Author(s): APARICIO-APARICIO, I.1, BALAGUER-GUILL, J.2, SENDRA-PÉREZ, C.1, SÁNCHEZ-JIMÉNEZ, J.L.1, PRIEGO-QUESADA, J.I.1, TORMO-ALCAÑIZ, M.T.2, CARRIÓN-GONZÁLEZ, C.1, Institution: 1. UNIVERSITY OF VALENCIA 2. AITEX , Country: SPAIN, Abstract-ID: 2596

INTRODUCTION:
Childhood cancer is a rare disease, being the leading cause of death in children. Anticancer therapies are associated with a significant decrease in muscle strength and cardiorespiratory fitness, which contributes to reduced functional capacity [1]. In recent years, structured, progressive, supervised, and individualized training programs are increasingly being implemented in pediatric oncology [2][3]. However, the evidence regarding the role of exercise during treatment remains limited compared to adult oncology. This single-case study aimed to evaluate the feasibility, safety, and preliminary effects of a multicomponent training program (strength and cardiorespiratory training) delivered during active childhood cancer treatment.
METHODS:
An 8-year-old child undergoing treatment for Wilms tumor (119cm; 21.5kg; 202 Maximal Heart Rate [HRmax]) completed a 6-week supervised training program combining strength and cardiovascular exercises (3 sessions/week). Exercise intensity was progressively increased each week (Rating of Perceived Exertion 4 to 6; 50 to 75% HRmax) monitored using the EPInfant and HR monitors during the sessions. Adherence was 94.4% (17/18 sessions); one session was canceled due to fever not related to exercise. Sessions occurred in hospital (n=5), online (n=3), and at the sport sciences faculty (n=9). Pre- and post-intervention assessments included upper limb strength (handgrip dynamometry), lower limb strength (Standing Broad Jump), functional walking capacity (6-Minute Walk Test), balance (Single Leg Stance Test), agility (4×10m Shuttle Run Test), and spirometry (Forced Vital Capacity (FVC); Forced expiratory volume (FEV); Forced Expiratory Flow (FEF); Peak Expiratory Flow (PEF); Maximal Expiratory Flow (MEF)). Hematological parameters were continuously monitored in coordination with the medical team of La Fe Hospital (Valencia, Spain), where the patient was being treated.
RESULTS:
Upper (dominant) and lower limb strength decreased (Δ−15.87%, Δ−37.5%, respectively). Functional walking performance improved (Δ+81.82%) with similar HRpeak. Balance improved (Δ30s dominant limb; Δ50s non-dominant), reaching maximum values, and agility improved (Δ−1.97s). No significant changes in pulmonary function were observed after six weeks of training, with values remaining within normal ranges. FEV and FEF increased (FEV1 Δ30%; PEF Δ22%; MEF75 Δ3%; MEF50 Δ32%; MEF25 Δ58%) above the predicted value, except MEF75.
CONCLUSION:
A supervised, progressive multicomponent exercise program during childhood cancer treatment was feasible and safe, with high adherence and no adverse events. Improvements in functional capacity, balance, agility, and respiratory parameters were observed, supporting the potential benefits of exercise as an adjuvant strategy during active childhood cancer treatment. However, larger studies are needed to clarify strength adaptations and confirm efficacy.
References: [1] Stössel et al., 2020. [2]; [3] Braam et al., 2016; 2018.