Individualized Physical Activity Prescriptions for Children and Adolescents With Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials

BACKGROUND: For improved health outcomes, children and adolescents with cancer must maintain physical activity. Individualized physical activity prescription is an effective way to promote physical activity in this group. OBJECTIVE: We reviewed and meta-analyzed evidence on the effectiveness of individualized physical activity prescriptions for improving physical activity and other health outcomes among children and adolescents with cancer. METHODS: Seven databases were searched from inception up to January 2024 for randomized controlled trials. Two researchers independently extracted data and assessed the quality of studies using the Risk-of-Bias tool. Data were pooled into Review Manager 5.3 for data synthesis and subgroup analyses. RESULTS: Seventeen randomized controlled trials were included. The systematic review summarized the characteristics of recent interventions. Meta-analyses showed that although individualized physical activity prescriptions had no overall effect on physical activity (n = 8 studies), anthropometry and body composition (n = 5), functional capacity (n = 3), quality of life (n = 8), fatigue (n = 3), and self-efficacy (n = 5), they improved cardiovascular fitness (n = 8, P = .02) and muscle strength (n = 8, P = .04). Subgroup analyses showed that studies providing 6-month interventions ( P = .003) or such interventions combined with motivational interviewing ( P = .002) reported significantly increased physical activity in patients. CONCLUSIONS: Individualized physical activity prescriptions appear to improve cardiovascular fitness and muscle strength in children and adolescents with cancer. IMPLICATIONS FOR PRACTICE: High-quality studies providing long-duration interventions and motivational interviewing are needed for optimal physical activity programs for children and adolescents with cancer. The application of electronic devices should increase the types of physical activities for this group to further improve health outcomes.