Indoor Wall Climbing with Childhood Cancer Survivors: An Exploratory
                    Study on Feasibility and Benefits

Julia Däggelmann; Aram Prokop; Vivien Lösse; Volker Maas; Sarah Otten; Wilhelm Bloch

doi:10.1055/a-1099-9592

Klin Padiatr 2020; 232(03): 159-165
DOI: 10.1055/a-1099-9592

Original Article

Indoor Wall Climbing with Childhood Cancer Survivors: An Exploratory Study on Feasibility and Benefits

Eine explorative Studie zur Machbarkeit und Effektivität einer Kletterintervention für Kinder und Jugendliche nach einer Krebserkrankung

Julia Däggelmann

¹Department of Molecular and Cellular Sports Medicine, Institute of Cardiology and Sports Medicine, German Sport University Cologne, Cologne, Germany

,

Aram Prokop

²Department of Pediatrics, Division of Pediatric Oncology and Hematology, Municipal Clinics of Cologne, Children’s Hospital Amsterdamer Strasse, Cologne, Germany

,

Vivien Lösse

¹Department of Molecular and Cellular Sports Medicine, Institute of Cardiology and Sports Medicine, German Sport University Cologne, Cologne, Germany

,

Volker Maas

²Department of Pediatrics, Division of Pediatric Oncology and Hematology, Municipal Clinics of Cologne, Children’s Hospital Amsterdamer Strasse, Cologne, Germany

,

Sarah Otten

¹Department of Molecular and Cellular Sports Medicine, Institute of Cardiology and Sports Medicine, German Sport University Cologne, Cologne, Germany

,

Wilhelm Bloch

¹Department of Molecular and Cellular Sports Medicine, Institute of Cardiology and Sports Medicine, German Sport University Cologne, Cologne, Germany

› Author Affiliations

Abstract

Background Exercise interventions in pediatric oncology include primarily traditional types of physical activity (PA) such as endurance and strength training, while there is a growing interest in recreational types of PA for pediatric cancer survivors, as well. One of these motivating and fun activities is indoor wall climbing. Therefore, this exploratory study aims to evaluate the feasibility and beneficial effects of a 10-week indoor wall climbing intervention in pediatric oncology.

Patients Thirteen childhood cancer survivors aged 6–21 years were included after cessation of their inpatient medical treatment of whom eleven completed the study.

Methods Study participants completed measurements of physical functioning at baseline (t0) and post-intervention (t1), as well as a questionnaire on program satisfaction at t1.

Results Survivors participated in 57.43±31.77% of the climbing sessions and no adverse events occurred. Most study participants evaluated the climbing experience to be fun and motivational. One child stated that the climbing intervention was too exhausting/overstraining. Significant positive effects were found in terms of ankle DF-ROM and ankle DF strength.

Discussion Indoor wall climbing seems feasible with childhood cancer survivors and suggests beneficial potentials on physical functioning. However, some preconditions (i. e. close supervision; slow increase of intensity; sufficient breaks) must be ensured.

Conclusion Indoor wall climbing could be a motivational adjunct to traditional types of exercise in pediatric oncology.

Zusammenfassung

Hintergrund Bewegungstherapeutische Interventionen in der pädiatrischen Onkologie schließen in erster Linie traditionelle Bewegungsformen wie bspw. Kraft- und Ausdauertraining ein. Es besteht jedoch vermehrtes Interesse an motivierenden Freizeitaktivitäten wie bspw. Klettern. Deshalb untersucht die vorliegende explorative Studie die Machbarkeit und Effektivität einer 10-wöchigen Kletterintervention in der pädiatrischen Onkologie.

Patienten Dreizehn Überlebende einer pädiatrischen Krebserkrankung im Alter von 6–21 Jahren, die die stationäre medizinische Behandlung abgeschlossen haben, wurden in die Studie eingeschlossen. Elf Studienteilnehmer/innen beendeten die Intervention und wurden in die Auswertung einbezogen.

Methodik Die Studienteilnehmer/innen nahmen vor (t0) und nach (t1) der Intervention an Testungen zur körperlichen Fitness teil. Ergänzend beantworteten sie einen Fragebogen zur Zufriedenheit mit der Kletterintervention.

Ergebnisse Die Teilnahmequote lag bei 57.43±31.77%. Es traten keine unerwünschten Ereignisse auf. Die meisten Studienteilnehmer/innen gaben an, dass ihnen die Kletterintervention Spaß gemacht hat und motivierend war. Ein Kind empfand die Kletterintervention als zu anstrengend und überfordernd. Signifikant positive Effekte konnten in Bezug auf die Beweglichkeit und Kraft im Sprunggelenk nachgewiesen werden.

Diskussion Klettern mit Überlebenden einer pädiatrischen Krebserkrankung scheint machbar und lässt positive Effekte auf ausgewählte physische Parameter vermuten. Dennoch müssen einige Sicherheitsaspekte (u. a. enge Überwachung, langsame Intensitätssteigerung, ausreichend Pausen) beachtet werden.

Schlussfolgerung Klettern kann eine vielversprechende Ergänzung zu den bisherigen Bewegungsinterventionen in der pädiatrischen Onkologie darstellen.

Key words

children - exercise - rehabilitation - climbing - cancer - oncology

Schlüsselwörter

Pädiatrie - Bewegung - Rehabilitation - Klettern - Krebs - Onkologie

Full Text

References

References
1 Baumann FT, Bloch W, Beulertz J. Clinical exercise interventions in pediatric oncology: A systematic review. Pediatr Res 2013; 74: 366-374
2 Beulertz J, Wurz A, Culos-Reed N. et al. Ankle dorsiflexion in childhood cancer patients: A Review of the literature. Cancer Nurs 2015; 38: 447-457
3 Beulertz J, Prokop A, Rustler V. et al. Effects of a 6-month, group-based, therapeutic exercise program for childhood cancer outpatients on motor performance, level of activity, and quality of life. Pediatr Blood Cancer 2016; 63: 127-132
4 Braam KI, van der Torre P, Takken T. et al. Physical exercise training interventions for children and young adults during and after treatment for childhood cancer. Cochrane Database Syst Rev 2016; 3: CD008796
5 Cheng J, Resurreccion D, Tzeng B. et al. Efficacy and safety of an indoor rock climbing program as a complimentary physical therapy and recreational activity for children with cerebral palsy. Am J Phys Med Rehabil 2004; 83: 243-244
6 Crawford JJ, Vallance JK, Holt NL. et al. A pilot randomized, controlled trial of a wall climbing intervention for gynecologic cancer survivors. Oncol Nurs Forum 2017; 44: 77-86
7 Däggelmann J, Rustler V, Eckert K. et al. Participation in organized sports, physical education, therapeutic exercise and non-organized leisure-time physical activity: how does participation differ between childhood cancer outpatients and healthy peers?. Ger J Exerc Sport Res 2018; 48: 387-394
8 Fencl M, Muras J, Steffen J. et al. Physiological effects of bouldering activities in upper elementary school students. Phys Educ 2011; 68: 199-209
9 Götte M, Kesting S, Albrecht C. et al. MOON-test – determination of motor performance in the pediatric oncology. Klin Padiatr 2013; 225: 133-137
10 Heitkamp HC, Fichter C, Thoma S. et al. A. Lumbar muscle strength training by climbing for scoliosis patients. Med Sci Sports Exerc 2005; 37: 363
11 Kascenska J, Dewitt J, Roberts T. Fitnessguidelines for rock climbing students. Journal of Physical Education, Recreation & Dance 1992; 63: 73-79
12 Keats MR, Culos-Reed SN, Courneya KS. et al. An examination of physical activity behaviors in a sample of adolescent cancer survivors. J Pediatr Oncol Nurs 2006; 23: 135-142
13 Keats MR, Culos-Reed SN. A community-based physical activity program for adolescents with cancer (project TREK): Program feasibility and preliminary findings. J Pediatr Hematol Oncol 2008; 30: 272-280
14 Keats MR, Culos-Reed N. A theory-driven approach to encourage physical activity in pediatric cancer survivors: a pilot study. J Sport Exerc Psychol 2009; 31: 267-283
15 Klinik Bad Oexen. FOR Familienorientierte Rehabilitation in der Klinik Bad Oexen. [Bad Oexen Hospital. FOR Family-based rehabilitation in Bad Oexen hospital.] http://www.badoexen.de/pdf/prospekte/Familienorientierte-Rehabilitation.pdf Accessed June 2, 2019
16 Li L, Ru A, Liao T. et al. Effects of rock climbing exercise on physical fitness among college students: A review article and meta-analysis. Iran J Public Health 2018; 47: 1440-1452
17 Marchese VG, Chiarello LA, Lange BJ. Strength and functional mobility in children with acute lymphoblastic leukemia. Med Pediatr Oncol 2003; 40: 230-232
18 Mazzoni ER, Purves PL, Southward J. et al. Effect of indoor wall climbing on self-efficacy and self-perceptions of children with special needs. Adapt Phys Activ Q 2009; 26: 259-273
19 Murnane A, Gough K, Thompson K. et al. Adolescents and young adult cancer survivors: Exercise habits, quality of life and physical activity preferences. Support Care Cancer 2015; 23: 501-510
20 Ozimek M, Rokowski R, Draga P. et al. The role of physique, strength and endurance in the achievements of elite climbers. PLoS One 2017; 12: e0182026
21 Pankov M, Baláša J, Bunca V. et al. Physiological demands of indoor wall climbing in children. Sports Technology 2015; 7: 183-190
22 Sheel AW. Physiology of sport rock climbing. Br J Sports Med 2004; 38: 355-359
23 Siegel SR, Fryer SM. Rock Climbing for Promoting Physical Activity in Youth. . Am J Lifestyle Med 2015; 11: 243-251
24 van der Ploeg RJ, Fidler V, Oosterhuis HJ. Hand-held myometry: reference values. J Neurol Neurosurg Psychiatry 1991; 54: 244-247
25 Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clin Rehabil 2012; 26: 664-671
26 Wright M, Bryans A, Gray K. et al. Physical activity in adolescents following treatment for cancer: Influencing factors. Leuk Res Treatment 2013; 2013: 592395
27 Wright M. Physical activity participation and preferences: developmental and oncology-related transitions in adolescents treated for cancer. Physiother Can 2015; 67: 292-299