Bewegungstherapeutische Potenziale und die Machbarkeit innovativer Therapieformen in der Kinderonkologie

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Background: Functional deficits like muscle weakness, limited joint range of motion, balance disorders or inefficient gait patterns are prominent in children and adolescents with cancer, having the potential to negatively impact everyday mobility and physical activity behavior. Although exercise interventions in pediatric oncology have shown to improve various physical and psychological parameters, no exercise-based concept directly targeted at improving these specific, mobility- and physical activity-related deficits exists. To provide best possible patient care, innovative therapy modalities like whole-body vibration (WBV) training need to be assessed in order to improve current exercise interventions.Methods: Specific functional deficits (ankle dorsiflexion function and various walking abilities) in children and adolescents after intense cancer treatment were investigated in a cross-sectional study (n=16 patients; n=16 age- and gender matched healthy peers). Moreover, a systematic review was performed in children and adolescents with disabilities, that suffer from comparable functional deficits like children and adolescents with cancer. It was establish whether there is evidence that WBV can be beneficial for the pediatric cancer population. Building on this, feasibility of WBV training in children and adolescents during (n=12) and following (n=11) intense cancer treatment was assessed in two pilot studies.Results: Children and adolescents after intense cancer treatment suffer limited walking abilities and ankle dorsiflexion dysfunction. Significant lower values in the patient group were found for walking capacity, maximum walking speed, active ankle dorsiflexion range of motion and strength. The available studies on WBV in children with disabilities indicated that WBV seems to be effective for improving functional parameters relevant to the pediatric cancer population, especially in terms of lower extremity muscle strength and mass, balance control as well as gait and walking ability. The performed pilot studies demonstrate that children and adolescents during (patients receiving inpatient chemotherapy) as well as after intense cancer treatment can safely train on the vibration platform (no WBV-related adverse effects, compliance of 56% during and 88% after intense treatment). For patients receiving chemotherapeutic treatment, platelet levels of 30,000/μL or higher seems to be necessary. In addition, children undergoing treatment, younger participants and those close to the cessation of intense treatment required intensive supervision in the assessed program (side-alternating vibration, frequencies ranging from 18 to 27 Hertz, steady 2mm peak-to-peak amplitude) and were only able to increase the load intensity gradually.Conclusions: Functional deficits are relevant cancer- and treatment-related adverse effects in pediatric oncology, that should be counteracted though specific supportive interventions. In this context, WBV seems to be effective for improving functional parameters relevant to the pediatric cancer population. WBV can be implemented into clinical care as an adjunct to exercise programs, both during and after intense cancer treatment. However, specific challenges need to be considered, which is why i.e. close training supervision by experienced or training exercise physiologists is recommended. Positive effects of WBV in pediatric oncology need to be confirmed in future studies.
Original languageGerman
Place of PublicationKöln
PublisherDeutsche Sporthochschule Köln
Number of pages62
Publication statusPublished - 2020

ID: 5157044

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