Safety and feasibility of exercise interventions in patients with hematological cancer undergoing chemotherapy: a systematic review.

OBJECTIVE: Exercise during and after cancer treatment has established quality of life and health benefits. However, particularly for patients with hematological cancer clear recommendations regarding the safety and feasibility of exercise are under-investigated. The aim of our systematic review was to summarize the literature regarding the feasibility and safety of exercise interventions in patients diagnosed with hematological cancer undergoing chemotherapy. METHOD: A systematic literature review was conducted using PubMed, SPORTDiscus, MEDLINE, Science Direct, and Web of Science electronic databases. Eligible studies were scientific publications reporting the feasibility and/or safety of an exercise intervention program carried out in inpatient patients diagnosed with hematological cancer undergoing chemotherapy. RESULT: Out of 12 studies (six RCTs) included in this review, six investigations reported results with regard to safety and 10 with regard to feasibility. While all studies claim that their exercise interventions were safe and/or feasible, it is noteworthy that this claim often remains unsupported as detailed information on how the feasibility of the intervention was asserted is missing. CONCLUSION: Exercise appears to be safe and feasible in hematological cancer patients. However, due to a striking lack of information on how the feasibility of the intervention was asserted, contextualizing the results and deducing recommendations for further studies remains challenging. Further research should therefore incorporate information on the execution of the exercise intervention in more detail.

Feasibility and suitability of a graded exercise test in patients with aggressive hemato-oncological disease.

PURPOSE: Physical activity promises to reduce disease-related symptoms and therapy-related side effects in patients suffering from aggressive lymphoma (L) or acute leukemia (AL). For an efficient training program, determination of patients' physical capacity with a purposive exercise test is crucial. Here, we evaluated the feasibility and suitability of a graded exercise test (GXT) frequently applied in patients suffering from solid tumors by assessing whether patients achieved criteria for maximal exercise testing according to the American College of Sports Medicine (ACSM). METHODS: The GXT was performed by 51 patients with an aggressive L or AL prior to the start or in the earliest possible phase of high-dose chemotherapy, following a recommended protocol for cancer patients, starting at 20 Watts (W), with an increase of 10 W/min until volitional exhaustion. Subsequently, we investigated whether the following ACSM criteria were fulfilled: (1) failure of heart rate to increase despite increasing workload, (2) post-exercise capillary lactate concentration ≥ 8.0 mmol L-1, (3) rating of perceived exertion at exercise cessation > 17 on the 6-20 Borg Scale. RESULTS: Out of 51 patients, two, six, and 35 participants met the first, second, and third criterion, respectively. No relevant relationships between the completion of the criteria and patients' characteristics (e.g., gender, age) were found. CONCLUSION: Although results of this study suggest a general feasibility of the applied GXT, the ACSM criteria were not met by the majority of the participants. Therefore, this study raises doubts about the suitability of the GXT protocol and the ACSM criteria for this group of patients.

Energy Cost of Physical Activities and Sedentary Behaviors in Young Children.

BACKGROUND: This study reports energy expenditure (EE) data for lifestyle and ambulatory activities in young children. METHODS: Eleven children aged 3 to 6 years (mean age = 4.8 ± 0.9; 55% boys) completed 12 semistructured activities including sedentary behaviors (SB), light (LPA), and moderate-to-vigorous physical activities (MVPA) over 2 laboratory visits while wearing a portable metabolic system to measure EE. RESULTS: Mean EE values for SB (TV, reading, tablet and toy play) were between 0.9 to 1.1 kcal/min. Standing art had an energy cost that was 1.5 times that of SB (mean = 1.4 kcal/min), whereas bike riding (mean = 2.5 kcal/min) was similar to LPA (cleaning-up, treasure hunt and walking) (mean = 2.3 to 2.5 kcal/min), which had EE that were 2.5 times SB. EE for MVPA (running, active games and obstacle course) was 4.2 times SB (mean = 3.8 to 3.9 kcal/min). CONCLUSION: EE values reported in this study can contribute to the limited available data on the energy cost of lifestyle and ambulatory activities in young children.