Precision-based exercise as a new therapeutic option for children and adolescents with haematological malignancies.

Children and adolescents with haematological malignancies (PedHM) are characterized by a severe loss of exercise ability during cancer treatment, lasting throughout their lives once healed and impacting their social inclusion prospects. The investigation of the effect of a precision-based exercise program on the connections between systems of the body in PedHM patients is the new frontier in clinical exercise physiology. This study is aimed at evaluating the effects of 11 weeks (3 times weekly) of combined training (cardiorespiratory, resistance, balance and flexibility) on the exercise intolerance in PedHM patients. Two-hundred twenty-six PedHM patients were recruited (47% F). High or medium frequency participation (HAd and MAd) was considered when a participant joined; > 65% or between 30% and < 64% of training sessions, respectively. The "up and down stairs'' test (TUDS), "6 min walking" test (6MWT), the "5 Repetition Maximum strength" leg extension and arm lateral raise test (5RM-LE and 5RM-ALR), flexibility (stand and reach), and balance (stabilometry), were performed and evaluated before and after training. The TUDS, the 5RM-LE and 5RM-ALR, and the flexibility exercises showed an increase in HAd and MAd groups (P < 0.05), while the 6MWT and balance tests showed improvement only in HAd group (P < 0.0001). These results support the ever-growing theory that, in the case of the treatment of PedHM, 'exercise is medicine' and it has the potential to increase the patient's chances of social inclusion.

Body Water Status and Short-term Maximal Power Output during a Multistage Road Bicycle Race (Giro d'Italia 2014).

An investigation of whether body water changes during the Giro d'Italia affected average maximal mean power (MMP) of different time durations and to establish whether phase-angle and body cell mass (BCM) are related to MMP in elite cyclists. Approximately 2 h after each stage of the race, a bioelectrical impedance analysis was performed on 8 cyclists and analysed according to bioelectrical impedance vector analyses. Additionally, MMP of different time durations were recorded during each stage. Body mass increased (p<0.001), vector-length shortened (p<0.001) and MMP15 (maximal mean power for 15 s; p=0.043) decreased in the course of the Giro d'Italia. The shortening of the vector was negatively related to MMP10 (r=- 0.749, p=0.032) and MMP15 (r=- 0.735, p=0.038) during stage 16 (heavy mountain-stage) and MMP60 (r=- 0.751, p=0.032), MMP300 (r=- 0.739, p=0.036) and MMP1800 (r=- 0.769, p=0.026) during stage 19 (time-trial). Additionally, the baseline phase-angle and BCM were associated to MMP15 best (r=0.781, p=0.022 and 0.756, p=0.030, respectively). In the course of the Giro d'Italia, MMP15 decreased, indicating progressive fatigue. The vector-length shortening and to some extent the body mass increase indicate that cyclists gained body water during the race. This gain was positively associated with performance during the last stages, possibly due to improved thermoregulation. Furthermore, phase-angle and BCM, shown to be linked to cellular function and to represent metabolic active tissue, reflect individual MMP of short duration in professional road cyclists.