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Exercise intervention in pediatric patients with solid tumors: the PAPEC trial
Fiuza-Luces C, Padilla JR, Soares-Miranda L, Santana-Sosa E, Quiroga JV, Santos-Lozano A, Pareja-Galeano H, Sanchis-Gomar F, Lorenzo-Gonzalez R, Verde Z, Lopez-Mojares LM, Lassaletta A, Fleck SJ, Perez M, Perez-Martinez A, Lucia A
Medicine and Science in Sports and Exercise 2017 Feb;49(2):223-230
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: The randomized controlled trial 'Physical Activity in Pediatric Cancer' (PAPEC) determined the effects of an in-hospital exercise intervention combining aerobic and muscle strength training on pediatric cancer patients with solid tumors undergoing neoadjuvant chemotherapy. METHODS: Participants were allocated to an exercise (n = 24, 17 boys; mean +/- SEM age 10 +/- 1 y) or control group (n = 25, 18 boys; 11 +/- 1 y). Training included three sessions/week for 19 +/- 2 weeks. Participants were assessed at treatment initiation, termination, and two months after end-treatment. The primary endpoint was muscle strength (as assessed by upper and lower-body five-repetition-maximum (5RM) tests). Secondary endpoints included cardiorespiratory fitness, functional capacity during daily life activities, physical activity, body mass and body mass index, and quality of life. RESULTS: Most sessions were performed in the hospital's gymnasium. Adherence to the program averaged 68 +/- 4% and no major adverse events or health issues were noted. A significant interaction (group x time) effect was found for all 5RM tests (leg/bench press and lateral row; all p < 0.001). Performance significantly increased after training (leg press: 40% (95% CI 15 to 41 kg); bench press: 24% (95% CI 6 to 14 kg); lateral row 25% (95%CI 6 to 15 kg)), whereas an opposite trend was found in controls. Two-month post values tended to be higher than baseline for leg (p = 0.017) and bench press (p = 0.014). In contrast, no significant interaction effect was found for any of the secondary endpoints. CONCLUSION: An in-hospital exercise program for pediatric cancer patients with solid tumors undergoing neoadjuvant treatment increases muscle strength despite the aggressiveness of such therapy.

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