Evaluating the feasibility of a rehabilitation intervention including physical activity as structured active play for preschoolers diagnosed with cancer during the first 6 months of treatment-a study based on data from the RePlay trial

UNLABELLED: The aim of this study was to evaluate the feasibility of a rehabilitation intervention consisting of structured active play designed for preschoolers diagnosed with cancer and their parents during treatment. Eighty-four consecutively enrolled children in RePlay (NCT04672681) were included. Feasibility was addressed across five domains: (a) participation acceptance, (b) attrition during the intervention period, (c) completion of outcome assessments, (d) adherence to the intervention, and (e) occurrence of adverse events during the intervention or outcome assessments. Further, survey data was used to describe the adherence practicalities. Descriptive statistics were used for data analysis. We found an 84% acceptance and 4% attrition rates. Completion rates of the primary outcome of gross motor function assessed with the Peabody Developmental Motor Scales - Second Edition (PDMS-2) were 44% at baseline and 80% at end-of-intervention. Median adherence to the intervention during admission was 57% [IQR 50 to 68%]. No serious adverse events were reported. Parents' survey responses showed that 94% considered the intervention relevant or very relevant for themselves and their child, though 54% found the scheduled timing of the hospital-based intervention unsuitable.

CONCLUSION: It is feasible to conduct a rehabilitation intervention consisting of structured active play for preschoolers during intensive cancer treatment. Assessment of gross motor function posed certain challenges, but completing evaluations at the end of the intervention was feasible. These findings emphasize the importance of flexible interventions and considerations of the timing and duration of outcome assessment. Future studies should incorporate strategies to enhance adherence and minimize participation barriers.

WHAT IS KNOWN: • Children diagnosed with cancer experience treatment-related physical side effects. • Research shows promising effects and feasibility of physical activity interventions for school-aged children diagnosed with cancer; however, knowledge on interventions specifically for preschoolers with cancer is scarce.

WHAT IS NEW: • It is feasible to conduct a rehabilitation intervention consisting of structured active play for preschoolers during intensive cancer treatment, including assessment of gross motor function. • Consideration of timing and duration of the outcome assessment and a flexible intervention may enhance adherence and minimize participation barriers.