Keywords
1. Pediatric Cancer Survivors
2. Muscle Strength Deficits
3. Bone Mineral Density
4. Resistance Training
5. Dual-Energy X-ray Absorptiometry
Recent findings published in the Journal of Sport and Health Science have revealed a troubling correlation between muscle strength deficits and low areal bone mineral density (aBMD) in pediatric cancer survivors. According to the study titled “Muscle strength deficits are associated with low bone mineral density in young pediatric cancer survivors: The iBoneFIT project,” this association could have significant implications for the long-term health and rehabilitation of children who have overcome cancer.
DOI: 10.1016/j.jshs.2024.01.003
The iBoneFIT project, conducted by researchers from the University of Granada, St. Jude Children’s Research Hospital, and several other esteemed institutions, aimed to document the prevalence of muscle strength deficits and examine their associations with aBMD in young pediatric cancer survivors.
The cross-sectional study included 116 pediatric cancer survivors with an average age of 12.1 ± 3.3 years, of whom 42% were female. Through the use of a handgrip test and a standing long jump test, the researchers assessed upper and lower body muscle strength, respectively. Dual-energy X-ray absorptiometry (DXA) was utilized to measure aBMD at various skeletal sites, including the total body, total hip, femoral neck, and lumbar spine.
The study’s results pointed to a concerning prevalence of muscle strength deficits in the study population. More than half of the participants were within the two lowest deciles for both upper (56.9%) and lower (60.0%) body muscle strength when compared to age- and sex-specific reference values. Additionally, these muscle strength deficits were associated with lower aBMD Z-scores across all measured sites, indicating an increased risk for bone health issues.
More precisely, the iBoneFIT study found that each one-decile decrease in upper-body muscle strength correlated with a 30%-95% higher likelihood of having low aBMD Z-scores at all skeletal sites. Similarly, for every decile decrease in lower-body muscle strength, there was a 35%-70% increased chance of low aBMD Z-scores at the total body, total hip, and femoral neck.
This groundbreaking research has implications for the way pediatric oncology rehabilitation is approached. The data underscore the importance of targeted interventions designed to enhance muscle strength as means not only to directly combat muscle weakness but also to potentially support and improve bone health in this vulnerable population.
The study also exposes the need for healthcare practitioners to regularly screen for and address musculoskeletal health concerns in pediatric cancer survivors. Early detection and intervention could play a critical role in reducing the risk of complications such as fractures, osteoporosis, and reduced physical functioning as these children grow older.
The comprehensive approach adopted by the iBoneFIT project holds the promise of informing future research and medical guidelines. The clear association between muscle strength and bone density emphasizes the interconnected nature of the human musculoskeletal system and, crucially, how childhood ailments and treatments can have lasting impacts on adult health.
As the field moves forward, the study’s authors, including primary correspondents Andres A. Marmol-Perez and Luis Gracia-Marco, call for more in-depth longitudinal studies to explore the causal relationships and to confirm the benefits of resistance training and other interventions for improving both muscle and bone health outcomes in pediatric cancer survivors.
The iBoneFIT project highlights the resilience and plight of young individuals who have survived cancer and advocates for their continued support across multiple domains of health. By spearheading research into the often-overlooked long-term effects of childhood cancer, the team behind this study inspires hope for improvements in post-cancer care and quality of life for survivors.
References
1. Marmol-Perez, A.A., Gil-Cosano, J.J., Ubago-Guisado, E., Llorente-Cantarero, F.J., Pascual-Gázquez, J.F., … Gracia-Marco, L. (2024). Muscle strength deficits are associated with low bone mineral density in young pediatric cancer survivors: The iBoneFIT project. Journal of Sport and Health Science, S2095-2546(24)00003-6. doi: 10.1016/j.jshs.2024.01.003.
Further research and clinical practice should strive to integrate these insights, ensuring pediatric cancer survivors receive not just life-saving treatments, but also life-enhancing support to build strength and stability for years to come.