Training in children with cancer

Through training, a child can build endurance and strength more quickly. This can be done under your guidance as a pediatric physical therapist, during or after pediatric oncology treatment for different types of cancer.

As a result of the oncological condition and medical treatments, limitations may occur in different organ systems. This can cause children to experience difficulties in performing physical activities such as sports and play, as well as more basic daily activities and independent walking. Organ systems that may contribute to reduced physical capacity include the nervous system, pulmonary system, cardiac system, blood and vascular system, and the muscular system.

Training physical fitness

There are several methods to improve physical fitness in children. The main principles are summarized below:

80/20 ratio: 80% of physical activity should be performed at low intensity (zones 1–2), and the remaining 20% at higher intensity (zones 4–5).
Training should be as specific as possible.
High-intensity interval training (HIIT) is an effective and efficient training method to improve endurance, such as oxygen uptake or VO2peak, and muscle power, such as Wpeak, in children without severe side effects.
Key principles of exercise training include individualization, specificity, progressive overload in intensity, and adequate rest and recovery.
A well-structured training program based on the F.I.T.T. principles: frequency, intensity, time, and type.

Articles

Braam, K. I., Van Dijk-Lokkart, E. M., Kaspers, G. J., Takken, T., Huisman, J., Bierings, M. B., Merks, J. H., Van De Heuvel-Eibrink, M. M., Van Dulmen–den Broeder, E., & Veening, M. A. (2015). Cardiorespiratory fitness and physical activity in children with cancer. Supportive Care in Cancer, 24(5), 2259–2268. [https://doi.org/10.1007/s00520-015-2993-1](https://doi.org/10.1007/s00520-015-2993-1)

Coombs, A., Schilperoort, H., & Sargent, B. (2020). The effect of exercise and motor interventions on physical activity and motor outcomes during and after medical intervention for children and adolescents with acute lymphoblastic leukemia: A systematic review. Critical Reviews in Oncology/Hematology, 152, 103004. [https://doi.org/10.1016/j.critrevonc.2020.103004](https://doi.org/10.1016/j.critrevonc.2020.103004)

Ha, L., Nevin, S. M., Wakefield, C. E., Jacovou, J., Mizrahi, D., & Signorelli, C. (2024). Exploring childhood cancer survivor, parent, healthcare and community professionals’ experiences of, and priorities for, using digital health to engage in physical activity: A mixed methods study. Journal of Cancer Survivorship: Research and Practice. Advance online publication. [https://doi.org/10.1007/s11764-024-01560-z](https://doi.org/10.1007/s11764-024-01560-z)

Kesting, S., Weeber, P., Schönfelder, M., Pfluger, A., Wackerhage, H., & Von Luettichau, I. (2022). A bout of high-intensity interval training (HIIT) in children and adolescents during acute cancer treatment: A pilot feasibility study. Cancers, 14(6), 1468. [https://doi.org/10.3390/cancers14061468](https://doi.org/10.3390/cancers14061468)

Sasso, J. P., Eves, N. D., Christensen, J. F., Koelwyn, G. J., Scott, J., & Jones, L. W. (2015). A framework for prescription in exercise-oncology research. Journal of Cachexia, Sarcopenia and Muscle, 6(2), 115–124. [https://doi.org/10.1002/jcsm.12042](https://doi.org/10.1002/jcsm.12042)

Wurz, A., McLaughlin, E., Lategan, C., Chamorro Viña, C., Grimshaw, S. L., Hamari, L., Götte, M., Kesting, S., Rossi, F., van der Torre, P., Guilcher, G. M. T., McIntyre, K., & Culos-Reed, S. N. (2021). The international Pediatric Oncology Exercise Guidelines (iPOEG). Translational Behavioral Medicine, 11(10), 1915–1922. [https://doi.org/10.1093/tbm/ibab028](https://doi.org/10.1093/tbm/ibab028)