Determinants of physical activity level in pediatric oncological patients treated with cardiotoxic therapy - a study protocol.

BACKGROUND

Childhood cancer and its therapy, especially that involving potentially cardiotoxic cancer treatment, can structurally affect muscle strength and heart function, and therefore may result in lowered physical activity (PA). This study protocol aims to find the significant determinants of PA levels in pediatric oncological patients 1-5 years after heart-toxic chemotherapy and/or radiation of the heart region.

METHODS

The study group will include children 1-5 years after completing cancer therapy involving cardiotoxicity risk factors. The primary outcome of interest is the PA measured with an ActiGraph GT3X Accelerometer for 14 consecutive days and the assessment of WHO pediatric age-adjusted PA norms achievement. Assessed PA levels will be evaluated according to the possible determinants of PA: disease/treatment related risk factors, treatment complications, possible complications after the treatment, cardiac function with echocardiography including 2D and 3D strain imaging, physical function and muscle strength in ALPHA (Assessing Levels of Physical Activity) health-related fitness test battery and exercise capacity in cardiopulmonary exercise testing. The self-efficacy and motivation to PA, quality of life (QoL), lifestyle, socio-demographic, and anthropogenic factors as well as knowledge about the positive impact of PA will be evaluated with original and validated questionnaires. The PA determinants of the study group will be compared to the results of the control group of children in the same follow-up period (> 1 year < 5 years) after completing cancer therapy without cardiotoxic methods.

DISCUSSION

The results may contribute to the development of future recommendations on prophylactic and therapeutic approaches, as well as proper lifestyle recommendations for children in long-term follow-up after cardiotoxic cancer therapy. The determinants will be used to develop targeted exercise prescriptions and exercise programs.

TRIAL REGISTRATION

NCT06256068.