The Impact of a Precision-Based Exercise Intervention in Childhood Hematological Malignancies Evaluated by an Adapted Yo-Yo Intermittent Recovery Test

Simple Summary Disability is a temporary phenomenon for every child, adolescent, and young adult with hematological malignancies during the intensive phases of cancer treatment, but it can become a long-lasting condition for many. Disability is an umbrella term for impairments, activity limitations and participation restrictions, denoting the negative aspects of the interaction between an individual and that individual's contextual, environmental, and personal factors. Adapted precision-based training programs during cancer treatment are an emerging therapeutic option in pediatric oncology and evaluating the impact of tailored exercise on individuals' performance is mandatory for adapting exercise/sports activities. Our research showed that a new intermittent and recovery test, the Yo-Yo AD, provided valid information on an individual's capacity to perform repeated intense exercise and to follow up on the impact of precision-based exercise intervention in childhood hematological malignancies. During cancer treatments in childhood hematological malignancies, reduced exercise tolerance is one of the main hardships. Precision-based training programs help children, adolescents, and young adults and their families to resume regular physical activity, exercise, and sports once they return to their communities after the intensive phases spent in hospital. This study was aimed at verifying whether an intermittent recovery test, the Yo-Yo AD, could provide a simple and valid way to evaluate an individual's capacity to perform repeated intense exercise and to follow up on the impact of tailored exercise in children, adolescents, and young adults with hematological malignancies. The Yo-Yo AD involved the repetition of several shuttles to muscle exhaustion, at pre-established speeds (walking and slow running). The heart rate (HR) and oxygen saturation (SaO(2)) were monitored during the test. The total distance and the walking/running ability, measured as the slope of the HR vs. distance correlation, were investigated before (T0) and after 11 weeks (T1) of precision exercise intervention. The Yo-Yo AD was also performed by healthy children (CTRL). Ninety-seven patients (10.58 +/- 4.5 years, 46% female) were enrolled. The Yo-Yo AD showed the positive impact of the exercise intervention by increasing the distance covered by the individuals (T0 = 946.6 +/- 438.2 vs. T1 = 1352.3 +/- 600.6 m, p < 0.001) with a more efficient walking/running ability (T0 = 2.17 +/- 0.84 vs. T1 = 1.73 +/- 0.89 slope, p < 0.0164). CTRLs performed better (1754.0 +/- 444.0 m, p = 0.010). They were equally skillful (1.71 +/- 0.27 slope) when compared to the patients after they received the precision-based intervention. No adverse events occurred during the Yo-Yo AD and it proved to be an accurate way of correctly depicting the changes in performance in childhood hematological malignancies.