Author(s): YAGÜE PEÑUELAS, R., MORENO-ACHA, S., PUENTE-GÓMEZ, B., BLANCO-ELVIRA, J., VICO-PLAZA, J., GARRIDO-RODRÍGUEZ, E., HIGES-NÚÑEZ, E., SANTANA-SOSA, E., SIERRA-RAMOS, A., RUIZ, J., ANDIÓN, M., BUENDÍA, S., BARO, M., PÉREZ, V., GARRIDO, C., MARMOL-PEREZ, A.,YANGUAS-CASÁS, N., SANTOS-LOZANO, A., LUCÍA, A., FIUZA-LUCES, C., Institution: UNIVERSIDAD EUROPEA DE MADRID, Country: SPAIN, Abstract-ID: 2019

INTRODUCTION:
Adolescents undergoing intensive cancer treatment experience rapid declines in both physical activity levels and functional capacity and adopt sedentary behaviors which ultimately contribute to early deconditioning. Evidence supporting structured exercise during this phase at this developmental stage remains limited. The objective of this randomized controlled trial was to investigate the effects of a supervised concurrent (aerobic + resistance) exercise intervention on physical activity levels and functional capacity during intensive treatment.
METHODS:
This secondary analysis of the EXERCADOL multicenter randomized controlled trial (NCT05539794) included 104 adolescents (12–19 years) undergoing intensive cancer treatment across four hospitals (Madrid, Spain). Participants were randomized to usual care [Control Group (CG)] or a supervised concurrent exercise program [Intervention Group (IG)]. Sessions were delivered three times weekly (45–60 min), mainly in-hospital, with bedside or online adaptations when needed. Assessments were conducted at diagnosis and post-intensive treatment (14–28 weeks). Physical activity and sedentary behavior were measured using Youth Activity Profile (YAP) and Assessment of Physical Activity Levels (APAL-Q) questionnaires. Functional capacity was assessed with the 30-second Chair Stand, Timed Up-and-Go (TUG) and Timed Up-and-Down Stairs (TUDS) tests. Constrained baseline linear mixed models with random intercepts for participants were applied (p≤.05).
RESULTS:
Participants were 63% male, mean age 14.9±1.8 years. School-time physical activity decreased in both groups at post-intervention (CG: 7.64 [95% CI: 4.03–11.26]; IG: 7.68 [5.07–10.29]; p=.987), consistent with the absence of mandatory physical education during treatment. In contrast, significant differences were observed outside school. For YAP out-of-school activity, adjusted baseline mean was 11.64 (10.45–12.84); post-intervention means were 9.90 (7.86–11.95) in CG and 12.46 (10.92–14.00) in IG, with a significant adjusted difference of 2.56 (0.06–5.06; p=.045). For APALQ, baseline was 13.06 (11.93–14.19); post-intervention means were 8.26 (6.50–10.01) in CG and 12.38 (11.02–13.73) in IG (difference: 4.12 [1.92–6.32]; p<.001). Functional capacity improved in IG: Chair Stand baseline was 23.86 (22.14–25.59); post-intervention means were 23.89 (21.46–26.33) in CG and 28.62 (26.38–30.85) in IG (difference: 4.72 [1.86–7.59]; p=.002). No significant differences were found for sedentary time (p=.109), TUG (p=.666) or TUDS (p=.727).
CONCLUSION:
A supervised, individualized concurrent exercise intervention implemented during intensive cancer treatment effectively preserved physical activity levels and improved lower-limb functional capacity in adolescents. Integrating structured exercise into standard supportive care may mitigate early treatment-related deconditioning and promote healthier lifestyle behaviors during this critical phase of life.