Balance training during acute medical treatment for pediatric cancer – subjective benefits and preliminary effects on selected physical abilities

Abstract

Background As balance training seems to be a promising training method to improve physical limitations of the lower limbs, this study aims to evaluate feasibility, subjective benefits and preliminary effects on physical abilities of balance training in pediatric cancer patients.

Patients 11 pediatric cancer patients (5–21 years) undergoing acute medical treatment were included in the study.

Method Participants took part in a 4-week balance training intervention. 3 trainings/week were conducted either supervised or self-administered. Subjective benefits were evaluated using a questionnaire, effects on selected physical abilities were assessed using functional-motor assessments.

Results Participants completed 71.21+37.34% of balance training sessions, no adverse events occurred. Participants were satisfied with the intervention and described various subjective benefits. Significant improvements were found in functional strength of the lower limbs as well as positive trends in balance.

Discussion Balance training seems feasible with pediatric cancer patients undergoing acute medical treatment potentially improving functions of the lower limbs relevant for daily physical activity.

Conclusion Balance training can be a valuable conjunct to general exercise programs in pediatric oncology.

Zusammenfassung

Hintergrund Da ein Gleichgewichtstraining eine vielversprechende Trainingsmethode zur Verbesserung körperlicher Beeinträchtigungen der unteren Extremitäten darstellt, untersucht die vorliegende Studie die Machbarkeit, subjektive und erste objektive Effekte eines Gleichgewichtstrainings auf körperliche Fähigkeiten bei onkologisch erkrankten Kindern.

Patienten 11 Kinder und Jugendliche (5–21 Jahre) während der akutmedizinischen Behandlung einer onkologischen Erkrankung wurden in die Studie eingeschlossen.

Methodik Die Patient*innen nahmen an einem 4-wöchigen Gleichgewichtstraining teil. 3 Trainingseinheiten/Woche wurden entweder supervidiert oder selbstständig umgesetzt. Subjektive Effekte wurden mit einem Fragebogen und die Effekte auf ausgewählte körperliche Fähigkeiten mittels funktionell-motorischer Testungen evaluiert.

Ergebnisse Die Teilnehmer*innen absolvierten 71.21+37.34% der Trainingseinheiten und es traten keine trainingsbedingten Zwischenfälle auf. Die Kinder waren zufrieden mit der Intervention und beschrieben verschiedene subjektive Effekte. Positive Veränderungen zeigten sich im Bereich der funktionellen Kraft der unteren Extremitäten und des Gleichgewichts.

Diskussion Ein Gleichgewichtstraining während der akutmedizinischen Behandlung in der Kinderonkologie scheint machbar und zeigt potenziell positive Effekte auf relevante Funktionen der unteren Extremitäten.

Schlussfolgerung Ein Gleichgewichtstraining kann eine wertvolle Ergänzung allgemeiner Bewegungsprogramme in der pädiatrischen Onkologie darstellen.

Keywords

balance training - sensorimotor training - physical activity - pediatric oncology - childhood cancer

Schlüsselwörter

Gleichgewichtstraining - Sensomotoriktraining - körperliche Aktivität - pädiatrische Onkologie - Krebs im Kindesalter

Publication History

Article published online:
20 June 2024

• References

• 1 Varedi M, McKenna R, Lamberg EM. Balance in children with acute lymphoblastic leukemia. Pediatr Int 2017; 59: 293-302 DOI: 10.1111/ped.13141.
• 2 Varedi M, Lu L, Phillips NS. et al. Balance impairment in survivors of pediatric brain cancers: risk factors and associated physical limitations. J Cancer Surviv 2021; 15: 311-324 DOI: 10.1007/s11764-020-00932-5.
• 3 Gilchrist L. Chemotherapy-induced peripheral neuropathy in pediatric cancer patients. Semin Pediatr Neurol 2012; 19: 9-17 DOI: 10.1016/j.spen.2012.02.011.
• 4 Söntgerath R, Eckert K. Impairments of Lower Extremity Muscle Strength and Balance in Childhood Cancer Patients and Survivors: A Systematic Review. Pediatr Hematol Oncol 2015; 32: 585-612 DOI: 10.3109/08880018.2015.1079756.
• 5 Lu Y, Xing M, Song J. Design and Implementation of Balance Ability Assessment Training System for Special Children Based on Education Cloud Integration. J Environ Public Health 2022; 1-11 DOI: 10.1155/2022/9359367.
• 6 Galea V, Wright MJ, Barr RD. Measurement of balance in survivors of acute lymphoblastic leukemia in childhood. Gait Posture 2004; 19: 1-10 DOI: 10.1016/s0966-6362(03)00014-6.
• 7 Streckmann F, Balke M, Cavaletti G. et al. Exercise and Neuropathy: Systematic Review with Meta-Analysis. Sports Med 2022; 52: 1043-1065 DOI: 10.1007/s40279-021-01596-6.
• 8 Streckmann F, Lehmann HC, Balke M. et al. Sensorimotor training and whole-body vibration training have the potential to reduce motor and sensory symptoms of chemotherapy-induced peripheral neuropathy-a randomized controlled pilot trial. Support Care Cancer 2019; 27: 2471-2478 DOI: 10.1007/s00520-018-4531-4.
• 9 Schedler S, Brock K, Fleischhauer F. et al. Effects of Balance Training on Balance Performance in Youth: Are There Age Differences?. Res Q Exerc Sport 2020; 91: 405-414 DOI: 10.1080/02701367.2019.1676371.
• 10 Lee K, Lee M, Song C. Balance training improves postural balance, gait, and functional strength in adolescents with intellectual disabilities: Single-blinded, randomized clinical trial. Disabil Health J 2016; 9: 416-422 DOI: 10.1016/j.dhjo.2016.01.010.
• 11 Au MK, Chan WM, Lee L. et al. Core stability exercise is as effective as task-oriented motor training in improving motor proficiency in children with developmental coordination disorder: a randomized controlled pilot study. Clin Rehabil 2014; 28: 992-1003 DOI: 10.1177/0269215514527596.
• 12 Alsakhawi RS, Elshafey MA. Effect of Core Stability Exercises and Treadmill Training on Balance in Children with Down Syndrome: Randomized Controlled Trial. Advances in therapy 2019; 36: 2364-2373 DOI: 10.1007/s12325-019-01024-2.
• 13 Wurz A, McLaughlin E, Lategan C. et al. Synthesizing the literature on physical activity among children and adolescents affected by cancer: evidence for the international Pediatric Oncology Exercise Guidelines (iPOEG). Transl Behav Med 2021; 11: 699-708 DOI: 10.1093/tbm/ibaa136.
• 14 Otten S, Bischoff C, Oschwald V. et al. Sensomotoriktraining in der Kinderonkologie – Umsetzung eines kindgerechten und spielerischen Trainingskonzepts. Bewegungstherapie und Gesundheitssport 2022; 38: 30-35 DOI: 10.1055/a-1714-3644.
• 15 Streckmann F, Kneis S, Leifert JA. et al. Exercise program improves therapy-related side-effects and quality of life in lymphoma patients undergoing therapy. Ann Oncol 2014; 25: 493-499 DOI: 10.1093/annonc/mdt568.
• 16 Kleinert J. Adjektivliste zur Erfassung der Wahrgenommenen Körperlichen Verfassung (WKV). Skalenkonstruktion und erste psychometrische Befunde. Zeitschrift für Sportpsychologie 2006; 13: 156-164 DOI: 10.1026/1612-5010.13.4.156.
• 17 Daeggelmann J, Otten S, Prokop A. et al. Feasibility of a combined supervised and home-based whole-body vibration intervention in children after inpatient oncological treatment. Sport Sci Health 2021; 17: 1025-1033 DOI: 10.1007/s11332-021-00770-7.
• 18 Jouck S. Dordel-Koch-Test (DKT). Ein Test zur Erfassung der motorischen Leistungsfähigkeit im Kindes- und Jugendalter [Dissertation]. Cologne, Germany: German Sport University Cologne. 2009
• 19 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 DOI: 10.1177/0269215511426889.
• 20 Marchese VG, Chiarello LA, Lange BJ. Effects of physical therapy intervention for children with acute lymphoblastic leukemia. Pediatr Blood Cancer 2004; 42: 127-133 DOI: 10.1002/pbc.10481.
• 21 Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39: 142-148 DOI: 10.1111/j.1532-5415.1991.tb01616.x.
• 22 Rustler V, Hagerty M, Daeggelmann J. et al. Exercise interventions for patients with pediatric cancer during inpatient acute care: A systematic review of literature. Pediatr Blood Cancer 2017; 64 DOI: 10.1002/pbc.26567.
• 23 Götte M, Kesting S, Taraks S. et al. Rahmenbedingungen individualisierter stationärer Bewegungsförderung in der kinderonkologischen Akutversorgung. Bewegungstherapie und Gesundheitssport 2015; 31: 117-123 DOI: 10.1055/s-0035-1550108.
• 24 Götte M, Kesting S, Winter C. et al. Experience of barriers and motivations for physical activities and exercise during treatment of pediatric patients with cancer. Pediatr Blood Cancer 2014; 61: 1632-1637 DOI: 10.1002/pbc.25071.
• 25 Roussenq SC, Hintz LG, Rafael AD. et al. Level of physical activity and sedentary behavior in children and adolescents diagnosed with cancer: A systematic review. Int J Health Sci (Qassim) 2022; 16: 54-63
• 26 Winter DA. Human balance and posture control during standing and walking. Gait Posture 1995; 3: 193-214 DOI: 10.1016/0966-6362(96)82849-9.
• 27 Ness KK, Baker KS, Dengel DR. et al. Body composition, muscle strength deficits and mobility limitations in adult survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 2007; 49: 975-981 DOI: 10.1002/pbc.21091.
• 28 Trost Stewart G, Loprinzi PD. Parental Influences on Physical Activity Behavior in Children and Adolescents: A Brief Review. American Journal of Lifestyle Medicine 2011; 5: 171-178 DOI: 10.1177/1559827610387236.
• 29 Schedler S, Kiss R, Muehlbauer T. Age and sex differences in human balance performance from 6-18 years of age: A systematic review and meta-analysis. PLoS One 2019; 14: e0214434 DOI: 10.1371/journal.pone.0214434.