Wilhelmenia L Ross1, Alyssa Le1, Daniel J Zheng1,2,3, Hannah-Rose Mitchell4, Jaime Rotatori1, Fangyong Li5,6, John T Fahey7, Kirsten K Ness8, Nina S Kadan-Lottick9,10. 1. Section of Pediatric Hematology-Oncology, Yale School of Medicine, PO Box 208064, 333 Cedar Street, LMP-2073, New Haven, CT, 06520-8064, USA. 2. Department of Medicine, Boston Children's Hospital, Boston, MA, USA. 3. Department of Pediatrics, Boston Medical Center, Boston, MA, USA. 4. Department of Psychology, University of Miami, Coral Gables, FL, USA. 5. Yale School of Public Health, New Haven, CT, USA. 6. Yale Center for Analytical Sciences, New Haven, CT, USA. 7. Section of Pediatric Cardiology, Yale School of Medicine, New Haven, CT, USA. 8. Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA. 9. Section of Pediatric Hematology-Oncology, Yale School of Medicine, PO Box 208064, 333 Cedar Street, LMP-2073, New Haven, CT, 06520-8064, USA. nina.kadan-lottick@yale.edu. 10. Yale Cancer Center, New Haven, CT, USA. nina.kadan-lottick@yale.edu.
Abstract
PURPOSE: Childhood cancer patients report low physical activity levels despite the risk for long-term complications that may benefit from exercise. Research is lacking regarding exercise barriers, preferences, and beliefs among patients (1) on- and off-therapy and (2) across the age spectrum. METHODS: Cross-sectional study in the Yale Pediatric Hematology-Oncology Clinic (October 2013-October 2014). Participants were ≥ 4 years old, > 1 month after cancer diagnosis at < 20 years, not acutely ill, expected to live > 6 months, and received chemotherapy and/or radiation. Participants (or parents if < 13 years) completed a survey. RESULTS: The 162 patients (99% participated) were 34% children (4.0-12.9 years), 31% adolescents (13.0-17.9 years), and 35% adults (≥ 18 years). Most had leukemia/lymphoma (66%); 32% were on-therapy. On-therapy patients were more likely than off-therapy patients (73 vs. 48%; p = 0.003) to report ≥ 1 barrier related to physical complaints, such as "just too tired" (46 vs. 28%; p = 0.021) or "afraid" of injury (22 vs. 9%; p = 0.027). The majority preferred walking (73%), exercising at home (91%), exercising in the afternoon (79%), and a maximum travel time of 10-20 min (54%); preferences did not vary significantly by therapy status or age. Most respondents (94%) recognized the benefits of exercise after cancer, but 50% of on- vs. 12% of off-therapy patients believed "their cancer diagnosis made it unsafe to exercise regularly" (p < 0.001). CONCLUSIONS: Physical activity barriers pertaining to physical complaints and safety concerns were more pronounced in on-therapy childhood cancer patients but persisted off-therapy. Preferences and beliefs were relatively consistent. Our data can inform interventions in different patient subgroups.
PURPOSE: Childhood cancerpatients report low physical activity levels despite the risk for long-term complications that may benefit from exercise. Research is lacking regarding exercise barriers, preferences, and beliefs among patients (1) on- and off-therapy and (2) across the age spectrum. METHODS: Cross-sectional study in the Yale Pediatric Hematology-Oncology Clinic (October 2013-October 2014). Participants were ≥ 4 years old, > 1 month after cancer diagnosis at < 20 years, not acutely ill, expected to live > 6 months, and received chemotherapy and/or radiation. Participants (or parents if < 13 years) completed a survey. RESULTS: The 162 patients (99% participated) were 34% children (4.0-12.9 years), 31% adolescents (13.0-17.9 years), and 35% adults (≥ 18 years). Most had leukemia/lymphoma (66%); 32% were on-therapy. On-therapy patients were more likely than off-therapy patients (73 vs. 48%; p = 0.003) to report ≥ 1 barrier related to physical complaints, such as "just too tired" (46 vs. 28%; p = 0.021) or "afraid" of injury (22 vs. 9%; p = 0.027). The majority preferred walking (73%), exercising at home (91%), exercising in the afternoon (79%), and a maximum travel time of 10-20 min (54%); preferences did not vary significantly by therapy status or age. Most respondents (94%) recognized the benefits of exercise after cancer, but 50% of on- vs. 12% of off-therapy patients believed "their cancer diagnosis made it unsafe to exercise regularly" (p < 0.001). CONCLUSIONS: Physical activity barriers pertaining to physical complaints and safety concerns were more pronounced in on-therapy childhood cancerpatients but persisted off-therapy. Preferences and beliefs were relatively consistent. Our data can inform interventions in different patient subgroups.
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