercise and testing during paediatric cancer treatment and that children with cancer have significantly lower physical capacity and functionality than healthy age-matched norms.
ClinicalTrials.gov: NCT01772862.
癌症患儿在强化治疗期间及之后体能和身体功能会严重下降。这可能会对他们的生活质量产生负面影响。
描述癌症患儿在治疗期间及之后的身体能力和功能，以及在“癌症患儿和青少年康复中的社会与体育活动及教育”研究中进行体育活动干预的可行性。
该研究纳入了2013年1月至2016年4月期间诊断为小儿癌症或朗格汉斯细胞组织细胞增多症且均接受化疗的患儿。连续符合条件的78名患儿中有75名（96.2%）被纳入研究。中位年龄为11岁（范围6至18岁）。根据体力、平衡和心肺适能测试评估身体能力和功能。患儿在诊断时、诊断后3个月和6个月以及治疗停止后1年接受测试。可行性评估受到医疗保健中复杂干预措施开发和评估报告标准的启发。
所有患儿均参与了体育干预项目，无一人退出。小儿癌症治疗期间的剧烈体育锻炼和生理测试是安全可行的，干预期间仅发生了5起轻微不良事件。癌症患儿的心肺适能在诊断时（差异19.1毫升/千克/分钟，95%置信区间15.4至22.7；p<0.0001）、诊断后3个月和6个月的治疗期间（差异分别为21.0毫升/千克/分钟，95%置信区间17.4至24.6；p<0.0001以及差异21.6毫升/千克/分钟，95%置信区间17.3至25.8；p<0.0001）以及治疗停止后1年（差异6.9毫升/千克/分钟，95%置信区间1.1至12.7；p<0.0072）均显著低于年龄匹配的健康儿童标准。此外，癌症患儿的身体功能出现了明显下降。
本研究表明，在小儿癌症治疗期间进行剧烈体育锻炼和测试是安全可行的，且癌症患儿的身体能力和功能明显低于年龄匹配的健康儿童标准。
ClinicalTrials.gov：NCT01772862。
