Functional Capacity of Children with Leukemia

Exercise Physiology Laboratory, Universidad Europea de Madrid, Madrid, Spain.
International Journal of Sports Medicine (Impact Factor: 2.07). 02/2008; 29(2):163-7. DOI: 10.1055/s-2007-964908
Source: PubMed


The purpose of this study was to determine if the functional capacity and quality of life of children receiving treatment against acute lymphoblastic leukemia (ALL) is decreased compared to healthy age and gender-matched children. Functional capacity was assessed with a number of measurements as the peak oxygen uptake (VO2peak) and ventilatory threshold determined during a ramp treadmill test, functional mobility (Timed Up and Down Stairs test [TUDS]) and ankle dorsiflexion passive and active range of motion (passive and active DF-ROM, respectively). Quality of life (QOL) was determined with the Spanish version of the Child Report Form of the Child Health and Illness Profile-Child Edition (CHIP-CE/CRF). Fifteen children (9 boys, 6 girls; mean [SD] age: 6.8 +/- 3.1 years) receiving maintenance therapy against ALL were studied and fifteen, nonathletic healthy children (9 boys, 6 girls; 6.9 +/- 3.3 years) were selected as controls. The mean values of VO2peak and active DF-ROM were significantly (p < 0.05) lower in patients (25.3 +/- 6.5 ml . kg (-1) . min (-1) vs. 31.9 +/- 6.8 ml . kg (-1) . min (-1) in controls and 19.6 +/- 8.0 degrees vs. 24.1 +/- 5.0 degrees , respectively). Children's self report of satisfaction (with self and health) (p < 0.05), comfort (concerning emotional and physical symptoms and limitations) (p < 0.01) and resilience (positive activities that promote health) (p < 0.01) were significantly decreased in patients with ALL. In summary, children receiving treatment against ALL have overall lower functional capacity and QOL than healthy children. However, their physical condition and health status are sufficiently high to allow them to participate in physical activities and supervised exercise programs.

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    • "In contrast, children tend to be less susceptible to major exercise-induced perturbations to the immune system (Koch et al., 2001). Some authors (San Juan et al., 2007a; 2007b; 2008) have investigated the effects of exercise on the immune system of children with ALL. Overall, the outcomes have revealed that the pattern, magnitude and direction of the exercise-induced leukocytosis were comparable between youth patients with ALL and healthy children. "
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    ABSTRACT: Cure rates of youth with Acute Lymphoblastic Leukemia (ALL) have increased in the past decades, but survivor's quality of life and physical fitness has become a growing concern. Although previous reports showed that resistance training is feasible and effective, we hypothesized that a more intense exercise program would also be feasible, but more beneficial than low- to moderate- intensity training programs. We aimed to examine the effects of an exercise program combining high-intensity resistance exercises and moderate-intensity aerobic exercises in young patients undergoing treatment for ALL. A quasi-experimental study was conducted. The patients (n = 6; 5-16 years of age) underwent a 12-week intra-hospital training program involving high-intensity strength exercises and aerobic exercise at 70% of the peak oxygen consumption. At baseline and after 12 weeks, we assessed sub-maximal strength (10 repetition-maximum), quality of life and possible adverse effects. A significant improvement was observed in the sub maximal strength for bench press (71%), lat pull down (50%), leg press (73%) and leg extension (64%) as a result of the training (p < 0.01). The parents' evaluations of their children's quality of life revealed an improvement in fatigue and general quality of life, but the children's self-reported quality of life was not changed. No adverse effects occurred. A 12-week in-hospital training program including high-intensity resistance exercises promotes marked strength improvements in patients during the maintenance phase of the treatment for Acute Lymphoblastic Leukemia without sideeffects. Parents' evaluations of their children revealed an improvement in the quality of life.
    Full-text · Article · Sep 2012 · Journal of sports science & medicine
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    • "One study was completed in children with ALL during the first six months of medical treatment [32], and six were completed among children with ALL during the maintenance or continuation phase of medical treatment [21, 23, 35–37, 43]. Outcome measures described included (1) immunological function [31] [35], (2) cardiovascular fitness [21–23, 35, 36, 38, 40], (3) muscle strength and flexibility [21–23, 33, 34, 36, 40, 43], (4) fatigue or sleep efficacy [30, 34, 40–42], (5) general physical function [9] [21] [32] [33] [36] [40], and (6) quality of life [9] [21] [32] [34] [39]. "
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    ABSTRACT: The purpose of this review is to summarize literature that describes the impact of exercise on health and physical function among children during and after treatment for cancer. Relevant studies were identified by entering the following search terms into Pubmed: aerobic training; resistance training; stretching; pediatric; children; AND cancer. Reference lists in retrieved manuscripts were also reviewed to identify additional trials. We include fifteen intervention trials published between 1993 and 2011 that included children younger than age 21 years with cancer diagnoses. Nine included children with an acute lymphoblastic leukemia (ALL) diagnosis, and six children with mixed cancer diagnoses. Generally, interventions tested were either in-hospital supervised exercise training or home based programs designed to promote physical activity. Early evidence from small studies indicates that the effects of exercise include increased cardiopulmonary fitness, improved muscle strength and flexibility, reduced fatigue and improved physical function. Generalizations to the entire childhood cancer and childhood cancer survivor populations are difficult as most of the work has been done in children during treatment for and among survivors of ALL. Additional randomized studies are needed to confirm these benefits in larger populations of children with ALL, and in populations with cancer diagnoses other than ALL.
    Full-text · Article · Oct 2011 · International Journal of Pediatrics
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    • "The practice of APA in children's hospitals not only aims to let hospitalized children move their bodies and find some pleasure but also to express themselves, regain control over their bodies and preserve muscular mass [12]. Most chronic diseases such as leukemia reduce the physical, psychological and psychomotor abilities of children [13]. For the sick child, physical activity further decreases the loss of physical ability related to the disease or treatment and it can make the child feel like a healthy child. "
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    ABSTRACT: IntroductionIn promoting the health of chronically ill children, the hospital should help children cope both medically and psychosocially with their disease. The University Children's Hospital of Nancy proposes adapted physical activity for hospitalized children, but the practice during hospitalization is not well developed or understood. The ACTIV'HOP study aims to assess the effects of adapted physical activity sessions for hospitalized children in terms of 1) health-related quality of life (HRQoL) and 2) satisfaction with hospital care.Research designACTIV'HOP is an individual randomized controlled trial of patients admitted to the University Children's Hospital of Nancy. The inclusion criteria are 1) age 5 to 18 years, 2) hospitalized for at least 3 days, and 3) no medical contra-indication to practice adapted physical activity.HypothesisChildren and adolescents practicing adapted physical activity during hospitalization have a better HRQoL on hospital discharge and better satisfaction with care.OutcomesHRQoL assessed by the Child Health Questionnaire on the first and last day of hospitalization, and satisfaction with care assessed by the Patients Judgment of Hospital Quality questionnaire were sent to the family home 11 to 15 days after hospital discharge. The French validated version of these questionnaires is used.
    Full-text · Article · Mar 2010 · Contemporary clinical trials
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