Therapeutic Exercise Protocol During Hospitalization in Pediatric Oncohematological Patients: Randomized Clinical Trial.
In a 30-participant randomized trial, a supervised in-hospital aerobic, resistance, and breathing exercise program was deliverable without recorded intervention-related adverse events requiring permanent discontinuation but was not superior to minimal active physiotherapy for fatigue, quality of life, strength, or functional capacity.
Open original publication →What the AI sees
In a 30-participant randomized trial, a supervised in-hospital aerobic, resistance, and breathing exercise program was deliverable without recorded intervention-related adverse events requiring permanent discontinuation but was not superior to minimal active physiotherapy for fatigue, quality of life, strength, or functional capacity.
Research significance
The trial provides evidence of supervised protocol feasibility but not efficacy over breathing exercises plus ambulation guidance; as an inference requiring larger, better-controlled studies, structured exercise may still help preserve function in selected hospitalized pediatric oncology patients if intervention exposure, fidelity, timing, and patient stratification are optimized.
Source abstract
BACKGROUND: Leukemias, lymphomas, and central nervous system tumors are among the most common pediatric cancers and may lead to motor deficits, impaired balance, reduced muscle strength, fatigue, and decreased functional capacity. Early physiotherapy during hospitalization may help prevent inactivity and support functional preservation in this population. OBJECTIVE: To evaluate the effects of a therapeutic exercise program on quality of life, muscle strength, fatigue, and functional capacity in hospitalized pediatric oncohematological patients. METHODS: Thirty participants aged 8-17 years with oncohematological diseases were randomized to an intervention group (IG) or a minimal active physiotherapy comparator group (CG). Assessments included the 6-min walk test, handgrip dynamometry, the PedsQL Multidimensional Fatigue Scale, and the PedsQL Cancer Module at admission and discharge. The IG performed daily 25-min supervised sessions including aerobic, resistance, and breathing exercises with ambulation guidance, whereas the CG received breathing exercises and ambulation guidance. RESULTS: No significant group × time interactions were observed for total fatigue or its domains, overall quality of life or its assessed domains, handgrip strength, or six-minute walk test distance. Time-related changes were observed for some outcomes, but these occurred without evidence of differential change between groups and were not interpreted as effects of the structured exercise protocol. No intervention-related adverse events requiring permanent protocol discontinuation were recorded. CONCLUSION: The structured in-hospital therapeutic exercise protocol could be delivered under close clinical supervision without recorded intervention-related adverse events requiring permanent discontinuation. However, the structured protocol did not demonstrate superiority over the minimal active physiotherapy comparator for fatigue, quality of life, muscle strength, or functional capacity. These findings should be interpreted cautiously because of the small sample size, clinical heterogeneity, variable intervention exposure, and limited intervention-fidelity data. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (ReBEC), RBR-8sxnfyd.