ACSM is pleased to announce the publication of a new pronouncement, “Initial Exercise Guidelines for Children and Adolescents during and beyond Cancer Treatments: ACSM Expert Consensus Statement.” The paper is published in Medicine & Science in Sports & Exercise (MSSE) and was chaired by Alejandro Lucia, MD, PhD and authored by the expert writing group of Martin Kaj Fridh, PhD, Sabine Kesting PhD, Marie A. Neu, Dr. med., Pedro L. Valenzuela, PhD, Matthew Wogksch, PhD, S. Nicole Culos-Reed, PhD, Kathryn Schmitz, PhD, FACSM, Kirsten K. Ness, PhD, PT, Steven J. Fleck, PhD, FACSM and Carmen Fiuza-Luces, PhD.
ACSM Expert Consensus statements serve as official statements (pronouncements) of the College on topics of high importance or with broad impact in the areas of sports medicine and exercise science. Expert consensus statements blend expert opinion and research evidence, to present a well-rounded summary.
The primary goal of this statement was to provide the first-ever exercise guidance for pediatric cancer patients with evidence-based exercise recommendations specifically for these populations. The international panel of experts screened more than 12,000 studies and synthesized findings from randomized controlled trials to establish practical exercise guidance for pediatric oncology care.
As a result, this new statement provides evidence that exercise is a promising supportive care measure, that can be safe, feasible, and improves strength and physical function for children and adolescents with cancer.
Key Findings from the expert panel include:
- Exercise can be performed safely during and after cancer treatment when appropriately supervised and individualized.
- Moderate-quality evidence shows that combined aerobic and resistance exercise improves muscle strength and physical function—two outcomes that directly affect a child’s ability to move, play, and participate in daily activities and recover from treatment.
- Moderate-quality evidence shows that aerobic exercise improves cardiorespiratory fitness after treatment, particularly among survivors of acute lymphoblastic leukemia.
- Children and adolescents with cancer should be encouraged to avoid prolonged inactivity and bed rest whenever medically feasible.
- Significant research gaps remain for outcomes such as cardiac health, bone health, immune function, fatigue, sleep, and cognitive function, underscoring the need for well-designed multicenter trials.
Cancer remains one of the leading causes of death among children and adolescents worldwide, with more than 380,000 young people diagnosed each year. While survival rates now exceed 80% in many high-income countries, treatment often leaves patients with significant short- and long-term physical challenges, including declines in muscle strength, physical function and cardiorespiratory fitness.
“Exercise should no longer be viewed as optional in pediatric oncology care,” said corresponding author Alejandro Lucia, MD, PhD, of Universidad Europea de Madrid. “This consensus statement shows that, when properly prescribed, exercise is safe and can improve physical function and strength in children and adolescents with cancer. Children and adolescents undergoing cancer treatment should no longer be encouraged to rest whenever possible,” said Lucia. Instead, appropriately prescribed exercise should be included as part of supportive cancer care, according to a new American College of Sports Medicine (ACSM) Expert Consensus Statement published in Medicine & Science in Sports & Exercise® (MSSE).”
Inside the statement:
- FITT-based (Frequency, Intensity, Time and Type) recommendations to help clinicians and exercise professionals implement exercise programs in real-world pediatric oncology settings.
- Recommendations for supervised concurrent aerobic and resistance training to improve muscle strength and physical function.
- Age-appropriate activities and strength exercises, targeting major muscle groups.
- Guidance on safety considerations, contraindications, and recommendations for adapting exercise to individual medical conditions and treatment status.
This paper is freely available to read and download on the ACSM website. In addition, for those wanting to incorporate this paper into a lecture, a short PowerPoint slide deck can be accessed here.
