Initial Exercise Guidance for Children and Adolescents during and beyond Cancer Treatment: ACSM Expert Consensus Statement.

PURPOSE: In children (≤14 yr) and adolescents (15-19 yr), cancer is highly heterogeneous and essentially differs from adult malignancies. Given the numerous sequelae and fitness impairments associated with treatment, there is a growing number of randomized controlled trials assessing the effects of exercise interventions in affected children/adolescents. As such, the purpose of this American College of Sports Medicine Expert Consensus Statement was to develop the first set of exercise guidelines for children/adolescents with cancer.

METHODS

We identified a list of outcomes with clinical relevance for the target population on which exercise may theoretically induce an improvement and developed exercise recommendations for those outcomes where there is sufficient evidence supporting such effect during/beyond treatment in children/adolescents.

RESULTS

Exercise training can generally be performed safely for children/adolescents with cancer. There is moderate evidence that concurrent (aerobic and strength) exercise training can improve two common cancer/treatment-related health outcomes, muscle strength and physical function, but not physical activity levels. Moderate evidence also supports that aerobic exercise improves cardiorespiratory fitness after (but not during) treatment. The evidence is, however, insufficient for other important outcomes (e.g., cardiac function, bone health, and immune function), reflecting a gap in the current state of knowledge.

CONCLUSIONS

The proposed recommendations should serve as an initial guide for healthcare and fitness professionals working with children/adolescents with cancer. Although current advances in the field are tantalizing, more research is needed to fill remaining gaps in knowledge to better serve this population and to improve clinical practice.