Physical activity and health-related fitness in children with a (supra)sellar tumor and hypothalamic dysfunction

Abstract

Background: Despite high survival rates, survivors of a pediatric (supra)sellar tumor may suffer from consequences such as visual impairment, hormonal deficiencies, neuropsychological disease and hypothalamic dysfunction. Hypothalamic dysfunction may result in reduced metabolic activity, hypothalamic obesity and decreased physical activity level. This can result in increased morbidity, higher mortality rates and decreased quality of life. It important to examine physical activity and health-related fitness in children with a (supra)sellar tumor, to gain more insight into the physical conditions and consequences of the tumor and evaluate and improve current healthcare.

Aim: The primary aim of this study is to describe physical activity and health-related fitness in children with a (supra)sellar tumor and hypothalamic dysfunction. The secondary aim is to examine which health-related fitness and disease-related factors are associated with physical activity.

Methods: A retrospective status research to examine physical activity defined as minutes Moderate-to-Vigorous Physical Activity (MVPA) and steps per day and health-related fitness defined as body composition, muscle strength, cardiorespiratory function (VO2peak and Mean Power) and motor abilities.

Results: A total of 49 children (mean age 11.63) were included in the study. The median MVPA is 20.7 minutes and 6070 steps per day. The median VO2peak in this study population is 72% of predicted and the median z-score for mean power is -2.10 for children older than 12 years. Correlations between the number of steps and Body Mass Index (BMI) (-0.314; P=0.036), visual impairment status (0.289; P=0.054), VO2peak corrected for weight (0.320 P=0.070) and Time to Rise from the Floor (-0.275; P=0.090) have been found. In regression analysis, only BMI (B=-262.49 ;P=0.01) was a significant factor associating with physical activity in children with a (supra)sellar tumor.

Conclusion and key findings: Findings indicate that physical activity and cardiovascular function are decreased in children with a (supra)sellar tumor and hypothalamic dysfunction. Furthermore BMI is associated with decreased physical activity. Further research should focus on including other factors such as disease-related factors, lifestyle and personal factors and social environment. That way, advices in increasing physical activity could be improved and the consequences of a (supra)sellar tumor on the physical domain for these children might be reduced.