Jung, Ruedi; Zürcher, Simeon J; Schindera, Christina; Eser, Prisca; Meier, Christian; Schai, Anna; Braun, Julia; Deng, Wei Hai; Hebestreit, Helge; Neuhaus, Cornelia; Schaeff, Jonathan; Rueegg, Corina S; von der Weid, Nicolas X; Kriemler, Susi (2023). Effect of a Physical Activity Intervention on Lower Body Bone Health in Childhood Cancer Survivors: A Randomised Controlled Trial (SURfit). International journal of cancer, 152(2), pp. 162-171. Wiley-Blackwell 10.1002/ijc.34234
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Jung_IntJCancer_2023.pdf - Published Version Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND). Download (1MB) | Preview |
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Intl_Journal_of_Cancer_-_2022_-_Jung_-_Effect_of_a_Physical_Activity_Intervention_on_Lower_Body_Bone_Health_in_Childhood.pdf - Accepted Version Available under License Publisher holds Copyright. Download (1MB) | Preview |
It is still 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 ≥16y at enrollment, <16y at diagnosis, and ≥5y in remission were identified from the national Childhood Cancer Registry. Participants randomized to the intervention group were asked to perform an additional ≥2.5h 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. 151 survivors (44% females, 7.5±4.9y at diagnosis, 30.4±8.6y 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 1.5-1.8% 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 non-standardized 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. This article is protected by copyright. All rights reserved.
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