Gait and Functional Movement Quality Improvements Following an Individualized Exercise Program in Pediatric Hemato-Oncological Patients

Abstract

Highlights What are the main findings? Principal component analysis identified four movement domains: Gait Efficiency, Gait Quality, Dynamic Balance, and Functional Abilities. Only Dynamic Balance improved significantly after six months of the individualized exercise program. What is the implication of the main finding? The improvement in dynamic balance may support better motor control in pediatric hemato-oncological patients. Gait analysis can help identify the most relevant movement domains to guide individualized exercise prescription. Abstract Background/Objectives: Exercise medicine is gaining significant importance in adult oncology to improve physical activity and quality of life (QoL). However, few studies have investigated the effects of adapted physical activities in the pediatric population. The aim of this secondary analysis is to compare the movement quality of a hematological/oncological pediatric population before and after an individualized exercise program (IEP). Methods: Participants who met the inclusion criteria (aged 5–18 years, oncological/hematological diagnosis, consent) underwent an IEP delivered both in the hospital and via telemedicine at home. The subject’s movement quality was assessed before and after six months of the IEP using instrumented functional tests (i.e., 6 min walking test, Timed Up and Go, T25-FW, and turning test). To reduce the number of variables obtained, principal component analysis (PCA) was performed, and the resulting scores were then compared. Results: A total of 18 subjects (median age 12 years; eight females) were included in the analysis. Through the PCA, four dimensions were identified: Gait Efficiency, Gait Quality, Dynamic Balance, and Functional Abilities. The pre–post comparison showed significant improvements (p = 0.002) in Dynamic Balance and a trend (p = 0.05) in Gait Efficiency. Conclusions: The presented results indicate the crucial Principal Components (PCs) of movement in children treated for cancer. Moreover, in our setting, under the IEP we observed a significant improvement in Dynamic Balance. The results are consistent with those observed in previous studies. However, the limited number of subjects and the study design preclude definitive conclusions.