Improving Functional Mobility in Children and Adolescents Undergoing Treatment for Non-Central Nervous System Cancers: A Systematic Review

PM R. 2017 Sep;9(9S2):S385-S397. doi: 10.1016/j.pmrj.2017.05.011.


Background: Childhood cancers and subsequent treatments can leave survivors with impairments that may lead to decreased physical performance. Rehabilitation can be an important component of promoting improved physical function in children and adolescents undergoing treatment for cancer.

Objective: To review and synthesize evidence for nonsurgical, nonpharmacologic, rehabilitation interventions for children and adolescents undergoing treatment for non-central nervous system cancers aimed at improving their physical impairments and functional mobility limitations.

Design: A systematic review of the literature, from January 1996 to October 2016, on interventions for improving functional mobility and physical impairments in pediatric patients on treatment or recently off treatment for a non-central nervous system cancer.

Setting: Not applicable.

Methods: Included articles were reviewed for quality. Evidence for each impairment area was analyzed.

Main outcome measures: Not applicable.

Results: A total of 22 articles met our inclusion criteria. Only 7 randomized controlled trials were identified, and most studies had few subjects. More than one half of the existing clinical trials were on exercise or programs to increase strength and physical activity, with some evidence to support improvements in strength but mixed evidence for improving physical activity. Relatively few assessed other interventions used in rehabilitation such as orthotics, neuromuscular re-education, and functional training.

Conclusion: The body of literature describing nonsurgical and nonpharmacological interventions for decreased functional mobility and its related impairments is only beginning to emerge as few studies of high quality were found in the literature. Rehabilitation researchers and clinicians need to collaborate to produce the multi-site trials that will be needed to best serve these children.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Child
  • Disability Evaluation
  • Disease-Free Survival
  • Exercise / physiology*
  • Female
  • Humans
  • Male
  • Neoplasms / mortality
  • Neoplasms / pathology*
  • Neoplasms / rehabilitation*
  • Neoplasms / therapy
  • Physical Fitness / physiology*
  • Prognosis
  • Quality of Life*
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome