Large Improvements in Health-Related Quality of Life and Physical Fitness during Multidisciplinary Inpatient Rehabilitation for Pediatric Cancer Survivors

Simple Summary After cancer treatment, children often suffer from various health problems. Rehabilitation can improve their quality of life. We present data for 236 children and 478 parents who filled out questionnaires before and after inpatient rehabilitation. In our sample, both children and parents reported that the quality of life of the children had substantially improved during rehabilitation, especially their physical and psychosocial quality of life. Children also improved in physical exercises and their functional status. Parents and children showed better agreement regarding the child's health status after rehabilitation than before. A specific method of statistical analysis (performance score) helped to reduce disagreement between parents and children. We therefore conclude that inpatient rehabilitation is effective for children after cancer treatment and that the performance score should be used in research on rehabilitation for children after cancer treatment to have the most accurate results. Rehabilitation is a key element in improving health-related quality of life (HRQOL) for pediatric cancer survivors. The aim of this study was to present data from a multidisciplinary inpatient rehabilitation treatment. Children took part in a four-week multidisciplinary family-oriented inpatient rehabilitation. A total of 236 children (>5-21 years) and 478 parents routinely completed electronic patient-reported outcomes (ePROs), performance-based assessments, and clinician-rated assessments before (T1) and at the end (T2) of rehabilitation. HRQOL was assessed with the PedsQL generic core and PedsQL cancer module. Data were analyzed using repeated measures analysis of variance (ANOVA). Statistically significant improvements with medium to large effect sizes were observed for most HRQOL scales (eta(2) = 0.09-0.31), as well as performance-based and clinician-rated assessments for physical activity and functional status (eta(2) > 0.28). Agreement between children's PROs and parents' proxy ratings was lower before (r(ICC) = 0.72) than after (r(ICC) = 0.86) rehabilitation. While the concordance between children and parents' assessment of changes during rehab was low to moderate (r = 0.19-0.59), the use of the performance score led to substantially increased scores (r = 0.29-0.68). The results of this naturalistic observational study thus highlight the benefits of multidisciplinary pediatric inpatient rehabilitation for childhood cancer survivors. The use of the performance score is recommended in this field.