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Effects of Exercise Intervention for Children with Acute Lymphoblastic Leukemia: A Systematic Review

Wong, Jeremy, DPT, PCS1; Fetters, Linda, PhD, PT, FAPTA2

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Background: The purpose of this systematic review is to examine the research literature on the effects of therapeutic exercise on strength, function, and endurance, when implemented during and immediately following chemotherapy, in children with acute lymphoblastic leukemia (ALL). This review of the literature, which includes children with ALL and the effects of therapeutic exercise across the levels of the International Classification of Function (ICF), has not been previously undertaken. Five-year survivability of ALL has significantly increased and a review to address the long-term effects of ALL and its treatment is merited.

Procedure: We searched 3 electronic databases and reviewed reference lists in relevant articles and online sources published between 1999 and 2012. Thirteen intervention studies were appraised that included 345 participants.

Results: Across all studies, therapeutic exercise was a safe intervention for patients with ALL, with each study noting positive outcomes. However, the validity of the studies overall was low, with a preponderance of studies lacking sufficient design rigor, a variety of exercise parameters, poor tracking of adherence to intervention, and incomplete statistical analyses.

Conclusions: Additional randomized controlled trials with greater statistical rigor, which examine practical exercise parameters, address participant compliance, and relate outcomes across levels of the International Classification of Function are needed to better determine the potential benefits of therapeutic exercise for children with acute lymphoblastic leukemia.

1 Division of Pediatric Rehabilitation Medicine, Physical Therapy, Children's Hospital, Los Angeles, CA; Adjunct Instructor of Clinical Physical Therapy, Division of Biokinesiology & Physical Therapy, Ostrow School of Denistry, University of Southern California, Los Angeles, CA

2 Division of Biokinesiology and Physical Therapy, Ostrow School of Denistry & Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA

Address correspondence to: Jeremy Wong, DPT, PCS, Division of Pediatric Rehabilitation Medicine, Children's Hospital, Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027 (jeremywong79@yahoo.com).

©2014 (C) Academy of Oncologic Physical Therapy, APTA
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