Physical activity and health related quality of life in pediatric cancer patients following a four-week inpatient rehabilitation program

Müller Carsten, Krauth Konstantin A, Gerß Joachim, Rosenbaum Dieter

Abstract

Purpose Chronic health conditions and impaired quality of life are commonly experienced in childhood cancer survivors. While rehabilitation clinics support patients in coping with the disease, studies evaluating an inpatient rehabilitation program on promoting physical activity (PA) and health related quality of life (HRQoL) are missing. Methods A four-week inpatient rehabilitation program was prospectively evaluated. 150 patients with leukemia or lymphoma (N=86), brain tumors (N=38) and sarcomas (N=26) were enrolled on average 17 months after cessation of acute medical treatment. PA amount and cadence (indicating the intensity of walking activity) using the StepWatchTM-3 Activity Monitor and HRQoL global and physical wellbeing scores using the KINDL® questionnaire were assessed before, immediately after, six and twelve months following the program, and analyzed using multiple linear mixed models. Results Significant effects on PA were only found at 12 months follow-up for amount and cadence variables (all p<0.05). While leukemia and lymphoma patients revealed the highest PA level throughout the study, rehabilitation effects were more pronounced for cadence variables in brain tumor and sarcoma patients. The rehabilitation program had immediate (t=4.56, p<0.001) and sustainable effects on HRQoL global scores (six months follow-up: t=4.08, p<0.001, twelve months follow-up: t=3.13, p<0.006). Conclusions Immediate and sustainable increases in HRQoL indicate that a four-week rehabilitation program is beneficial for improving psychosocial wellbeing, while the significant increase in PA levels could be related to general recovery as well. The lack of a control group hampers the evaluation of the rehabilitation program on promoting PA levels in pediatric cancer patients.