Feasibility of a Cardio-Oncology Tele-Rehabilitiation Program in Pediatric Patients with Cancer

Authors

Inga Zimba, Department of Pediatrics, Division of Pediatric Cardiology, NewYork Presbyterian Morgan Stanley Children’s Hospital - Columbia University Irving Medical Center, NEW YORKFollow
Ruskin S. Del Mundo, Department of Pediatrics, Division of Pediatric Cardiology, NewYork Presbyterian Morgan Stanley Children’s Hospital - Columbia University Irving Medical Center, NEW YORKFollow
Mary E. McCown, Department of Pediatrics, Division of Pediatric Cardiology, NewYork Presbyterian Morgan Stanley Children’s Hospital - Columbia University Irving Medical Center, NEW YORK
Elena J. Ladas, Department of Pediatrics, Division of Pediatric Hematology, Oncology & Stem Cell Transplant, NewYork Presbyterian Morgan Stanley Children’s Hospital - Columbia University Irving Medical Center, NEW YORK
Vidhu V. Thaker, Department of Pediatrics, Division of Molecular Genetics, NewYork Presbyterian Morgan Stanley Children’s Hospital - Columbia University Irving Medical Center, NEW YORK
Pooja S. Vyas, Department of Pediatrics, Division of Pediatric Hematology, Oncology & Stem Cell Transplant, NewYork Presbyterian Morgan Stanley Children’s Hospital - Columbia University Irving Medical Center, NEW YORK
Michael A. Fremed, Department of Pediatrics, Division of Pediatric Cardiology, NewYork Presbyterian Morgan Stanley Children’s Hospital - Columbia University Irving Medical Center, NEW YORK
Aimee M. Layton, Department of Pediatrics, Division of Pediatric Cardiology, NewYork Presbyterian Morgan Stanley Children’s Hospital - Columbia University Irving Medical Center, NEW YORKFollow

Abstract

Childhood cancer survivors are eight times more likely to die of heart disease than people who have never had cancer. Exercise during treatment has been found to help protect the heart against the harmful effects of treatment and reduce the risk of developing heart disease in early adulthood. There is insufficient data on the feasibility of delivering cardio- oncology rehabilitation (CORE) in an outpatient telehealth setting. PURPOSE: This study aims to pilot the feasibility and safety of tele- CORE in children ages 10-15 years old. METHODS: Pediatric cancer survivors who underwent cancer treatment participated in this study. Participants performed a 12-week tele-CORE program. A cardiopulmonary exercise test (CPET) was administered prior to intervention to generate an exercise prescription (with heart rate zones) and screen for exercise contraindications. A stationary bike with modifiable resistance levels, resistance bands, dumbbells, and FitBit were provided. Supervised 45-60 min virtual exercise sessions were held twice weekly consisting of cardio, strength training, stretching, and plyometrics. RESULTS: The study is actively enrolling. Preliminary findings of the first 4 participants (Ages 12.5 ± 2.5; Female 25%; BMI 35.8 ± 3.3) are as follows. Baseline peak VO2 values were 22.0 ± 5.4 ml/kg/min. Average attendance was 16 out of 24 sessions (95%CI 9-22). There has been one minor adverse event where a patient expressed chest discomfort during cycling. Exercise was terminated, patient rested, then resumed at a lower intensity. Chest discomfort did not persist. The clinical team was notified, the patient was cleared to resume exercise, but a repeat echocardiogram was ordered to investigate possible cardiotoxicity from cancer therapy. CONCLUSION: Our pilot data demonstrates good compliance of tele-CORE in pediatric cancer patients receiving treatment. The team was able to successfully intervene during a minor adverse event. Preliminary findings show tele-CORE to be feasible and safe in children and adolescents undergoing cancer treatment.

Recommended Citation

Zimba, Inga; Del Mundo, Ruskin S.; McCown, Mary E.; Ladas, Elena J.; Thaker, Vidhu V.; Vyas, Pooja S.; Fremed, Michael A.; and Layton, Aimee M. (2024) "Feasibility of a Cardio-Oncology Tele-Rehabilitiation Program in Pediatric Patients with Cancer," International Journal of Exercise Science: Conference Proceedings: Vol. 15: Iss. 5, Article 16.
Available at: https://digitalcommons.wku.edu/ijesab/vol15/iss5/16