Effect of a physical activity intervention on lower body bone health in childhood cancer survivors: A randomized controlled trial (SURfit).
Ruedi JungSimeon Joel ZürcherChristina SchinderaPrisca EserChristian MeierAnna SchaiJulia BraunWei Hai DengHelge HebestreitCornelia NeuhausJonathan SchaeffCorina Silvia RueeggNicolas Xavier von der WeidSusi KriemlerPublished in: International journal of cancer (2022)
It remains controversial whether physical activity promotes bone health in childhood cancer survivors (CCS). We aimed to assess the effect of a one-year general exercise intervention on lower body bone parameters of CCS. CCS ≥16 years at enrollment, <16 years at diagnosis and ≥5 years in remission were identified from the national Childhood Cancer Registry. Participants randomized to the intervention group were asked to perform an additional ≥2.5 hours of intense physical activity/week, controls continued exercise as usual. Bone health was assessed as a secondary trial endpoint at baseline and after 12-months. We measured tibia bone mineral density (BMD) and morphology by peripheral quantitative computed tomography and lumbar spine, hip and femoral neck BMD by dual-energy x-ray absorptiometry. We performed intention-to-treat, per protocol, and an explorative subgroup analyses looking at low BMD using multiple linear regressions. One hundred fifty-one survivors (44% females, 7.5 ± 4.9 years at diagnosis, 30.4 ± 8.6 years at baseline) were included. Intention-to-treat analysis revealed no differences in changes between the intervention and control group. Per protocol analyses showed evidence for an improvement in femoral neck and trabecular BMD between 1.5% and 1.8% more in participants being compliant with the exercise program. Trabecular BMD increased 2.8% more in survivors of the intervention group with BMD z-score ≤-1 compared to those starting at z-score >-1. A nonstandardized personalized exercise programs might not be specific enough to promote bone health in CCS, although those compliant and those most in need may benefit. Future trials should include bone stimulating exercise programs targeting risk groups with reduced bone health and motivational features to maximize compliance.
Keyphrases
- bone mineral density
- physical activity
- postmenopausal women
- body composition
- randomized controlled trial
- public health
- computed tomography
- dual energy
- healthcare
- childhood cancer
- high intensity
- young adults
- resistance training
- health information
- magnetic resonance imaging
- study protocol
- health promotion
- bone loss
- drug delivery
- positron emission tomography
- high resolution
- magnetic resonance
- risk assessment
- sleep quality
- bone regeneration
- systemic lupus erythematosus
- human health
- open label
- single cell
- image quality
- pet ct