Interactive Online Program with Rewards Helps Kids Stay Active After Cancer Treatment, Study Shows

Interactive Online Program with Rewards Helps Kids Stay Active After Cancer Treatment, Study Shows
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An online interactive system that offered rewards for exercising helped childhood cancer survivors stay physically active, according to results of a pilot clinical trial. Greater physical activity appeared to benefit their quality of life, fitness, and cognitive function.

A new study in children treated for acute lymphoblastic leukemia (ALL) is now enrolling in the U.S.

The pilot study’s results were presented at the 2018 Cancer Survivorship Symposium in Orlando, Florida, in a poster, titled “Randomized web-based physical activity intervention in adolescent survivors of childhood cancer.”

Survivors of childhood cancer have an increased risk of heart disorders, obesity, stroke, and diabetes. These conditions can be avoided or reduced with regular physical activity, which is associated with better heart and muscular health, weight control, and reduced tiredness.

Despite these known benefits, almost half of childhood cancer survivors do not follow the recommended guidelines for physical activity.

Researchers at St. Jude Children’s Research Hospital wanted to see if they could change that with an online system that rewarded physical activity. They investigated whether their age-appropriate, interactive website would increase activity levels of adolescent childhood cancer survivors.

The 24-week pilot study (NCT01778127) enrolled 97 cancer survivors ages 11 to 14 who exercised less than 60 minutes per day. Participants were randomized to an experimental group and a control group.

Both groups received an educational handout about the importance of physical activity, examples of ways to get physically active, and a wearable activity monitor.

The experimental group also had access to the website, which allowed participants to connect their activity monitor to the computer and log their weekly activity on the website. When they reached certain activity goals, they received rewards, such as T-shirts or gift cards, by mail.

Fitness parameters, cognitive measures, such as memory and attention, and health-related quality of life, measured through the Pediatric Quality of Life Inventory questionnaire, were assessed at the beginning and end of the study.

Approximately 25 percent of participants had been treated for acute lymphoblastic leukemia (ALL). Among the 97 participants who started the study, 74 completed it (53 in the experimental group, and 25 in the control group).

While the time kids spent in moderate to vigorous activities decreased by an average of 24.3 minutes per week in the control group, it increased by an average of 4.7 minutes per week in the group with access to the website.

“In this age group, it is common to see a decrease in physical activity over time, even among healthy kids,” said Carrie Howell, PhD, the study’s lead author, in a press release.

“Therefore, we are encouraged that our intervention was successful at maintaining physical activity levels, but a longer program may be needed to create lasting exercise habits,” Howell said.

Health-related quality of life, as well as several fitness and cognitive measures, were significantly improved in the experimental group, whereas no changes in those measures were seen in the control group.

Based on these results, the team designed a larger clinical trial, ALTE1631 (NCT03223753), to investigate the potential long-term benefits of this interactive system in survivors of childhood ALL. Participants will use the system for a year and be assessed after six months and one year.

The study is currently recruiting (more information is here) and hopes to enroll 384 patients between the ages of 8 and 15, who completed treatment at Children’s Oncology Group institutions across the United States.

Researchers also hope to further explore the association between physical activity and cognition in childhood cancer survivors, as there is previous evidence that exercise may improve cognitive function.

Marta Figueiredo holds a BSc in Biology and a MSc in Evolutionary and Developmental Biology from the University of Lisbon, Portugal. She is currently finishing her PhD in Biomedical Sciences at the University of Lisbon, where she focused her research on the role of several signalling pathways in thymus and parathyroid glands embryonic development.
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Marta Figueiredo holds a BSc in Biology and a MSc in Evolutionary and Developmental Biology from the University of Lisbon, Portugal. She is currently finishing her PhD in Biomedical Sciences at the University of Lisbon, where she focused her research on the role of several signalling pathways in thymus and parathyroid glands embryonic development.
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