Table1_Effect of exercise on bone health in children and adolescents with cancer during and after oncological treatment: A systematic review and meta-analysis.DOCX

Background: Although regular physical activity and exercise programs might improve bone health caused by oncological treatment and the disease itself, it remains unknown the pooled effect of exercise interventions following frequency, intensity, time and type prescriptions.
Objective: This systematic review and meta-analysis aimed to synthesise evidence regarding the effectiveness of exercise interventions on bone health in children and adolescents with cancer during and after oncological treatment.
Methods: A systematic search was conducted in the MEDLINE (via PubMed), Web of Science and Scopus databases from November 2021 to January 2022. Randomised controlled trials (RCTs) and non-RCTs reporting pre-post changes of the effectiveness of exercise interventions on DXA-measured bone parameters in young population (1–19 years) during or after oncological treatment were included. Pooled (ESs) and 95% confidence intervals (95%CIs) were calculated. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed.
Results: A total of eight trials with 341 participants were included. The meta-analyses did not reveal a statistically significant increase in whole body areal bone mineral density (ES = 0.10; 95%CI: −0.14, 0.34), lumbar spine (ES = 0.03; 95%CI: −0.21, 0.26) or femoral neck (ES = 0.10; 95%CI: −0.37, 0.56). Similarly, during the oncological treatment phase the ES was 0.04 (95%CI: −0.17, 0.25) and after the ES was 0.07 (95%CI: −0.20, 0.33).
Conclusion: To date, exercise interventions have been inappropriate and therefore, ineffective to illustrate any beneficial effect on bone health in children and adolescents with cancer during and after oncological treatment.
Systematic Review Registration: PROSPERO registration number: CRD42022310876

背景：尽管规律的体力活动与运动计划或可改善肿瘤治疗及疾病本身所引发的骨骼健康问题，但目前仍不清楚遵循频率、强度、时间与类型规范的运动干预所产生的汇总效应。
研究目的：本系统评价与Meta分析旨在综合分析肿瘤治疗期间及治疗结束后，癌症患儿与青少年群体中运动干预对骨骼健康的有效性相关证据。
研究方法：本研究于2021年11月至2022年1月期间，在MEDLINE（通过PubMed检索）、Web of Science及Scopus数据库中开展系统性文献检索。纳入标准为：报告了肿瘤治疗期间或治疗结束后，年轻人群（1~19岁）接受运动干预后，双能X线吸收测定法（DXA）所测得的骨骼参数干预前后变化的随机对照试验（RCT）与非随机对照试验（non-RCTs）。本研究计算了汇总效应量（ESs）与95%置信区间（95%CIs），并严格遵循《系统评价与Meta分析优先报告条目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses，PRISMA）指南进行报告。
研究结果：本研究共纳入8项试验，涉及341名受试者。Meta分析结果显示，受试者的全身面积骨密度（ES=0.10；95%CI：-0.14~0.34）、腰椎（ES=0.03；95%CI：-0.21~0.26）及股骨颈（ES=0.10；95%CI：-0.37~0.56）均未出现具有统计学意义的提升。类似地，在肿瘤治疗期间，汇总效应量为0.04（95%CI：-0.17~0.25），治疗结束后则为0.07（95%CI：-0.20~0.33）。
研究结论：截至目前，现有运动干预方案并不恰当，因此无法证实其对肿瘤治疗期间及治疗结束后的癌症患儿与青少年群体的骨骼健康存在任何有益作用。
系统评价注册：本研究在国际前瞻性系统评价注册平台（PROSPERO）的注册编号为CRD42022310876。