Corinna Winter

Changes in physical activity and health-related quality of life during the first year after total knee arthroplasty†

Despite its impact on the overall outcome and health‐related quality of life (HRQOL) after knee surgery, physical activity has not been investigated directly using accelerometry or step monitoring during the first year after total knee arthroplasty (TKA) due to osteoarthritis (OA). Therefore, the present study aimed to evaluate the development of physical activity over 12 months after surgery and its relationship to clinical outcome and HRQOL.

Level of activity in children undergoing cancer treatment

The diagnosis of cancer bears severe implications for pediatric patients. One immense restriction consists in a reduced level of activity due to different factors. Physical activity affects various aspects of development and can be regarded as an essential part of a childs life. In the present study physical activity in patients undergoing cancer therapy was quantified in order to determine the extent of the restriction and to provide baseline information for the assessment of possible interventions.

Physical activity and childhood cancer.

This review provides a survey of studies investigating physical activity and exercise interventions in patients during tumor treatment and survivors of childhood cancer. PubMed and Medline databases were searched using relevant terms. References of selected papers were tracked. A total of 28 studies could be identified. Seventeen studies investigated physical activity, 11 studies determined the effect of activity enhancing interventions during and after therapy. Even though most studies showed limitations and results were not consistent, considerably reduced physical activity is highly probable in patients during and after therapy. Studies on interventions provided promising results and revealed challenges to be faced. Pediatr Blood Cancer 2010;54:501–510.

Comparison of self-reported physical activity in children and adolescents before and during cancer treatment

Physical activities are important for the development of children and increasing evidence suggests beneficial effects of physical activity promotion during cancer treatment as well. The present study aimed at evaluating the current need of exercise interventions in pediatric cancer patients undergoing acute treatment and identifying risk factors for inactivity.

Experience of barriers and motivations for physical activities and exercise during treatment of pediatric patients with cancer

Due to growing evidence about the value of exercise in pediatric cancer patients, the purpose of this study was to determine factors that influence participation in physical activities and exercise in children and adolescents during treatment.

Early decrements in bone density after completion of neoadjuvant chemotherapy in pediatric bone sarcoma patients

BackgroundBone mineral density (BMD) accrual during childhood and adolescence is important for attaining peak bone mass. BMD decrements have been reported in survivors of childhood bone sarcomas. However, little is known about the onset and development of bone loss during cancer treatment. The objective of this cross-sectional study was to evaluate BMD in newly diagnosed Ewings and osteosarcoma patients by means of dual-energy x-ray absorptiometry (DXA) after completion of neoadjuvant chemotherapy.MethodsDXA measurements of the lumbar spine (L2-4), both femora and calcanei were performed perioperatively in 46 children and adolescents (mean age: 14.3 years, range: 8.6-21.5 years). Mean Z-scores, areal BMD (g/cm2), calculated volumetric BMD (g/cm3) and bone mineral content (BMC, g) were determined.ResultsLumbar spine mean Z-score was -0.14 (95% CI: -0.46 to 0.18), areal BMD was 1.016 g/cm2 (95% CI: 0.950 to 1.082) and volumetric BMD was 0.330 g/cm3 (95% CI: 0.314 to 0.347) which is comparable to healthy peers. For patients with a lower extremity tumor (n = 36), the difference between the affected and non-affected femoral neck was 12.1% (95% CI: -16.3 to -7.9) in areal BMD. The reduction of BMD was more pronounced in the calcaneus with a difference between the affected and contralateral side of 21.7% (95% CI: -29.3 to -14.0) for areal BMD. Furthermore, significant correlations for femoral and calcaneal DXA measurements were found with Spearman-rho coefficients ranging from ρ = 0.55 to ρ = 0.80.ConclusionsThe tumor disease located in the lower extremity in combination with offloading recommendations induced diminished BMD values, indicating local osteopenia conditions. However, the results revealed no significant decrements of lumbar spine BMD in pediatric sarcoma patients after completion of neoadjuvant chemotherapy. Nevertheless, it has to be taken into account that bone tumor patients may experience BMD decrements or secondary osteoporosis in later life. Furthermore, the peripheral assessment of BMD in the calcaneus via DXA is a feasible approach to quantify bone loss in the lower extremity in bone sarcoma patients and may serve as an alternative procedure, when the established assessment of femoral BMD is not practicable due to endoprosthetic replacements.

Objective assessment of brace wear times and physical activities in two patients with scoliosis / Objektive Erfassung von Korsetttragezeiten und Alltagsaktivität bei zwei Patienten mit idiopathischer Skoliose

Abstract Conservative treatment of adolescent idiopathic scoliosis consists of therapeutic exercise and the application of braces. The effectiveness of bracing mainly depends on patient compliance, which can be determined by means of temperature sensors. This methodological paper describes the feasibility of objectively determining compliance and daily physical activities before and during conservative scoliosis treatment, being a relevant indicator for quality of life in children and adolescents. One patient with low compliance (61.4±24.9%) reduced her activity level during bracing by 50.1%, whereas another patient with a satisfactory compliance (85.7±19.5%) increased her daily activity level by 33.7% during conservative treatment. Zusammenfassung Die konservative Behandlung der idiopathischen Skoliose besteht neben krankengymnastischen Maßnahmen aus einer Korsetttherapie. Die Effektivität der Behandlung hängt überwiegend von der Mitarbeit der Patienten ab, die objektiv mittels Temperatursensoren bestimmt werden kann. Dieser methodische Beitrag beschreibt die Möglichkeit der objektiven Bestimmung der Korsetttragezeit und der Alltagsaktivitäten vor und während der Korsetttherapie, da diese einen wichtigen Indikator der Lebensqualität von Kindern und Jugendlichen darstellen. Während bei einer Patientin eine geringe Korsetttragedauer (61,4±24,9%) und während der Korsetttherapie ein deutlich verringertes Aktivitätsniveau von 50,1% ermittelt wurden, wies die zweite Patientin eine zufriedenstellende Compliance (85,7±19,5%) auf und steigerte während der konservativen Behandlung ihre Alltagsaktivität um 33,7%.