Exercise Prescription Based on a Six Minute Walk Test in Childhood Acute Lymphoblastic Leukemia Survivors
Bibliographic record
Abstract
PURPOSE: Advance in cancer treatment induced drastic improvements in survival rate of Acute Lymphoblastic Leukemia (ALL) for pediatric patients. These medical advancements came at the cost of cardiac dysfunction. Regular physical activity (PA) has been known to have a preventive effect on these health issues. Previous studies have shown that survivors are less active than their peers and below the recommended PA guidelines. The aim of this study is to evaluate the intensity measured from the Six Minute Walk Test (6MWT) comparatively to maximal exercise test and verified if it is compatible with standard recommendations. METHODS:We tested 177 ALL survivors. We used a 6MWT and a cardiopulmonary exercise test (VO2max). Classification of risk level factors was based on treatment dosage, age at diagnosis, sex, prognostic risk group, time from the end of the treatment (Standard Risk (SR) and High Risk (HR)). Participants were divided in two groups according to their median cardiorespiratory fitness level (<84.3% vs ≥84.3) RESULTS: Mean survivors age was 22.27±6.30. The survivors included had 44.6% SR and 55.4% HR factors. The mean VO2max.measured was significantly lower than the one predicted; 85.8%±16.5. The heart rate measured at the end of the walk represents a mean of 75.8% of the maximal predicted. The mean intensity measured at the end of the walk test was 60.4%±17.9 of the VO2max. There is no significant difference between low and high cardiorespiratory fitness level of relative exercise intensity during the 6MWT (p=0.609). We observe a trending difference in relative exercise intensity during the 6MWT depending on risk factors (SR=63.3%±17.0 vs HR=58.1%±18.4; p=0.051). CONCLUSIONS:Although the physical cardiorespiratory fitness of survivors is lower, our results demonstrate that with a self-pace exercise (i.e. 6MWT) participants reached similar level as those of a healthy population. Their physical fitness level does not impact the relative intensity levels measured during the 6MWT. Criteria link to the disease (ALL risk prognostic: SR and HR) needs to be considered while prescribing PA to this population. Survivors have greater chances of overcoming their disease than in past history, but specific and increased knowledge about physical activity is needed to prevent late-effects related to the treatments.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".