PASTEC - a prospective, single-center, randomized, cross-over trial of pure physical versus physical plus attentional training in children with cancer.

Despite recent improvements in survival rates in children with cancer, long-term toxicities remain a major concern. Physical activity could reduce the impact of long-term sequelae, notably in neuropsychological and physical areas. We report of a randomized trial of pure physical versus physical/attentional training in pediatric oncology patients. Twenty-two patients aged 6-18 y.o. were included, irrespective of their clinical diagnosis or treatment status, stratified by age and randomized 1:1 into pure physical vs. physical/attentional activity arms, with a cross-over at study midpoint. Neurological, motor and neuropsychological assessments were performed at inclusion, start, crossover and end of the program. Feasibility, defined as > 80% patients attending > 80% of sessions, was the primary endpoint. Secondary outcomes were improvements in neuropsychological and motor performance tests. While 68% of patients attended more than 80% of sessions during the pre-crossover phase of the study, this dropped to 36% post-crossover. Our study therefore failed to meet our primary endpoint. Nonetheless, significant improvements in anxiety (p<0.001), emotional control (p = 0.04), organization skills (p = 0.03), as well as motor deficit scores (p = 0.04) were observed. We noted no significant difference between the pure physical and the physical/attentional training arms, or when analyzing subgroups by age or sequence of intervention. We conclude that physical activity has a positive impact on anxiety, emotional and organizational aspects as well as motor deficits. Attendance dropped during the course of the study and motivational interventions should be included in future studies or equivalent programs.Supplemental data for this article is available online at https://doi.org/10.1080/08880018.2021.1994677 .

[Health for performance†: a concept that must prevail in sports]. / Health for Performance†: un concept à ancrer dans le sport.

Competitive sports demand numerous sacrifices from young adolescent athletes to reach early performance. This comes at a high price: many injuries, sometimes serious, recurrent fatigue, or undue pressure, bordering on abuse definitions. We present a new concept, which seems quite obvious: health for performance. In the presence of complete biopsychosocial health, adolescent athletes can thrive and meet their athletic, social and academic goals. A conducive sports environment, one which integrates interdisciplinarity with healthcare stakeholders, can allow for a complete harmonious positive development, one which is aligned with Public Health goals. Healthy adolescents may become performing athletes, but they will most definitely contribute positively to their wellbeing, as well as society in general.

Le sport de compétition exige des jeunes adolescents de nombreux sacrifices pour la performance dès le plus jeune âge. Ceci n'est pas sans conséquences, comme en témoignent les blessures parfois graves, la fatigue fréquente et les pressions subies, proches des définitions de la maltraitance. Nous présentons ici un concept nouveau, pourtant si évident : la santé pour la performance. En présence d'une santé bio-psycho-sociale complète, les jeunes athlètes se développent harmonieusement et peuvent atteindre leurs objectifs. Un environnement sportif favorable, fonctionnant en interdisciplinarité avec les acteurs de la santé, permet un apprentissage physique complet et favorise un développement positif des adolescents, en accord avec les objectifs de santé publique. Ainsi ils contribueront tant à leur bien-être qu'à celui de la société.