Author Identifier (ORCID)
Anna Maria Markarian: https://orcid.org/0000-0003-2863-1544
Robert U. Newton: https://orcid.org/0000-0003-0302-6129
Dennis R. Taaffe: https://orcid.org/0000-0001-6381-1597
Carolyn J. Peddle-McIntyre: https://orcid.org/0000-0001-9913-4022
Jodie Cochrane Wilkie: https://orcid.org/0000-0003-1234-9579
Daniel A. Galvão: https://orcid.org/0000-0002-8209-2281
Abstract
Background: Survivors of childhood acute lymphoblastic leukemia (ALL) often exhibit early deficits in muscle and movement competence, which can compromise long-term health. Integrative neuromuscular training (INT), a multifaceted approach combining fundamental movement activities with strength exercises, may help address these deficits during critical developmental periods. Methods: Eight children treated for ALL (aged 6–12 years) completed a supervised INT intervention (2 sessions/week for 8 weeks). Primary outcomes were feasibility (recruitment, retention, adherence, compliance, and tolerance) and program acceptability. Secondary outcomes included muscle function (isometric midthigh pull [IMTP], countermovement jump, and handgrip strength), dual-energy x-ray absorptiometry (DXA)-derived body composition, peripheral quantitative computed tomography (pQCT)-derived muscle measures, and health-related quality of life assessed using the Pediatric Quality of Life Inventory (PedsQL). Pre- to post-intervention changes were evaluated using paired tests (paired t-tests or Wilcoxon signed-rank tests, depending on normality) and corresponding effect sizes (Cohen's d or rank-biserial correlation). Results: Recruitment was 80%, retention was 100%, and adherence was 100%, although the intervention extended beyond 8 weeks. The program was well-tolerated and demonstrated high acceptability, with no adverse events reported. Exploratory analyses suggested improvements in muscle strength (IMTP and countermovement jump peak force, and left handgrip strength), modest increases in whole-body lean mass, and specific PedsQL domains (school functioning, general fatigue, cognitive fatigue), with limited changes in muscle power and pQCT-derived muscle measures. Conclusion: INT is feasible and acceptable for survivors of childhood ALL, though maintaining twice-weekly attendance was challenging. Preliminary results indicate potential benefits for muscle strength, mass, and specific quality-of-life domains, underscoring the need for strategies to support consistent participation in this population.
Keywords
Acute lymphoblastic leukemia, feasibility, integrative neuromuscular training, muscle strength and mass, quality of life
Document Type
Journal Article
Date of Publication
1-1-2026
Publication Title
Pediatric Blood & Cancer
Publisher
Wiley
School
Exercise Medicine Research Institute / School of Medical and Health Sciences
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Comments
Markarian, A. M., Newton, R. U., Taaffe, D. R., Gottardo, N. G., Valvi, S., Peddle‐McIntyre, C. J., Wilkie, J. C., & Galvão, D. A. (2026). Feasibility and preliminary efficacy of integrative neuromuscular training for childhood cancer survivors: A pilot study. Pediatric Blood & Cancer. Advance online publication. https://doi.org/10.1002/1545-5017.70377