Feasibility and Acceptability of an Exercise Intervention for Childhood Cancer Patients within a Clinical Setting
Introduction: Physical activity (PA) is important for the development and health of children and lifelong participation is greatly encouraged. However, childhood cancer patients display significantly reduced levels of PA, both during treatment and into adulthood. As survival rates of childhood cancer are improving, it is of increased importance to reduce negative effects of treatment and late effects associated with a sedentary lifestyle. While research and implementation has been established abroad, there lacks a research community in the UK, and hence it is not surprising why PA pathways are not being developed at a similar rate. This study therefore investigates the feasibility and acceptability of a three-session exercise intervention in a clinical setting on a paediatric oncology ward in the UK. Methods: Participants were recruited from a UK paediatric ward and were categorised into three subcategories: patients (n=9), parent/carers (n=9) and healthcare professionals (HCP) (n=15). Patients (5- 18 years) were all treated on The Kamran’s Ward at the John Radcliffe Hospital (UK) and have different cancer types. Patients wee also asked to complete the ASK questionnaire (pre-) to assess current PA levels and determine and set the individual exercise intensity and appropriate exercises for each of the PA sessions. A PedsQL questionnaire (pre-) to assess health-related quality of life. Perceptions, participation and support levels were obtained through semi-structured interviews. Patients then carried out three exercise taster sessions (game-based, technology-based and conditioning-based) on the ward. Heart rate (HR) and rate of perceived exertion (RPE) and fun score were noted during each session. Patients then re-completed the PedsQL and a post-intervention interview. Parents took part in two semi-structured interviews (pre- and post-) and HCP took part in one semi-structured interview to determine perceptions, advice and intervention feedback. Qualitative data was analysed using thematic analysis and PedsQL data was analysed using a paired t-test. Results: Feasibility was determined as >50% of eligible patients participated. Acceptability was determined through the positive response from all participating groups, as well as the safe execution of sessions that were able to elicit a moderate exercise intensity (50-70% predicted HRmax) within a clinical setting. No adverse effects were witnessed. There was not a significant difference between pre and post PedsQL. In addition, fear and fatigue emerged as prominent barriers for patients with regards to regular PA participation. Conclusion: This study highlights that implementation of an exercise programme on a paediatric oncology ward (UK) is feasible, accepted and safe, and should encourage future implementation and improvements to existing pathways for this population.
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