Exercise therapy in pediatric lower extremity bone tumor patients during acute treatment. Daily physical activities and effects on bone mineral content Sport- und Bewegungstherapie mit Kindern und Jugendlichen während der Akuttherapie eines Knochentumors der unteren Extremität: Entwicklung des Alltagsaktivitätsniveaus und Einfluss auf die Knochendichte

Müller C, Winter CC, Boos J, Vieth V, Hardes J, Gosheger G, Rosenbaum D

Abstract

Tumor treatment in childhood and adolescence has a significant impact on daily physical activities and bone metabolism. This project evaluated the effects of additional physical exercises during inpatient stays on physical activity levels and the course of development of bone density in pediatric patients undergoing treatment for lower extremity bone tumors. 21 children and adolescents aged 13.6 years were enrolled in this trial and assigned to an intervention group (n = 10) or a control group (n = 11). All patients received standardized physiotherapeutic treatment based on their disability. Additional physical exercises were offered during inpatient stays for patients of the intervention group. Bone density of the lumbar spine (L2 to L4) and the femoral neck not affected by the tumor was assessed by means of dual X-ray absorptiometry (DXA) at the time of local therapy, as well as after 6 and after 12 months. Daily physical activities were simultaneously assessed 6 and 12 months after local therapy in the domestic environment by means of an accelerometer worn for 7 days and a minimum of 8 hours per day. Both patient groups revealed a substantial reduction in bone density during the acute treatment. With regard to the course of development of bone density, group comparisons revealed small to large effects in favor of the exercise intervention. In addition, the intervention group consistently demonstrated significantly higher daily physical activities compared to the control group (average number of steps per day and periods of moderate to vigorous physical activities). The results demonstrate the feasibility of additional physical exercises during inpatient stays for children and adolescents undergoing treatment of a lower extremity bone tumor.