Grading the evidence on the effects of exercise interventions in children and adolescents during and beyond cancer treatment: an umbrella review of systematic reviews with meta-analyses.
AI interpretation is pending for this paper.
Open original publication →What the AI sees
Not AI summarized yet.
Research significance
Pending deeper interpretation.
Source abstract
OBJECTIVE: To synthesise the evidence on the effects of exercise interventions in children and adolescents during and beyond cancer treatment, and to evaluate the methodological quality and certainty of this evidence. DESIGN: Umbrella review of systematic reviews with meta-analyses. DATA SOURCE: PubMed, Web of Science, Scopus, SPORTDiscus and CINAHL were searched from inception to January 2026. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Systematic reviews with meta-analysis of controlled trials (randomised or non-randomised) evaluating exercise interventions in children and adolescents (≤19 years) during and beyond cancer treatment. Reviews without quantitative synthesis, those including only observational studies, or interventions where the isolated effect of exercise could not be determined were excluded. RESULTS: 19 systematic reviews with meta-analyses, including 53 primary studies (n=2361 participants), were identified, yielding 80 effect estimates. Attending to the most comprehensive meta-analyses, exercise induced significant benefits on cardiorespiratory fitness (mean difference (MD) 6.92% (95% CI 1.01% to 12.82%)), cognitive function (standardised mean difference (SMD) 0.26 (95% CI 0.08 to 0.44)) and cognitive performance (SMD 0.41 (95% CI 0.17 to 0.65)), with moderate certainty of evidence. Exercise also induced significant benefits on muscle strength (SMD 0.81 (95% CI 0.05 to 1.57)), functional mobility (MD -1.17 s (95% CI -1.86 to -0.49)) and cancer-related fatigue (SMD -0.62 (95% CI -1.21 to -0.03)), although the certainty was low or very low. These effects were observed across meta-analyses focused exclusively on studies conducted during treatment (n=26), after treatment (n=3) or both (n=51). In contrast, no significant effects of exercise were observed for depression, bone mineral density, health-related quality of life, anthropometry or other clinical outcomes (such as mortality, relapse risk and withdrawal rates). CONCLUSION: Exercise appears to be a beneficial intervention in childhood cancer for improving some physical, cognitive and psychosocial outcomes. However, more high-quality research is warranted to strengthen clinical recommendations and inform personalised exercise prescriptions, given that the certainty of evidence remains variable and overall low across outcomes. PROSPERO REGISTRATION NUMBER: CRD420251031412.