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A Pilot Study to Examine the Feasibility and Effects of a Home-Based Aerobic Program on Reducing Fatigue in Children With Acute Lymphoblastic Leukemia

Yeh, Chao Hsing PhD, RN; Man Wai, Jackson Pui PhD; Lin, Un-Shan MSN, RN; Chiang, Yi-Chien PhD, RN

doi: 10.1097/NCC.0b013e3181e4553c

Background: Fatigue is one of the most frequent symptoms experienced by children with cancer during treatment. Effective management of fatigue is essential for improving children's quality of life.

Objective: The aim of this study was to examine the feasibility of a home-based aerobic exercise intervention to reduce fatigue in children with acute lymphoblastic leukemia (ALL).

Methods: A 6-week home-based aerobic exercise intervention was implemented for children who were in the intervention group, whereas patients in the control group received routine care. Multivariate analysis was used to examine the effects of the aerobic exercise intervention on the children's self-reported levels of fatigue at posttest and 1-month follow-up. Two types of analysis were used: intent-to-treat analysis and per-protocol analysis.

Results: This study was conducted with 22 children with ALL: 12 in the intervention group and 10 in the control group who were matched by age and sex. For per-protocol analysis, the finding indicated that children who received the exercise intervention reported significantly lower "general fatigue" subscale than those in the control group at the 1-month follow-up measurement. For intent-to-treat analysis, the findings indicated that there were no intervention and time effect for any of the 3 fatigue subscales at either posttest or 1-month follow-up.

Conclusion: The finding indicated that the exercise program is feasible and warrants being tested in a clinical trial with a much larger sample of children for ALL.

Implications for Practice: It suggests that a home-based exercise program may reduce fatigue for ALL children who are undergoing maintenance chemotherapy.

Author Affiliations: School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Yeh); and Laboratory for Exercise Physiology Research, Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan (Dr Wai); Department of Nursing, Cardinal Tien College of Healthcare & Management, Taipei (Ms Lin); and Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taiwan (Dr Chiang).

This research was supported by a grant awarded to Dr Yeh from National Health Research Institutes, Taiwan (NHRI-EX95-9302PI), and National Science Council, Taiwan (NSC94-2314-B-182-014), and a grant awarded to Dr Chiang from National Science Council, Taiwan (NSC-97-2314-B-255-006).

Correspondence: Yi-Chien Chiang, PhD, RN, Department of Nursing, Chang Gung Institute of Technology, 261 Wen-Hwa 1 Rd, Kwei-San, Taoyuan 33302, Taiwan (

Accepted for publication April 18, 2010.

© 2011 Lippincott Williams & Wilkins, Inc.