Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany.
Department of Molecular and Cellular Sports Medicine, Institute of Cardiology and Sports Medicine, German Sport University Cologne, Cologne, Germany.
Pediatr Res. 2022 Mar;91(4):743-756. doi: 10.1038/s41390-021-01523-5. Epub 2021 Apr 15.
Research indicates reduced physical performance from diagnosis into survivorship of pediatric cancer patients. However, there is no systematic information or guideline available on the methods to assess physical performance and function in this population. The purpose was to systematically compile and describe assessments of physical performance and function in patients and survivors of pediatric cancer, including cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait and motor performance test batteries.
We searched the databases PubMed, SPORTDiscus, and Cochrane Database and performed abstract and full-text selection of 2619 articles according to the Cochrane Handbook of Systematic Reviews. Information on patients characteristics, assessments, information on validity and reliability, and relevant references was extracted.
In summary, 63 different assessments were found in 149 studies including 11639 participants. Most studies evaluated cardiorespiratory fitness and muscle strength with the majority conducted off treatment. Some outcomes (e.g. speed) and diagnoses (e.g. neuroblastoma) were severely underrepresented. With the exception of gait, leukemia patients represented the largest group of individuals tested.
Insufficient data and patient heterogeneity complicate uniform recommendations for assessments. Our results support researchers and practitioners in selecting appropriate assessment to meet their specific research questions or individual daily practice needs.
This systematic review includes 149 studies and provides a comprehensive summary of 63 assessments to evaluate cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait or motor performance test batteries in patients and survivors of pediatric cancer. We present the most studied fields within the pediatric cancer population, which are cardiorespiratory fitness and muscle strength, off treatment phase, and leukemia patients. We propose research priorities by identification of subgroups in terms of cancer type, phase of treatment, and outcome of interest that are underrepresented in studies currently available.
研究表明，儿科癌症患者从诊断到生存期间的身体机能会下降。然而，目前尚无针对该人群身体机能和功能评估方法的系统信息或指南。本研究的目的是系统地整理和描述儿科癌症患者和幸存者的身体机能和功能评估方法，包括心肺功能、肌肉力量、速度、平衡、灵活性、功能性移动能力、步态和运动性能测试组合。
我们检索了 PubMed、SPORTDiscus 和 Cochrane Database 数据库，并根据 Cochrane 系统评价手册对 2619 篇文章进行了摘要和全文筛选。提取了有关患者特征、评估方法、有效性和可靠性信息以及相关参考文献的信息。
总之，在 149 项研究中发现了 63 种不同的评估方法，涉及 11639 名参与者。大多数研究评估了心肺功能和肌肉力量，其中大部分是在治疗结束后进行的。一些结果（如速度）和诊断（如神经母细胞瘤）严重代表性不足。除了步态，白血病患者是接受测试的最大个体群体。
数据不足和患者异质性使得评估方法的统一建议变得复杂。我们的研究结果为研究人员和从业者选择适当的评估方法提供了支持，以满足他们特定的研究问题或个人日常实践需求。
本系统评价包括 149 项研究，提供了 63 种评估方法的综合总结，用于评估儿科癌症患者和幸存者的心肺功能、肌肉力量、速度、平衡、灵活性、功能性移动能力、步态或运动性能测试组合。我们呈现了儿科癌症人群中研究最多的领域，包括心肺功能和肌肉力量、治疗后阶段和白血病患者。我们通过确定癌症类型、治疗阶段和现有研究中代表性不足的关注结果的亚组，提出了研究重点。
