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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

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Abstract

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 (VO2peak ml/kg/min), minute ventilation (VE L/min), output of carbon dioxide (VCO2 L/min), respiratory exchange ratio (RER), peak heart rate (beats/min), maximal load (W), VO2 at anaerobic threshold (VO2 at AT, ml/kg/min), pulse oxygen (PO2 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; η2 partial = 0.046, P = 0.035) for VO2peak. 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), VCO2 − 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 VO2peak, VE, VCO2, 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.

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Acknowledgments

Patients and their families, the Hemato-Oncology Unit, Pediatrics and the Cardiology Service of the Santa Creu and Sant Pau Hospital in Barcelona.

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Authors and Affiliations

  1. Physiotherapy Department, Universitat Inernacional de Catalunya, Barcelona, Spain

    Jahn Dubery Manchola-González, Caritat Bagur-Calafat & Montserrat Girabent-Farrés

  2. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    Josep Ricard Serra-Grima, Roser Álvarez Pérez & Isabel Badell

  3. Research group in physical activity, performance and health (GRI-AFIRS), School of Health Sciences, TecnoCampus-Pompeu Fabra University, Barcelona, Spain

    Manuel Vicente Garnacho-Castaño

  4. Navarrabiomed-Universidad Pública de Navarra (UPNA)-Complejo Hospitalario de Navarra (CHN), Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008, Pamplona, Navarra, Spain

    Robinson Ramírez-Vélez

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  1. Jahn Dubery Manchola-González
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  2. Caritat Bagur-Calafat
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Correspondence to Robinson Ramírez-Vélez.

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The study was approved by the university’s institutional review board. Written informed consent was obtained from all participants.

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The authors declare that they have no conflicts of interest.

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Manchola-González, J.D., Bagur-Calafat, C., Girabent-Farrés, M. et al. 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. Support Care Cancer 28, 3171–3178 (2020). https://doi.org/10.1007/s00520-019-05131-2

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  • DOI: https://doi.org/10.1007/s00520-019-05131-2

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