P J Piscione1, E Bouffet2, B Timmons3, K S Courneya4, D Tetzlaff1, J E Schneiderman5, C B de Medeiros6, U Bartels2, D J Mabbott7. 1. Department of Rehabilitation Services, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G-1X8, Canada. 2. Division of Haematology/Oncology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G-1X8, Canada. 3. Department of Paediatrics, McMaster University, Hamilton, Ontario, L8S 4L8, Canada. 4. Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada. 5. Physiology and Experimental Medicine, Research Institute, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G-1X8, Canada. 6. Neurosciences and Mental Health, Hospital for Sick Children, 686 Bay Street, Toronto, Ontario, M5G-0A4, Canada. 7. Neurosciences and Mental Health, Hospital for Sick Children, 686 Bay Street, Toronto, Ontario, M5G-0A4, Canada; Department of Psychology, University of Toronto, Toronto, Ontario, M5S-1A1, Canada. Electronic address: donald.mabbott@sickkids.ca.
Abstract
AIMS: We examined the efficacy of exercise training for improving physical functioning and cardiopulmonary fitness in survivors of paediatric brain tumours (BTs) treated with cranial irradiation. METHODS: We conducted a controlled clinical trial with crossover of exercise training versus no training in the community in either a group or combined group/home setting. A volunteer sample of 28 children treated with cranial irradiation for brain tumours completed training (meanage = 11.53 years; mean time since diagnosis = 5.25 years). end-points were physical functioning assessed by four subtests from the Bruininks-Oseretsky Test of motor performance (BOT-2) and pro-rated work rate from a cycle ergometer. Linear mixed modelling was used to evaluate time, training, training setting, and carryover effects. RESULTS: Adherence to training was 84%. Performance on the BOT-2 was below average for all assessments. However, training resulted in improvement in bilateral coordination (F (1, 30) = 6.59, p = 0.02), irrespective of training setting and improved performance was maintained even approximately 12°weeks after training had ended (F (1, 24) = 9.60, p = 0.005). Training resulted in increased pro-rated work rate for participants in the group training setting only (F (1, 25) = 4.57, p = 0.04) and these participants maintained their improved work rate approximately 12°weeks after training had ended (F (1, 20) = 8.38, p = 0.01). CONCLUSION:Exercise training improves physical functioning and fitness in paediatric BT survivors. Exercise interventions that ameliorate adverse physical effects and promote health in long-term survivors are highly recommended in this vulnerable population. (ClinicalTrials.gov, NCT01944761).
RCT Entities:
AIMS: We examined the efficacy of exercise training for improving physical functioning and cardiopulmonary fitness in survivors of paediatric brain tumours (BTs) treated with cranial irradiation. METHODS: We conducted a controlled clinical trial with crossover of exercise training versus no training in the community in either a group or combined group/home setting. A volunteer sample of 28 children treated with cranial irradiation for brain tumours completed training (mean age = 11.53 years; mean time since diagnosis = 5.25 years). end-points were physical functioning assessed by four subtests from the Bruininks-Oseretsky Test of motor performance (BOT-2) and pro-rated work rate from a cycle ergometer. Linear mixed modelling was used to evaluate time, training, training setting, and carryover effects. RESULTS: Adherence to training was 84%. Performance on the BOT-2 was below average for all assessments. However, training resulted in improvement in bilateral coordination (F (1, 30) = 6.59, p = 0.02), irrespective of training setting and improved performance was maintained even approximately 12°weeks after training had ended (F (1, 24) = 9.60, p = 0.005). Training resulted in increased pro-rated work rate for participants in the group training setting only (F (1, 25) = 4.57, p = 0.04) and these participants maintained their improved work rate approximately 12°weeks after training had ended (F (1, 20) = 8.38, p = 0.01). CONCLUSION: Exercise training improves physical functioning and fitness in paediatric BT survivors. Exercise interventions that ameliorate adverse physical effects and promote health in long-term survivors are highly recommended in this vulnerable population. (ClinicalTrials.gov, NCT01944761).
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