Purpose

To determine whether a 12-week supervised dose-graded aerobic exercise (D-GAE) training, when implemented in conjunction with traditional rehabilitation, could help pediatric survivors of acute lymphoblastic leukemia (ALL) enhance their cardiopulmonary capacity and improve their physical performance.

Methods

Fifty-eight pediatric survivors of ALL (age 13.78 ± 2.47 years; boys 60.34%) were assigned at random to either undergo the D-GAE in addition to the traditional physical rehabilitation (D-GAE group; n = 29) or the traditional physical rehabilitation solely (control group; n = 29). The cardiopulmonary fitness (peak oxygen uptake (VO_2peak), ventilatory equivalent (VEq/VO₂), minute ventilation (V_E, L/min), oxygen pulse (O₂P), maximum heart rate (HR_max), 1-min heart rate recovery (HRR₁), and respiratory exchange ratio (RER)) and physical performance (6-min walk test (6-MWT), timed up and down stairs (TUDS), and 4 × 10-m shuttle run test (4 × 10mSRT)) were assessed on the pre- and post-intervention occasions.

Results

The mixed-model ANOVA revealed a meaningful increase of VO_2peak (P = .002), V_E (P = .026), O₂P (P = .0009), HR_max (P = .004), and HRR₁ (P = .011), and reduction of VEq/VO₂ (P = .003) and RER (P = .003) in the D-GAE group compared with the control group. Besides, the analysis detected a favorable increase in the physical performance for the D-GAE group (6-MWT (P = .007), TUDS (P < .001), 4 × 10mSRT (P = .009)).

Conclusion

A 12-week D-GAE program in conjunction with traditional rehabilitation holds promise in enhancing cardiopulmonary fitness and improving the physical performance of pediatric survivors of ALL. Clinicians and physical rehabilitation professionals can, therefore, integrate the D-GAE into the traditional rehabilitation protocols for such a patient population to optimize their cardiopulmonary fitness and physical function, while also facilitating a gradual transition to practice and adaption.

Implications for Cancer Survivors

The favorable outcomes of this study bolster the inclusion of D-GAE as a crucial element in the care and rehabilitation of pediatric survivors of ALL. By embracing these findings, healthcare professionals and oncologists can contribute to mitigating the long-term cardiopulmonary and physical complications associated with cancer treatments and fostering a state of enhanced well-being and increased physical activity among survivors.

中文翻译：

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剂量分级有氧运动方案对急性淋巴细胞白血病儿科幸存者心肺健康和身体机能的有效性：一项随机临床试验

目的

旨在确定为期 12 周的监督剂量分级有氧运动 (D-GAE) 训练与传统康复结合实施是否可以帮助急性淋巴细胞白血病 (ALL) 儿科幸存者增强心肺功能并改善其身体表现。

方法

58 名 ALL 儿科幸存者（年龄 13.78 ± 2.47 岁；男孩 60.34%）被随机分配接受除传统物理康复外的 D-GAE（D-GAE 组；n  = 29）或传统物理康复治疗。仅进行康复治疗（对照组；n  = 29）。心肺健康（峰值摄氧量（VO _2peak）、通气当量（VEq/VO ₂）、每分钟通气量（V _E、L/min）、氧脉搏（O ₂ P）、最大心率（HR _max）、1-分钟心率恢复 (HRR ₁ ) 和呼吸交换比 (RER)）和身体表现（6 分钟步行测试 (6-MWT)、定时上下楼梯 (TUDS) 和 4 × 10 米穿梭跑测试(4 × 10mSRT)) 在干预前和干预后进行评估。

结果

混合模型方差分析显示 VO _2peak ( P  = .002)、V _E ( P  = .026)、O ₂ P ( P  = .0009)、HR _max ( P  = .004) 和 HRR ₁显着增加( P = .011)， 与对照组相比，D-GAE 组的VEq/VO ₂ ( P  = .003) 和 RER ( P = .003) 降低。此外，分析发现 D-GAE 组的身体表现有良好的提高（6-MWT ( P  = .007)、TUDS ( P  < .001)、4 × 10mSRT ( P  = .009)）。

结论

为期 12 周的 D-GAE 计划与传统康复相结合，有望增强 ALL 儿科幸存者的心肺健康和身体机能。因此，临床医生和物理康复专业人员可以将 D-GAE 整合到此类患者群体的传统康复方案中，以优化他们的心肺健康和身体功能，同时也促进逐步过渡到实践和适应。

对癌症幸存者的影响

这项研究的良好结果支持将 D-GAE 作为 ALL 儿科幸存者护理和康复的关键要素。通过接受这些发现，医疗保健专业人员和肿瘤学家可以为减轻与癌症治疗相关的长期心肺和身体并发症做出贡献，并促进幸存者的福祉增强和身体活动增加。