Effects of a structured exercise therapy on cancer-related fatigue during and after paediatric stem cell transplantation: a randomized controlled trial

Abstract

Introduction. Exercise therapy is a frequently applied method in paediatric oncology but there is insufficient evidence for its effectiveness in paediatric stem cell transplantation. Methods. In a single-centre randomized controlled trial, the effect of exercise therapy (intervention group) was compared with concentration and relaxation techniques (control group). Overall, 72 children were recruited before transplantation and randomly assigned into these 2 groups. They received exercise therapy during and after their hospital stay. A total of 47 inpatient children (age: 6–18 years) were evaluated in phase I: 21 in the intervention and 26 in the control group. The expression of cancer-related fatigue before and after therapy was documented by using the PedsQL 3.0 Multidimensional Fatigue Scale. Results. All patients deteriorated with regard to fatigue during their hospital stay. A total of 23 outpatient children (stratified into 4 groups) who continued or started exercise therapy showed a significant improvement over 3 and 6 months (phase II) after discharge from hospital (total fatigue score: p < 0.001, general fatigue: p = 0.002, sleep and rest fatigue: p < 0.001). Conclusions. Inpatient children showed no positive effects of exercise therapy on cancer-related fatigue. After discharge, the children in exercise therapy attained better physical constitution. Exercise therapy is effective for successful rehabilitation and outpatient reintegration and therefore recommended to reduce cancer-related fatigue.