Review Article

Exercise Interventions in Children with Cancer: A Review

Table 2

Description of the randomized exercise trials in children with cancer.

First author
and year
DemographicsExercise intervention (type of training, frequency, and duration) *Main outcomes

Marchese, 2004 [21].Intervention group: 𝑁 = 1 3 .
ALL receiving maintenance therapy. 8 males. Mean age at the time of the study: 7.6 (range, 4.3–10.6) yrs.
Control group: 𝑁 = 1 5 .
12 males.
Mean age at the time of the study: 8.6 (range 5.1–15.8) yrs
Intervention: five sessions (20 to 60 minutes immediately after initial testing, and 2, 4, 8, and 12 weeks later) of PT (stretching and strengthening exercises, supervised) and an individualized home-based exercise program (bilateral ankle dorsiflexion stretching for 30 sec 5 days per week, bilateral lower extremity strengthening 3 sets, 3 days per week, and aerobic exercises).
Control: no instructions related to physical fitness and no PT intervention.
Duration: 16 weeks, during treatment.
Hemoglobin level (−), ankle dorsiflexion strength (−), TUDs (−), 9-minute walk-run (−), and QOL (−). Ankle dorsiflexion range of motion (active) and knee extension strength increased in intervention group from before to after test.

Hinds, 2007 [42].Intervention group: 𝑁 = 1 4 . Children and adolescents with cancer. 9 males. Mean age at the time of the study: 13.0 (range 8.5–17.4) yrs
Control group: 𝑁 = 1 5 . 3 males. Mean age at the time of the study: 11.9 (range 7.4–18.1) yrs
Intervention: enhanced physical activity (pedaling a stationary bike-style exerciser, 30 minutes, twice daily during brief hospitalization).
Control: standard care.
Duration: 2–4 days, during treatment.
Sleep efficiency (+).

Moyer-Mileur, 2009 [36].Intervention group: 𝑁 = 6 . Children receiving maintenance therapy for ALL. 3 males. Mean age at the time of the study: 7.2 ± 0.7 yrs.
Control group: 𝑁 = 7 . 4 males. Mean age at the time of the study: 5.9 ± 0.7 yrs.
Intervention: an individualized exercise program (three 15–20-minute sessions of moderate-to-vigorous activity per week) and nutritional education.
Control: received standard diet recommendation and performed activity as tolerated.
Duration: 12 months, enhanced physical activity program
Nutrient intake (−), height (−), weight (−), or BMI (−) between intervention and control groups. No intervention effect for upper body strength (push-up completed) or flexibility (sit and reach distance).
Self-reported PA (+) and a cardiovascular fitness (+).

Hartman, 2009 [33].Intervention group: 𝑁 = 2 5 .
Children with ALL. 14 boys. Median age at the time of the study: 5.3 (range 1.3–15.6) yrs.
Control group: 𝑁 = 2 6 . 16 boys. Median age at the time of the study: 6.2 (range 1.7–17.1) yrs.
Intervention: preventive PT program (weekly strengthening and stretching exercise and short-burst high-intensity exercise in BMD twice per week).
Control: standard care.
Duration: 2 years, during treatment.
Percentage of body fat (−) or less body mass (−). BMD decreased significantly in both groups between the start and end of treatment.
Motor performance (−) or ankle dorsiflexion range of motion (−) between groups.

*(+) to indicate a significant effect; (−) to indicate no significant effect/change.
ALL: acute lymphoblastic leukemia; BMD: bone mineral density; BMI: body mass index; PA: physical activity; PT: physical therapy; QOL: quality of life; TUDs: time up and down stair test.