Hostname: page-component-76d6cb85b7-7262s Total loading time: 0 Render date: 2026-07-15T09:24:53.162Z Has data issue: false hasContentIssue false
  • English
  • Français

Effect of virtual reality-based exercise intervention on sleep quality in children with acute lymphoblastic leukemia and healthy siblings: A randomized controlled trial

Published online by Cambridge University Press:  15 March 2022

Müberra Tanriverdi Open the ORCID record for Müberra Tanriverdi [Opens in a new window] ,
Erkan Cakir ,
Muhammed Emin Akkoyunlu  and
Fatma Betül Cakir Open the ORCID record for Fatma Betül Cakir [Opens in a new window]
Müberra Tanriverdi
Affiliation:
Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Bezmialem Vakif University, Istanbul, Turkey
Erkan Cakir
Affiliation:
Pediatric Pulmonology, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey
Muhammed Emin Akkoyunlu
Affiliation:
Department of Pulmonology, İstanbul Medipol University, Istanbul, Turkey
Fatma Betül Cakir*
Affiliation:
Pediatric Hematology Oncology, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey
*
Author for correspondence: Fatma Betül Cakir, Pediatrics, Division of Pediatric Hematology Oncology, Bezmialem Vakif Universitesi Tip Fakultesi, Istanbul, Turkey. E-mail: fbetulcakir@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Sleep is one of the important measurements of the quality of life for children especially suffering from a chronic illness such as cancer. Our aim was to determine the changes in sleep quality and to investigate the effect of virtual reality-based exercise (VRBE) approaches on sleep in patients with acute lymphoblastic leukemia (ALL) off treatment.

Method

The participants (ALL and healthy siblings) were evaluated for sleep quality with polysomnography and “Children's Sleep Habit Questionnaire” before and after 12 weeks. The study randomized into two groups: an exercise group who received VRBE in two days in a week, 45 min of each session for 12 weeks and an control group who were managed with supportive measures. The VRBE comprised of aerobic exercise in four different games by Nintendo Wii Fit Plus®.

Results

This randomized controlled trial was carried out on 38 participants. Before intervention, ALL patients (n = 24) and healthy siblings (n = 14) had similar sleep quality in terms of polysomnography and Children's Sleep Habit Questionnaire findings. After intervention, total time asleep (p = 0.023), respiratory disturbance index of hypopnea (p = 0.005), apnea/hypopnea index (p = 0.008), and number of apnea (p = 0.028) statistically significant improved.

Significance of results

Patients with ALL off treatment had similar values of sleep quality with healthy siblings. Novel types of exercises like VRBE have positive effects on sleep disorders in children with ALL and also healthy siblings. Future studies are needed comparing the different types of interventions.

Keywords

Acute lymphoblastic leukemiaExercise therapyPediatricsSleep disordersVirtual reality

Information

Type
Original Article
Information
Palliative & Supportive Care , Volume 20 , Issue 4 , August 2022 , pp. 455 - 461
Check for updates
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

REFERENCES

Bauman, FT, Bloch, W and Beulertz, J (2013) Clinical exercise interventions in pediatric oncology: A systematic review. Journal of Pediatric Research 74, 366–374. doi:10.1038/pr.2013.123CrossRefGoogle Scholar
Beck, SE and Marcus, CL (2009) Pediatric polysomnography. Sleep Medicine Clinics 4, 393–406. doi:10.1016/j.jsmc.2009.04.007CrossRefGoogle ScholarPubMed
Beulertz, J, Prokop, A, Rustler, V, et al. (2016) Effects of a 6-month, group-based, therapeutic exercise program for childhood cancer outpatients on motor performance, level of activity, and quality of life. Pediatric Blood & Cancer 63, 127–132. doi:10.1002/pbc.25640CrossRefGoogle ScholarPubMed
Braam, KI, van Dijk-Lokkart, EM, Veening, MA, et al. (2010) Design of the quality of life in motion (QLIM) study: A randomized controlled trial to evaluate the effectiveness and cost-effectiveness of a combined physical exercise and psychosocial training program to improve physical fitness in children with cancer. Cancer 10, 624. doi:10.1186/1471-2407-10-624Google ScholarPubMed
Braam, KI, van Dijk-Lokkart, EM, Kaspers, GJL, et al. (2018) Effects of a combined physical and psychosocial training for children with cancer: A randomized controlled trial. BMC Cancer 18, 1–12. doi:10.1186/s12885-018-5181-0CrossRefGoogle ScholarPubMed
Cheung, YT, Brinkman, TM, Mulrooney, DA, et al. (2017) Impact of sleep, fatigue, and systemic inflammation on neurocognitive and behavioral outcomes in long-term survivors of childhood acute lymphoblastic leukemia. Cancer 123, 3410–3419. doi:10.1002/cncr.30742CrossRefGoogle ScholarPubMed
Daniel, LC, Wang, M, Mulrooney, DA, et al. (2019) Sleep, emotional distress, and physical health in survivors of childhood cancer: A report from the childhood cancer survivor study. Psycho-Oncology 28, 903–912. doi:10.1002/pon.5040CrossRefGoogle ScholarPubMed
Douglas, NJ, Thomas, S and Jan, MA (1992) Clinical value of polysomnography. Lancet 339, 347–350. doi:10.1016/0140-6736(92)91660-ZCrossRefGoogle ScholarPubMed
Fiş, NP, Arman, A, Ay, P, et al. (2010) Çocuk uyku alışkanlıkları anketinin türkçe geçerliliği ve güvenilirliği. Anatolian Journal of Psychiatry 11, 151–160.Google Scholar
Gordijn, MS, van Litsenburg, RR, Gemke, RJ, et al. (2013) Sleep, fatigue, depression and quality of life in survivors of childhood acute lymphoblastic leukemia. Pediatric Blood & Cancer 60, 479–485. doi:10.1002/pbc.24261CrossRefGoogle ScholarPubMed
Hartman, A, Hop, W, Takken, T, et al. (2013) Motor performance and functional exercise capacity in survivors of pediatric acute lymphoblastic leukemia. Pediatric Blood & Cancer 60, 494–499. doi:10.1002/pbc.24243CrossRefGoogle ScholarPubMed
Hinds, PS, Hockenberry, MJ, Gattuso, JS, et al. (2007) Dexamethasone alters sleep and fatigue in pediatric patients with acute lymphoblastic leukemia. Cancer 110, 2321–2330. doi:10.1002/cncr.23039CrossRefGoogle ScholarPubMed
Howell, CR, Krull, KR, Partin, RE, et al. (2018) Randomized web-based physical activity intervention in adolescent survivors of childhood cancer. Pediatric Blood & Cancer 65, e27216. doi:10.1002/pbc.27216CrossRefGoogle ScholarPubMed
Kawada, T (2013) Physical activity and sleep by actigraphy in children with cancer. Pediatric Blood & Cancer 61, 955.CrossRefGoogle ScholarPubMed
Kim, Y and Park, S (2019) Feasibility and benefits of a combined programme of exercise and play for paediatric cancer survivors: A pilot study. European Journal of Cancer Care 28, e13111. doi:10.1111/ecc.13111CrossRefGoogle ScholarPubMed
Krull, MR, Howell, CR, Partin, RE, et al. (2020) Protein supplementation and resistance training in childhood cancer survivors. Medicine & Science in Sports & Exercise 52, 2069–2077. doi:10.1249/MSS.0000000000002345CrossRefGoogle ScholarPubMed
Marchese, VG, Chiarello, LA and Lange, BJ (2004) Effects of physical therapy intervention for children with acute lymphoblastic leukemia. Pediatric Blood & Cancer 42, 127–133. doi:10.1002/pbc.10481CrossRefGoogle ScholarPubMed
Mendoza, JA, Baker, KS, Moreno, MA, et al. (2017) A fitbit and Facebook mHealth intervention for promoting physical activity among adolescent and young adult childhood cancer survivors: A pilot study. Pediatric Blood & Cancer 64, e26660. doi:10.1002/pbc.26660CrossRefGoogle Scholar
Miyachi, M, Yamamoto, K, Ohkawara, K, et al. (2010) METs in adults while playing active video games: A metabolic chamber study. Medicine & Science in Sports & Exercise 42, 1149–1153. doi:10.1249/mss.0b013e3181c51c78CrossRefGoogle ScholarPubMed
Morales, JS, Valenzuela, PL, Rincón-Castanedo, C, et al. (2018) Exercise training in childhood cancer: A systematic review and meta-analysis of randomized controlled trials. Cancer Treatment Reviews 70, 154–167.CrossRefGoogle ScholarPubMed
Müller, C, Krauth, KA, Gerß, J, et al. (2016) Physical activity and health-related quality of life in pediatric cancer patients following a 4-week inpatient rehabilitation program. Supportive Care in Cancer 24, 3793–3802. doi:10.1007/s00520-016-3198-yCrossRefGoogle ScholarPubMed
Mulrooney, DA, Ness, KK, Neglia, JP, et al. (2008) Fatigue and sleep disturbance in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study (CCSS). Sleep 31, 271–281. doi:10.1093/sleep/31.2.271CrossRefGoogle Scholar
Orsey, AD, Wakefield, DB and Cloutier, MM (2013) Physical activity (PA) and sleep among children and adolescents with cancer. Pediatric Blood & Cancer 60, 1908–1913. doi:10.1002/pbc.24641CrossRefGoogle ScholarPubMed
Owens, JA, Spirito, A and McGuinn, M (2000) The Cildren's Sleep Habits Questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children. Sleep 23, 1043–1052.Google Scholar
Rosen, GM, Shor, AC and Geller, TJ (2008) Sleep in children with cancer. Current Opinion in Pediatrics 20, 676–681. doi:10.1097/MOP.0b013e328312c7adCrossRefGoogle ScholarPubMed
Schulz, KF, Altman, DG, Moher, D, et al. (2010) CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. Trials 11, 32. doi:10.1186/1745-6215-11-32CrossRefGoogle ScholarPubMed
So, CJ, Palmer, CA, Gonzalez, RD, et al. (2021) Which objective sleep elements predict children's perceptions of good sleep quality? A preliminary investigation based on polysomnography and actigraphy. Sleep Health 7, 65–71. doi:10.1016/j.sleh.2020.07.001CrossRefGoogle ScholarPubMed
Speyer, E, Herbinet, A, Vuillemin, A, et al. (2010) Effect of adapted physical activity sessions in the hospital on health-related quality of life for children with cancer: A cross-over randomized trial. Pediatric Blood & Cancer 55, 1160–1166. doi:10.1002/pbc.22698CrossRefGoogle ScholarPubMed
Su, HL, Wu, LM, Chiou, SS, et al. (2018) Assessment of the effects of walking as an exercise intervention for children and adolescents with cancer: A feasibility study. European Journal of Oncology Nursing 37, 29–34. doi:10.1016/j.ejon.2018.10.006CrossRefGoogle ScholarPubMed
van Litsenburg, RR, Huisman, J, Hoogerbrugge, PM, et al. (2011) Impaired sleep affects quality of life in children during maintenance treatment for acute lymphoblastic leukemia: An exploratory study. Health and Quality of Life Outcomes 9, 25. doi:10.1186/1477-7525-9-25CrossRefGoogle Scholar
Walter, LM, Nixon, GM, Davey, MJ, et al. (2015) Sleep and fatigue in pediatric oncology: A review of the literature. Sleep Medicine Reviews 24, 71–82. doi:10.1016/j.smrv.2015.01.001CrossRefGoogle ScholarPubMed
Zupanec, S, Jones, H and Stremler, R (2010) Sleep habits and fatigue of children receiving maintenance chemotherapy for ALL and their parents. Journal of Pediatric Oncology Nursing 27, 217–228. doi:10.1177/1043454209358890CrossRefGoogle ScholarPubMed