Effects of a combined physical and psychosocial training for children with cancer: a randomized controlled trial

BMC Cancer

Tim Takken¹  Laurien M. Buffart²  Jaap Huisman³  Elisabeth M. van Dijk-Lokkart⁴  Johannes H. M. Merks⁵  Marry M. van den Heuvel-Eibrink⁶  Eline van Dulmen-den Broeder⁷  Katja I. Braam⁷  Gertjan J. L. Kaspers⁷  Margreet A. Veening⁷  Marc B. Bierings⁸ 

[1] Child Development & Exercise Center, Wilhelmina Children’s Hospital, University Medical Center Utrecht;Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam Public Health research institute;Department of Medical Psychology and Social Work, Wilhelmina Children’s Hospital, University Medical Center Utrecht;Department of Medical Psychology, VU University Medical Center;Department of Pediatric Oncology, Emma Children’s Hospital/Academic Medical Center;Department of Pediatric Oncology/Hematology, Erasmus Medical Center, Sophia Children’s Hospital;Department of Pediatric Oncology/Hematology, VU University Medical Center;Department of Pediatric Oncology/Hematology, Wilhelmina Children’s Hospital, University Medical Center Utrecht;

关键词: Children;    Cancer;    Physical exercise;    Psychosocial;    Intervention;   

DOI  :  10.1186/s12885-018-5181-0

来源: DOAJ

【 摘 要 】

Abstract Background Physical fitness and psychosocial function is often reduced in children during or shortly after cancer treatment. This study evaluates the effect of a combined physical exercise and psychosocial intervention on cardiorespiratory fitness, muscle strength, body composition, psychosocial function and health-related quality of life (HrQoL). In addition, intervention mediators, applicability and adherence were examined. Methods This multicenter randomized controlled trial included 68 children with cancer [mean age 13.2 (SD: 3.1) years; 54% male] during treatment or within 12-months post-treatment. The 12-week intervention consisted of 24 individual physical exercise sessions supervised by a physiotherapist, and 6 psychosocial training sessions for children and 2 for parents. Physical fitness and psychosocial function were assessed at baseline, directly post-intervention and at 12 months’ post-baseline. Generalized estimating equations were used to simultaneously assess intervention effects at short and long-term. Additionally, we evaluated within-group differences over time. Potential physical and psychosocial mediators in the intervention effect on HrQoL were examined using the product-of-coefficient test. Applicability and adherence were assessed by trainer-report. Results This study was able to compare 26 children who received the study intervention, with 33 children who received usual care. No significant differences in the effects of the intervention were found on physical fitness and psychosocial function at short-term. At 12-months follow-up, significantly larger improvements in lower body muscle strength (β = 56.5 Newton; 95% CI: 8.5; 104.5) were found in the intervention group when compared to the control group. Within-group changes showed significant improvements over time in HrQoL and bone density in both groups. Intervention effects on HrQoL were not significantly mediated by physical fitness and psychological function. Intervention applicability was satisfactory with an average session attendance of 67% and 22% dropout (mainly due to disease recurrence). Conclusions This 12-week physical exercise and psychosocial training intervention for children with cancer was applicable and showed satisfactory adherence. We found no significant between-group differences in effect, except for a significant improvement in lower body muscle strength at long-term in the intervention group compared to the control group. Yet, both the intervention and the control group showed improvements in bone mineral density and HrQoL over time. Trial registration The trial was registered at the Dutch Trial Registry (NTR1531). Registered 12 November 2008.

【 授权许可】

Unknown