Grant title: Feasibility and preliminary efficacy of a consumer co-designed exercise programme in survivors of paediatric sarcoma
We are grateful to receive funding to complete our novel exercise intervention study for survivors of childhood sarcoma. Our study will be the first to explore the feasibility, acceptability and efficacy of therapeutic exercise to improve fitness, physical function and physical activity in survivors of childhood sarcoma. Improvements in these outcomes could dramatically improve the quality of survivorship and play a major role in mitigating the significant risk of disabling secondary health conditions later in life – Prof Stewart Graeme Trost
Background
Sarcoma is the name of a diverse group of cancers that grow as tumours in the bone, muscle and connective tissues. Sarcomas are one of the most common types of childhood cancers, accounting for approximately 20% of all cancer diagnoses.
In Australia, approximately 90 paediatric cases of sarcoma are diagnosed each year. The most common sarcomas in children are rhabdomyosarcoma, which forms in muscle tissue, and osteosarcoma and Ewing’s sarcoma, which form in bone. With advances in surgical intervention, radiotherapy, and chemotherapy, the survival rates of children with sarcoma have increased dramatically, with the overall 5-year survival rates ranging from 77–81%.
Survivors of childhood sarcomas who required surgical removal of the tumour often have difficulty performing activities of daily living such as walking, running, throwing and carrying. These restrictions can lead to reduced participation in meaningful physical activities (fitness, sport and active recreation). Over time, these activity limitations and participation restrictions place childhood sarcoma survivors at increased risk for disabling secondary conditions such as obesity, diabetes, heart disease and depression.
Research conducted in children with other chronic health conditions, including other cancer types, suggests that therapeutic exercise tailored to the child’s needs and impairment level can improve physical function and quality of life. However, no studies have examined the benefits of exercise training in survivors of childhood sarcoma.
Aims and objectives
Our pilot study will determine if a novel consumer co-designed therapeutic exercise programme is feasible, acceptable and potentially effective. The objectives are:
- Engage consumers to explore their lived experience with exercise and determine how they would like to structure the exercise programme.
- Evaluate the resultant programme’s feasibility and acceptability.
- Examine the impact of the programme on aerobic fitness, functional ability, and habitual physical activity.
- Determine if the effects of the programme persist after 6 months.
How will it be done
First, we will conduct interviews with survivors of childhood sarcoma and ask them about their previous experiences with exercise and how they would like the exercise programme to be delivered.
We will then evaluate the new exercise programme. Eighteen survivors of childhood sarcoma residing in a 150km radius of Queensland Children’s Hospital will be recruited from the Orthopaedic Oncology Unit. Participants will receive weekly fully personalised, goal-directed exercise therapy for 12 weeks, with an accompanying home-based programme (3 sessions per week).
We will evaluate adherence to the programme using attendance records and data from wearable sensors. Acceptability will be measured by questionnaire and structured interviews. Change in aerobic fitness, functional ability and daily physical activity will be examined at the end of the programme and at 6 months follow-up.
Potential impact
The proposed study will be the first to explore the feasibility, acceptability and preliminary efficacy of a novel goal-directed therapeutic exercise programme to improve fitness, physical function and physical activity in survivors of childhood sarcoma. If shown to be feasible, acceptable and efficacious, the programme has strong potential for testing in larger studies involving more research centres and subsequent use in routine clinical practice.