Changes in fitness are associated with changes in body composition and bone health in children after cancer.

AIM: This study examined the effects of physical activity on the fitness, body composition and mental health of children after cancer or bone marrow transplantation. METHODS: We focused on 22 children aged from seven to 14 years who had received chemotherapy and/or bone marrow transplantation in our medical centre. Ten children took part in a six-month exercise programme, and 12 children who did not exercise formed the control group. At baseline and at the end of the trial, we measured aerobic fitness, body composition, bone density and assessed the child's mood and quality of life. We pooled all participants together post hoc to compare changes in fitness with the various study outcomes. RESULTS: We found no differences between groups in changes in fitness, body composition or mental health indices. Significant correlations were found between changes in aerobic fitness and changes in lean body mass (r = 0.74, p = 0.002), bone mineral content (r = 0.57, p = 0.026) and femoral neck bone mineral density (r = 0.59, p = 0.027) in all participants. CONCLUSION: Group-based exercise training did not improve aerobic fitness in children after cancer or bone marrow transplantation. However, changes in fitness throughout the study period were associated with changes in body composition and bone health in all participants.

[Aerobic fitness and cardiorespiratory function of pediatric cancer survivors].

INTRODUCTION: Overall, more than 80% of children diagnosed with cancer will survive their immediate disease. This growing group of childhood cancer survivors is at an increased risk for several chronic diseases and increased mortality. Physical activity is a well-known and powerful means to reduce such complications, yet many children are not active as recommended. Furthermore, the complex treatments might adversely affect the heart and lungs, possibly limiting physical performance. AIM: To measure aerobic fitness among childhood cancer survivors, while assessing maximal cardiac and respiratory functions. METHODS: Eighteen children (mean age 11.5 +/- 2.1 years, 50% males) who had completed medical treatment for cancer, and 16 healthy children, performed a cardiorespiratory exercise test on a bicycle ergometer until exhaustion. Peak oxygen uptake, O2 pulse and several ventilatory parameters were measured and compared between the groups. RESULTS: The mean maximal load obtained by the cancer survivor group was lower than expected, compared with controls (89% +/- 19 vs. 101/% +/- 18, p = 0.055). Peak oxygen consumption was also lower, with a marginal statistical significance (33.3 +/- 7.5 vs. 38.9 +/- 9.7 ml O2/kg/min, p = 0.075), yet was significantly lower when expressed as a percent of age- and sex- appropriate norms [78% +/- 15 vs. 94% +/- 16, p = 0.0081. Cardiac and respiratory functions were normal in all children, with no between-group differences. CONCLUSIONS: We conclude that aerobic fitness is lower in children who have survived cancer, with no evidence of significant cardiac or lung damage. Given the importance of regular physical activity for this at-risk population, it should be continuously encouraged, while administering a personally tailored exercise prescription.