Effect of Adapted Physical Activity Sessions in the Hospital on Health-Related Quality of Life for Children With Cancer: A Cross-Over Randomized Trial

Background. To assess the efficacy of adapted physical activity (APA) on health-related quality of life (HRQoL) of hospitalized children and adolescents with cancer between 9 and 18 years of age. Procedure. A two-sequence, four-period cross-over study, Activites Physiques en Oncologie Pediatrique (APOP), compared hospital stay with APA sessions versus hospital stay without APA sessions on children's HRQoL. Children and parents completed the child and parent forms, respectively, of a HRQoL questionnaire, the Child Health Questionnaire, on the last day of hospitalization. We used mixed linear regression to determine the effect of treatment, of treatment order and whether response to previous treatment influenced HRQoL. Results. Thirty children were included (mean age 13.6 +/- 2.9 years; 18 males). Cross-over analysis revealed no effect of period or interaction between APA and period. HRQoL was higher when children practiced than did not practice APA during their hospitalization, as reported by both children and parents, for the dimensions physical functioning (P < 0.0001), role/social-physical (P = 0.001), self-esteem (P < 0.0001), and mental health (P < 0.0001). In addition, APA had a significant effect on the behavior dimension (P = 0.01), as reported by children, and on the bodily pain dimension (P = 0.0004), as reported by parents. The highest significant difference in scores between with and without APA was observed for the self-esteem dimension (P < 0.0001) for both children and parents. Conclusion. APA during hospitalization for children with cancer was associated with better HRQoL for most of the HRQoL psychological and physical dimensions. Whether this effect is specific for children with cancer should be explored. Pediatr Blood Cancer. 2010;55:1160-1166. (C) 2010 Wiley-Liss, Inc.