Effects of a home-exercise programme in childhood survivors of acute lymphoblastic leukaemia on physical fitness and physical functioning: results of a randomised clinical trial

• Published in: Supportive care in cancer Vol. 28; no. 7; pp. 3171 - 3178
• Main Authors: Manchola-González, Jahn Dubery, Bagur-Calafat, Caritat, Girabent-Farrés, Montserrat, Serra-Grima, Josep Ricard, Pérez, Roser Álvarez, Garnacho-Castaño, Manuel Vicente, Badell, Isabel, Ramírez-Vélez, Robinson
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-07-2020; Springer; Springer Nature B.V
• Subjects: Anaerobic threshold; Clinical trials; Exercise; Exercise therapy; Health aspects; Heart beat; Heart rate; Leukemia; Medicine; Medicine & Public Health; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Palliative care; Physical fitness; Rehabilitation Medicine; Physical fitness; Acute lymphoblastic leukaemia/therapy; Children; Flexibility; Strength; Exercise therapy
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-019-05131-2

Purpose
The aim of this study was to evaluate the effects of a home-exercise programme on physical fitness indicators and physical functioning after completion of chemotherapy in children and adolescents diagnosed with acute lymphoblastic leukaemia (ALL).
Methods
Twenty-four survivors of ALL were assigned to usual care (control group,
n
= 12, 11.0 ± 3.7 years) or to a home-exercise programme (intervention group,
n
= 12, 11.8 ± 4.3 years). Peak oxygen uptake (VO
2
peak ml/kg/min), minute ventilation (VE L/min), output of carbon dioxide (VCO
2
L/min), respiratory exchange ratio (RER), peak heart rate (beats/min), maximal load (W), VO
2
at anaerobic threshold (VO
2
at AT, ml/kg/min), pulse oxygen (PO
2
ml/beat), heart rate at anaerobic threshold (beats/min), handgrip test (pounds), flexibility (cm), Timed Up & Go test TUG (s), and Timed Up and Down Stairs test (TUDS s) were measured at baseline and over 16 weeks of intervention.
Results
Adjusted mixed linear models revealed a significant group-time interaction + 6.7 (95% CI = 0.6–12.8 ml/kg/min; η
2
partial = 0.046,
P
= 0.035) for VO
2
peak. Similarly, changes in mean values were observed after the home-exercise programme compared with baseline for VE (L/min) − 8.8 (3.0) (
P
= 0.035), VCO
2
− 0.2 (0.08), (
P
= 0.041), maximal load (W) − 35.5 (12.8) (
P
= 0.024), TUDS (s) 0.8 (2.6) (
P
= 0.010), and TUG (s) 0.6 (0.1) (
P
= 0.001); however, the group-time interaction was not significant.
Conclusion
The home-exercise programme resulted in changes in measures of VO
2
peak, VE, VCO
2
, and functional capacity during daily life activities (TUDS and TUG test). This is an interesting and important study that surely adds to the current body of knowledge/literature on the safety of exercise interventions, especially in children with haematological cancer.