Dr Peter Wright

Background: Children and young people with cancer face barriers when engaging with exercise, such as treatment-related side effects, psychosocial burdens and lack of individualised provisions. Digital health tools, such as smartphone applications, have emerged as a promising driver to support healthcare provisions in exercise prescription among patients. It is vital to explore how such technologies can be developed more effectively in order to strengthen the evidence supporting their use and for more appropriate implementation within healthcare. This study aims to explore user experiences, preferences and suggested improvements from healthy children and young people aged 9-21 years. Methods: An augmented reality (AR) application was specifically developed for children and young people aged 9-21 years undergoing cancer treatment and a protocol for a pilot study was designed. The target sample of this pilot study is 90 healthy children and young people aged 9-21 years. Practical 30-min workshops will be conducted encouraging participants to engage with the smartphone app. Focus groups will explore participant experiences, preferences, and suggested improvements. Data will be analysed deductively with apriori themes derived from the semi-structured interviews. Discussion: Obtaining user experiences, preferences and suggested improvements is especially important for the development of novel apps, such as those prescribing exercise and using algorithms and augmented reality software. Results from this study will directly influence the development of an augmented reality application, which will also be applied within a long-term trial in paediatric oncology.

Background and purpose: 
Breast cancer can be a significant challenge for those affected. Knowledge of physical function, social-emotional challenges, and perceived cognitive function based on the cancer treatment regimens
may help to inform adequate support.

Methods: 
For this prospective observational pilot study, we collected data of seventy-nine women (mean age 54.6 ± 9.5 years) before (T0) and after (T1) initial breast cancer treatment. Functional Assessment of Cancer Therapy-Breast (FACT-B) and Functional Assessment of Cancer Therapy–Cognitive-Function (FACT-Cog) were used to collect data of four treatment subgroups: SCR = Surgery + Chemotherapy + Radiation Therapy; SC = Surgery + Chemotherapy; SR = Surgery + Radiation Therapy; S = Surgery. A mixed ANOVA and posthoc analysis (Tukey, Games-Howell) were used to detect interactions (group by time) and the main effect. A repeated-measures ANOVA displayed individual group differences (time).

Results: 
Significant interaction showed more deterioration was experienced with SC and SCR than SR and S for FACTB (p

Conclusion: 
Our study showed that the extent of change in health-related quality of life (HRQoL) and perceived
cognitive function (PCF) depends on the treatment regimen. Multidisciplinary support initiated early in breast cancer therapy is needed, especially for women undergoing combined cancer treatment. Routine assessment of patient reported outcomes (PROs) in oncology practice may increase the transparency of patients’ perceived circumstances, leading to personalized and optimized acute and survivorship care.

Keywords: HRQoL, Cognitive function, Survivorship, Support

The purpose of this study was to determine if the Drums Alive Kids Beats intervention could improve behavior in children with developmental delays (DD). The original pilot study that this study on behavior is linked to is titled, “The Effects of a Drums Alive Kids Beats Intervention on the Physical Performance and Motor Skills of Children with Developmental Delays,” which was published in the December edition of the Open Journal of Pediatrics (OJPED, Vol.11 No.4 2021). During the facilitation of said intervention on physical and motor skills, the facilitators noticed unanticipated improvements in behavior, both individually and as a community through better awareness, self-control, self-efficacy, social interaction, and positive energy. Therefore, while maintaining the integrity of the MOT 4 - 6 testing protocols and Drums Alive intervention, a parallel study was conducted to objectively measure six behavioral domains, namely, motivation, impulse control, coordination, concentration, implementation of tasks, and creativity using a self-designed measurement tool with three elements for each domain that was approved by Dr. Heiner Lagenkamp, Department of Sports and Physical Activities, Teaching and Research, Ruhr University, Germany. The 20 participants were German students between 5.10 and 10.2 years of age with no inclusion or exclusion characteristics who were divided into two intervention groups, IG Kindergarten (IG Kinder) and IG Elementary (IG Elem), with varied DD, i.e. transgressive behavior, ADHD, ADD, autism, anger management, visual acuity, self-control, and self-esteem. During the MOT 4 - 6 study and Drums Alive Kids Beats intervention, the facilitators monitored and assessed each participant for pre- and post-performance vis a vis behavior concurrently with physical and motoric
skills. As the original study provided statistically significant improvements of between 14% - 24% in physical and motor skill performance with regards to overall scoring and 7 subdivisions of tasks, the results of this parallel study on behavior, with its 6 domains and 18 elements of between 24% - 28%, were even more compelling. The evidence indicated that the Drums Alive Kids Beats intervention with its multidisciplinary approach of music, movement, and drumming, could be used as an effective tool and therapeutic approach to improve behavior in children with developmental delays. 

Background: Breast cancer in young women can be a major challenge for those affected. To offer support, the establishment of a biopsychosocial profile may be beneficial. Methods: For this prospective observational pilot study, we collected data of 19 women with a mean age of 42.8 ± 5.4 years (30.0-49.0 year) before (T0) and after (T1) initial breast cancer treatment. The handgrip strength (HGS), 6-minute walk test (6MWT), and bioimpedance analysis for the detection of phase angle (PhA) and bioimpedance vector analysis (BIVA) were used. Assessments included the Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Cancer Therapy-Breast (FACT-B), and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F).

Results: Women (age

Conclusion: Routine assessment of biomarkers of physical function, mental health, HRQoL, and CRF may lead to individual risk stratification and multidisciplinary intervention in young patients with breast cancer, which could help to personalize and optimize survivorship care plans. 

(Rehab Oncol 2022;0000:1–10) Key words:
mental health, physical functioning, survivorship

Background and purpose

Breast cancer can be a major challenge for affected women. Knowledge of the physical function, symptoms of cancer-related fatigue, anxiety, and depression based on the cancer treatment may help to guide adequate support.

Methods

For this prospective observational study, we collected data from seventy-nine women with a mean age 54.6 ± 9.5 years prior to the onset of breast cancer treatment (T0) and after (T1/T2). Handgrip strength test (HGS), six-minute walk test (6MWT), the phase angle (PhA), the hospital anxiety and depression scale (HADS), and functional assessment of chronic illness therapy-fatigue (FACIT-F) were used to collect data from four treatment subgroups SC, surgery + chemotherapy; SCR, surgery + chemotherapy + radiation therapy; SR, surgery + radiation therapy; and S, surgery.

Results

A mixed ANOVA revealed a significant interaction between time and group for PhA, F = 8.55, p F = 3.59, p F = 4.47, p F = 2.77, p 

Conclusion

Our study showed that the extent of change in physical function, symptoms of fatigue, anxiety, and depression depends on the treatment conditions. The potentially higher risk of impaired function due to the prevalence of values below a critical threshold requires early initiated multidisciplinary support.

The objective of this original pilot study was to determine if the Drums Alive® Kids Beats intervention could provide statistically significant improvements to physical and motor skill performance on participants with Developmental Delays (DD) using the Dusseldorf Motor-Proficiency-Test for children (MOT 4-6) model. The researchers selected the research-based Drums Alive Kids Beat intervention because of its multidisciplinary methodology that in previous studies demonstrated positive effects on physiological, psychological, neurological, educational, rhythmical, and socio-emotional literacy. Facilitators used standardized Drums Alive approved lesson plans and equipment to conduct the intervention through a battery of music, movement and drumming-centered exercises and activities. The 30 participants were German students between 4.9 and 10.2 years of age, without any inclusion or exclusion characteristics, who were divided into three groups consisting of two intervention groups: IG Kindergarten (IG Kinder), IG Elementary (IG Elem) with varied physical, social, and emotional DD that affected gross and fine motor skills, movement, coordination, and behavioral control; and, a Control Group (CG) that had normal physical and motor skill development (Table 1). The results of the study suggested that the Drums Alive Kids Beats intervention provided statistically significant improvements in physical and motor skill performance in children with DD, namely, 24% improvement (IG Kinder), 14% (IG Elem) vice a minor 4% improvement (CG). Of note, during this study to measure physical capability pre- and post-intervention, the facilitators noticed significant improvements in behavior in both IG groups; therefore, they chose to conduct a collateral study to measure six behavioral domains which will be documented in a future publication to demonstrate the exclusive relationship between the Drums Alive Kids Beats intervention and improvement in behavior.

Keywords

Multidisciplinary, Music, Movement, Drumming, Developmental Delay, Behavior

Background: Knowledge of clinically established factors of physical function such as body composition, bioelectrical phase angle (PhA) and handgrip strength (HGS) with mortality predictive and health-related relevance is limited in prostate cancer survivors (PCS). Therefore, the aim of this study was to characterise and compare body composition data of PCS with extensive reference data as well as to analyse PhA and HGS and the prevalence of critical prognostic values at an early stage of cancer survivorship.

Methods: One hundred and forty-eight PCS were examined at the start (T1) and end (T2) of a 3-week hospitalised urooncological rehabilitation, which began median 28 days after acute cancer therapy. Examinations included a bioimpedance analysis and HGS test. Comparison of body composition between PCS and reference data was performed using bioimpedance vector analysis (BIVA).

Results: BIVA of the whole PCS group showed abnormal physiology with a cachectic state and a state of overhydration/oedema, without significant changes between T1 and T2. The age- and BMI-stratified subgroup analysis showed that PCS aged 60 years and older had this abnormal pattern compared to the reference population. HGS (T1: 38.7 ± 8.9 vs T2: 40.8 ± 9.4, kg), but not PhA (T1/T2: 5.2 ± 0.7, °), changed significantly between T1 and T2. Values below a critical threshold reflecting a potentially higher risk of mortality and impaired function were found for PhA in 20% (T1) and 22% (T2) of PCS and in 41% (T1) and 29% (T2) for HGS.

Conclusions: BIVA pattern and the prevalence of critically low HGS and PhA values illustrate the necessity for intensive continuation of rehabilitation and survivorship care especially in these ‘at risk’ cases. The routine assessment of body composition, PhA and HGS offer the opportunity to conduct a risk stratification for PCS and could help personalising and optimising treatment in rehabilitation and ongoing survivorship care.

Background: Research indicates reduced physical performance from diagnosis into survivorship of pediatric cancer patients. However, there is no systematic information or guideline available on the methods to assess physical performance and function in this population. The purpose was to systematically compile and describe assessments of physical performance and function in patients and survivors of pediatric cancer, including cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait and motor performance test batteries.

Methods: We searched the databases PubMed, SPORTDiscus, and Cochrane Database and performed abstract and full-text selection of 2619 articles according to the Cochrane Handbook of Systematic Reviews. Information on patients characteristics, assessments, information on validity and reliability, and relevant references was extracted.

Results: In summary, 63 different assessments were found in 149 studies including 11639 participants. Most studies evaluated cardiorespiratory fitness and muscle strength with the majority conducted off treatment. Some outcomes (e.g. speed) and diagnoses (e.g. neuroblastoma) were severely underrepresented. With the exception of gait, leukemia patients represented the largest group of individuals tested.

Conclusions: Insufficient data and patient heterogeneity complicate uniform recommendations for assessments. Our results support researchers and practitioners in selecting appropriate assessment to meet their specific research questions or individual daily practice needs.

Impact: This systematic review includes 149 studies and provides a comprehensive summary of 63 assessments to evaluate cardiorespiratory fitness, muscle strength, speed, balance, flexibility, functional mobility, gait or motor performance test batteries in patients and survivors of pediatric cancer. We present the most studied fields within the pediatric cancer population, which are cardiorespiratory fitness and muscle strength, off treatment phase, and leukemia patients. We propose research priorities by identification of subgroups in terms of cancer type, phase of treatment, and outcome of interest that are underrepresented in studies currently available.

Objective: To investigate the effect of a new therapeutic approach, using an oscillating rod to strength the pelvic floor and deep abdominal musculature and to speed up recovery of continence after radical prostatectomy.

Design: Prospective randomized controlled clinical trial.

Setting: Inpatient uro-oncology rehabilitation clinic.

Subjects: Ninety-three (intervention group (IG)) and ninety-one patients (control group (CG)) with urinary incontinence after prostatectomy were examined.

Intervention: All patients were randomly allocated to either standard pelvic floor muscle exercises and oscillating rod therapy (IG) or standard pelvic floor muscle exercises and relaxation therapy (CG).

Main outcome measures: Urinary incontinence (1- and 24-hour pad test) was assessed, and health-related quality of life (HRQL; Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire) was measured for all patients before and after three weeks of treatment.

Results: One hundred and eighty-four patients (mean (SD) age: 64.1 (6.94) years) completed the study. The IG showed a significant reduction in urinary incontinence (1-hour pad test: P = 0.008, 24-hour pad test: P = 0.012) and a significant improvement of HRQL (P = 0.017) compared with CG. Continence was significantly improved in both groups (1-hour pad test: 22.6-8.5 g (IG) vs. 23.0-18.1 g (CG)/24-hour pad test: 242.9-126.7 g (IG) vs. 237.6-180.9 g (CG)).

Conclusion: The study demonstrated that a combination of conventional continence exercises and the new oscillation rod training increased abdominal and pelvic floor musculature and speeded up recovery of continence after radical prostatectomy.

Keywords: Oscillating rod; continence exercises; prostate cancer; radical prostatectomy; urinary incontinence.

Motor skill deficits, mainly in coordination, such as hand to eye, is one of many of the characteristics or symptoms of an intellectual disability. Therefore, exercise therapy, with coordinative elements as well as special approaches to education, is a necessary action to achieve optimal health outcomes; and, to influence the development of the affected children in the best possible way (Brault, 2010). Hence, the aim of this study was to examine the physiological, symptom specific and cognitive effects of a multi-modular Drums Alive Kids Beats® Intervention in children with diverse abilities. Children with intellectual disabilities, aged 13.9 ± 2.7 years of age, were divided into two separate intervention groups and either attended the conventional school physical education lessons (PEG); or, participated in additional Drums Alive® Kids Beats Intervention classes (DG) twice a week. To give perspective, before and after the assessments for the 7-week intervention program were conducted, the performance was measured using the German Motor Skill Test (DMT). Furthermore, the children´s behavior and competencies were assessed by means of two questionnaires, the HKI and the VFE, as well as the Developmental Behavior Checklist (DBC), which monitors daily behavioral patterns. Results showed significant improvements of the DG in aerobic performance (p=0.11), coordination (p=0.038) & strength (0.015). Regarding the children´s monitored behavior (DBC), the DG also showed significant improvements (p=0.007) compared to the PEG. No significant changes were found in the competencies within each group and when measured against other groups. Findings of this study revealed that a sportive multi-modular drumming exercise program that combines endurance, strength training and highly coordinative movements, with emotional elements in an enriched environment, had significant effects on motor skill performance and behavior in children with intellectual disabilities.