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Purpose <p>With the rising survival rate among children and adolescents with acute lymphoblastic leukemia (ALL), prioritizing patient-centered care to address the long-term effects of chemotherapy through tailored rehabilitation interventions is essential for optimizing their quality of life. The purpose of this study was to investigate the impact of an 8-week intervention using adaptive variable-resistance training (Adaptive-VRT) on chemotherapy-induced sarcopenia, fatigue, and functional restrictions in pediatric survivors of ALL.</p> Methods <p>A prospective randomized controlled trial included a total of 62 survivors of ALL, aged 12–18&#xa0;years, and completed maintenance chemotherapy. Participants were randomized into two groups: the Adaptive-VRT group (<i>n</i> = 31), assigned the&#xa0;Adaptive-VRT intervention, and the control group (<i>n</i> = 31), which adhered to the standard exercise protocol. Baseline and post-intervention measurements were undertaken to analyze sarcopenia-related variables (i.e., muscle thickness and muscle strength), fatigue, and functional performance.</p> Results <p>The Adaptive-VRT group exhibited more favorable changes in muscle thickness [thigh thickness (<i>P</i> &lt; .001; <i>η</i><sup>2</sup><sub><i>P</i></sub> = 0.32); rectus femoris (<i>P</i> &lt; .001; <i>η</i><sup>2</sup><sub><i>P</i></sub> = 0.21); vastus intermedius (<i>P</i> = .002; <i>η</i><sup>2</sup><sub><i>P</i></sub> = 0.15)], and peak concentric torque of quadriceps [at speed of 90°/s (<i>P</i> = .005; <i>η</i><sup>2</sup><sub><i>P</i></sub> = 0.13), 120°/s (<i>P</i> = .021; <i>η</i><sup>2</sup><sub><i>P</i></sub> = 0.10), or 180°/s (<i>P</i> = .008; <i>η</i><sup>2</sup><sub><i>P</i></sub> = 0.11)] in comparison with the control group. Additionally, the Adaptive-VRT group reported lower fatigue levels (<i>P</i> = .031; <i>η</i><sup>2</sup><sub><i>P</i></sub> = 0.08) and demonstrated better functional performance [6-min walk test (<i>P</i> &lt; .001; <i>η</i><sup>2</sup><sub><i>P</i></sub> = 0.25), 4 × 10-m shuttle running test (<i>P</i> &lt; .001; <i>η</i><sup>2</sup><sub><i>P</i></sub> = 0.24), as well as timed up and down stairs (<i>P</i> &lt; .0006; <i>η</i><sup>2</sup><sub><i>P</i></sub> = 0.18)].</p> Conclusion <p>The findings suggest that Adaptive-VRT is a promising intervention for ameliorating chemotherapy-induced sarcopenia, fatigue, and functional limitations in pediatric ALL survivors.</p> Trial registration <p>ClinicalTrials.gov Identifier: NCT06338020.</p>

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Effect of adaptive variable-resistance training on chemotherapy-induced sarcopenia, fatigue, and functional restriction in pediatric survivors of acute lymphoblastic leukemia: a prospective randomized controlled trial

  • 期刊论文

  • 发表日期：

    2025年2月22日

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  • Ragab K. Elnaggar,
  • Waleed S. Mahmoud,
  • Mohamed S. Abdrabo,
  • Mahmoud S. Elfakharany

摘要

Purpose

With the rising survival rate among children and adolescents with acute lymphoblastic leukemia (ALL), prioritizing patient-centered care to address the long-term effects of chemotherapy through tailored rehabilitation interventions is essential for optimizing their quality of life. The purpose of this study was to investigate the impact of an 8-week intervention using adaptive variable-resistance training (Adaptive-VRT) on chemotherapy-induced sarcopenia, fatigue, and functional restrictions in pediatric survivors of ALL.

Methods

A prospective randomized controlled trial included a total of 62 survivors of ALL, aged 12–18 years, and completed maintenance chemotherapy. Participants were randomized into two groups: the Adaptive-VRT group (n = 31), assigned the Adaptive-VRT intervention, and the control group (n = 31), which adhered to the standard exercise protocol. Baseline and post-intervention measurements were undertaken to analyze sarcopenia-related variables (i.e., muscle thickness and muscle strength), fatigue, and functional performance.

Results

The Adaptive-VRT group exhibited more favorable changes in muscle thickness [thigh thickness (P < .001; η2P = 0.32); rectus femoris (P < .001; η2P = 0.21); vastus intermedius (P = .002; η2P = 0.15)], and peak concentric torque of quadriceps [at speed of 90°/s (P = .005; η2P = 0.13), 120°/s (P = .021; η2P = 0.10), or 180°/s (P = .008; η2P = 0.11)] in comparison with the control group. Additionally, the Adaptive-VRT group reported lower fatigue levels (P = .031; η2P = 0.08) and demonstrated better functional performance [6-min walk test (P < .001; η2P = 0.25), 4 × 10-m shuttle running test (P < .001; η2P = 0.24), as well as timed up and down stairs (P < .0006; η2P = 0.18)].

Conclusion

The findings suggest that Adaptive-VRT is a promising intervention for ameliorating chemotherapy-induced sarcopenia, fatigue, and functional limitations in pediatric ALL survivors.

Trial registration

ClinicalTrials.gov Identifier: NCT06338020.