Exercise training improves physical function and fitness in long-term paediatric brain tumour survivors treated with cranial irradiation

P J Piscione; E Bouffet; B Timmons; K S Courneya; D Tetzlaff; J E Schneiderman; C B de Medeiros; U Bartels; D J Mabbott

doi:10.1016/j.ejca.2017.04.020

Exercise training improves physical function and fitness in long-term paediatric brain tumour survivors treated with cranial irradiation

Eur J Cancer. 2017 Jul:80:63-72. doi: 10.1016/j.ejca.2017.04.020. Epub 2017 May 25.

Authors

P J Piscione¹, E Bouffet², B Timmons³, K S Courneya⁴, D Tetzlaff¹, J E Schneiderman⁵, C B de Medeiros⁶, U Bartels², D J Mabbott⁷

Affiliations

¹ Department of Rehabilitation Services, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G-1X8, Canada.
² Division of Haematology/Oncology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G-1X8, Canada.
³ Department of Paediatrics, McMaster University, Hamilton, Ontario, L8S 4L8, Canada.
⁴ Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada.
⁵ Physiology and Experimental Medicine, Research Institute, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G-1X8, Canada.
⁶ Neurosciences and Mental Health, Hospital for Sick Children, 686 Bay Street, Toronto, Ontario, M5G-0A4, Canada.
⁷ Neurosciences and Mental Health, Hospital for Sick Children, 686 Bay Street, Toronto, Ontario, M5G-0A4, Canada; Department of Psychology, University of Toronto, Toronto, Ontario, M5S-1A1, Canada. Electronic address: donald.mabbott@sickkids.ca.

PMID: 28551430
DOI: 10.1016/j.ejca.2017.04.020

Abstract

Aims: We examined the efficacy of exercise training for improving physical functioning and cardiopulmonary fitness in survivors of paediatric brain tumours (BTs) treated with cranial irradiation.

Methods: We conducted a controlled clinical trial with crossover of exercise training versus no training in the community in either a group or combined group/home setting. A volunteer sample of 28 children treated with cranial irradiation for brain tumours completed training (mean age = 11.53 years; mean time since diagnosis = 5.25 years). end-points were physical functioning assessed by four subtests from the Bruininks-Oseretsky Test of motor performance (BOT-2) and pro-rated work rate from a cycle ergometer. Linear mixed modelling was used to evaluate time, training, training setting, and carryover effects.

Results: Adherence to training was 84%. Performance on the BOT-2 was below average for all assessments. However, training resulted in improvement in bilateral coordination (F (1, 30) = 6.59, p = 0.02), irrespective of training setting and improved performance was maintained even approximately 12°weeks after training had ended (F (1, 24) = 9.60, p = 0.005). Training resulted in increased pro-rated work rate for participants in the group training setting only (F (1, 25) = 4.57, p = 0.04) and these participants maintained their improved work rate approximately 12°weeks after training had ended (F (1, 20) = 8.38, p = 0.01).

Conclusion: Exercise training improves physical functioning and fitness in paediatric BT survivors. Exercise interventions that ameliorate adverse physical effects and promote health in long-term survivors are highly recommended in this vulnerable population. (ClinicalTrials.gov, NCT01944761).

Keywords: Brain tumour; Exercise training; Fitness; Paediatric; Physical function; Radiation; Survivorship.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Brain Neoplasms* / physiopathology
Brain Neoplasms* / radiotherapy
Cardiorespiratory Fitness / physiology
Child
Child, Preschool
Cranial Irradiation / adverse effects*
Exercise Therapy*
Female
Humans
Linear Models
Male
Motor Skills / physiology*
Physical Conditioning, Human*
Physical Fitness / physiology*
Quality of Life
Survivors*

Associated data

ClinicalTrials.gov/NCT01944761

Grants and funding

2009-03-23/CIHR/Canada