Physical activity levels and influencing factors among children with leukemia during chemotherapy: a cross-sectional study.
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BACKGROUND: Physical activity is an important intervention method for promoting the physical and mental recovery of children with leukemia. How to maintain or enhance the physical activity level of these children during treatment remains a significant issue in clinical rehabilitation and health management. This study aimed to investigate factors influencing physical activity among pediatric leukemia patients during chemotherapy, providing a reference for clinical healthcare providers to develop targeted physical activity intervention programs. METHODS: This cross-sectional study employed convenience sampling to recruit 205 pediatric leukemia patients undergoing chemotherapy in the pediatric hematology departments of two tertiary hospitals in Shandong Province, China, from October 2024 to February 2025. Questionnaire data were analyzed using multiple linear regression to identify influencing factors. RESULTS: This cross-sectional study included 205 pediatric leukemia patients undergoing chemotherapy (mean age 9.47 ± 3.16 years; 57.6% male). At enrollment, 30.7% were in induction, 48.3% in consolidation, and 20.9% in maintenance. LSI scores ranged from 0 to 86, with a median of 18.00 (P25 = 9.00, P75 = 30.00). Low-intensity activities were reported by 179 participants (87.3%), moderate-intensity activities by 60 participants (29.3%), and vigorous-intensity activities by 10 participants (4.9%). Based on the Godin classification (moderate-to-vigorous LSI ≥24), 19 participants (9.3%) were classified as active. Multiple linear regression analysis identified chemotherapy phase, symptom burden, maternal support, and exercise self-efficacy as significant independent predictors of physical activity levels (P < 0.001), collectively explaining 47.7% of the variance. CONCLUSION: Pediatric leukemia patients during chemotherapy demonstrate low physical activity levels, primarily influenced by chemotherapy phase, symptom burden, maternal support, and exercise self-efficacy. Clinical interventions should adopt a phased approach aligned with treatment intensity, emphasize family engagement, and incorporate individualized goal-setting to enhance children's physical activity participation and overall quality of life.