A Systematic Review Of The Evidence For Exercise Interventions To Enhance The Quality Of Life Of Children And Young Adults With Cancer.

Background: Advances in modern medicine and treatments for childhood cancer have greatly increased survivor rates and have resulted in a growing population of childhood cancer survivors. Due to these improving survival rates, more attention is being directed towards improving the QOL of children and young adults with cancer. Exercise interventions have been suggested by recent literature to enhance the QOL of children and young adults with cancer. A systematic review is necessary to compare and analyse results of existing studies in order to synthesise all the available evidence. Objectives: The aim of this review is to evaluate the effectiveness of exercise as an intervention to improve the QOL of children and young adults with cancer. Search Strategies: Six databases were searched using a pre-determined selection of key words. The search was conducted between the 20 th and 29 th of March, 2013. The databases were: PubMed, Medline, Cinahl, Scopus, The Knowledge Network and Cochrane. Additionally, the reference lists of all included articles were hand searched to identify any additional relevant studies. Selection Criteria: All studies, published in English, that investigated the effects of exercise intervention on QOL of children and young adults that met the pre-determined eligibility criteria of this review were included. Data Collection and Analysis: Data was gathered and analysed and the methodological quality of all studies was assessed using the PEDro scale. Results: Nine articles were selected for inclusion in this review. The results of these articles were varied. Two studies found no significant difference in QOL outcome measures post- intervention. Alternatively five studies found significant differences for at least one criteria of a QOL outcome measure. It was unclear whether any effect occurred on functional mobility due to substantially varied results of four studies. Additionally no effect of exercise interventions was found on fatigue. Functional mobility and fatigue were included as secondary outcome measures as they have been found to be predictors of QOL. Conclusion: It was difficult to draw conclusions due to the varying results. The majority of studies did demonstrate that exercise had a positive effect on various aspects of QOL. This promising trend suggests there is a possibility for exercise to enhance the QOL of children and young adults with cancer. These results need to be interpreted with caution due to methodological limitation and low quality study designs. Additionally, further research is required.msc_physpreunpub1672_ethesesunpu