Plain English Summary
Background and study aims
Despite a 13% increase in the childhood cancer incidence over the last 40 years, the 5-year survival rate has now been set up at 80%. However, curing cancer has important consequences. One of the most common issues in paediatric cancer survivors is a reduction of the bone mineral density. Recent evidence highlights the survivorship phase (rather than the treatment one) for performing interventions to improve bone health. Exercise can improve bone health in healthy children; however, this effect has not been studied yet in this population.
This intervention will analyse the influence of a 9-month exercise intervention on bone mass in growing paediatric cancer survivors.
Who can participate?
Paediatric cancer survivors 6 to 18-years of age at recruitment, ≥ 1year from diagnosis and not currently receiving treatment for cancer.
What does the study involve?
Participants will be randomly allocated to the intervention or control group. The intervention will involve a combination of strength and jumping activities. Likewise, the intervention will aim to improve muscular fitness before implementing mechanical loading through jumping exercises. This exercise program will be completed at home and delivered through an online platform. The control group will not perform the exercise program, but they will be offered the same program at the end of the intervention. Nutritional and sun exposure counselling will also be given to both groups.
What are the possible benefits and risks of participating?
The main expected benefit of participating in this study is the improvement in bone mass which lowers the risk of having future bone diseases, such as osteoporosis. The risks of participating are similar to those derived of exercise practice.
Where is the study run from?
1. Virgen de las Nieves Hospital (Spain)
2. Reina Sofía Hospital (Spain)
3. Regional University Hospital of Málaga (Spain)
When is the study starting and how long is it expected to run for?
May 2020 to April 2022
Who is funding the study?
“la Caixa” Foundation (Spain)
Who is the main contact?
Dr Luis Andrés Gracia Marco, firstname.lastname@example.org
Effect of an exercise program on bone health in paediatric cancer survivors
A 9-month plyometric-exercise intervention improves bone health in paediatric cancer survivors
Approved 10/01/2020, Review Committee for Research Involving Human Subjects of Andalucía (Comite de Etica de Investigación de Cordoba. Avda. Menéndez Pidal s/nº 14004-Córdoba, Spain; no tel. provided; no email provided), ref: 4500
Interventional randomized controlled trial
Primary study design
Secondary study design
Randomised controlled trial
Patient information sheet
Not available in web format, please use the contact details below to request a patient information sheet
Paediatric cancer survivors at risk of endocrine dysfunction
iBoneFIT is a multicentre randomized controlled trial. Participants will be allocated into two groups: intervention group (a 9-month exercise intervention) and control group (no exercise program for 9-months). Specific dietary advice regarding calcium and vitamin D will be given to both groups. Simple randomization will be applied using an online tool.
Intervention group: The program will be delivered via an online platform. Nutritional and sun exposure counselling will also be given. The 9-month intervention will involve 3 to 4 days/week of a home-based jumping programme. The jumping programme takes approximately 10 min/day and all activities will be performed on hard surfaces. In brief, the jumping intervention will consist of 3 stages and the volume of each stage will increase progressively. In stage 1 (2 months), participants will perform body mass-based squats; in stage 2 (3 months), participants will perform squat jumps; in stage 3 (4 months), participants will perform countermovement jumps.
Furthermore, five behavior change techniques were used to increase participants’ engagement (i.e. action planning and goal setting, provide instructions and demonstrations of how to perform the behavior, self-monitoring of behavior, provide feedback on performance and information about health consequences). Likewise, a gamification design (i.e. points, rankings and rewards) was included to improve the interest, incentive and purposiveness of this non-game program.
Control group: no exercise program will be delivered. At the end of the intervention, the exercise program will be offered to all participants in the control group.
Educational advice and leaflets about the importance of healthy lifestyles, nutrition and sun exposure will be given to both groups on a monthly basis.
Primary outcome measure
1. Bone mineral density measured using Dual energy X-ray Absorptiometry (DXA) at baseline, post-intervention and follow-up (4 months post-intervention)
2. Bone architecture and geometry using specific software for Hip Structural Analysis Trabecular Bone Score at baseline, post-intervention and follow-up (4 months post-intervention)
Secondary outcome measures
1. Biochemical markers measured using venous blood samples between 8:00 and 10:00 after an overnight fast at baseline, post-intervention and follow-up (4 months post-intervention)
2. Physical activity measured using tri-axial accelerometers at baseline, post-intervention and follow-up (4 months post-intervention)
3. Physical fitness measured using the ALPHA fitness test battery at baseline, post-intervention and follow-up (4 months post-intervention)
4. Psychological distress measured using State-Trait Anxiety Inventory for Children (STAIC-T), Children Depression Inventory (CDI) and Positive Affect Schedule for children (PANAS-C) at baseline, post-intervention and follow-up (4 months post-intervention)
5. Well-being measured using Subjective Happiness Scale (SHS), Life Orientation Test-Revised (LOT-R) and Positive Affect Schedule for children (PANAS-C) at baseline, post-intervention and follow-up (4 months post-intervention)
6. Quality of life measured using the Paediatric Quality of Life Inventory (PedsQLTM 4.0 Generic Core Scales) at baseline, post-intervention and follow-up (4 months post-intervention)
Overall trial start date
Overall trial end date
Reason abandoned (if study stopped)
Participant inclusion criteria
1. Paediatric cancer survivors 6 to 18 years old
2. ≥ 1yr from diagnosis
3. Have been exposed to radiotherapy or chemotherapy
4. Not currently receiving treatment for cancer
Target number of participants
A minimum of 102 participants (51 per group)
Participant exclusion criteria
1. Simultaneous participation in another study
2. Previous diagnosed anorexia nervosa/bulimia; known pregnancy, alcohol or drug abuse
3. Children requiring chronic oral glucocorticoid therapy or pharmacologic agents for reduced BMD other than calcium or vitamin D
4. Presence of an injury (before inclusion) that may affect daily life activities and can be aggravated by exercise
5. Have a lower limb prosthesis
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Virgen de las Nieves Hospital
Ribera del Beiro, s/n
Trial participating centre
Reina Sofía Hospital
Menendez Pidal, s/n
Trial participating centre
Regional University Hospital of Málaga
Arroyo de los Ángeles, s/n
“la Caixa” Foundation
Caixa Foundation, Fundación Caixa, “la Caixa”, Fundación Bancaria Caixa d’Estalvis i Pensions de Barcelona
Funding Body Type
private sector organisation
Funding Body Subtype
Trusts, charities, foundations (both publically funded and privately funded)
Results and Publications
Publication and dissemination plan
The exploitation of iBoneFIT results will concern the following steps: (i) identifying the exploitable results, (ii) identifying the best exploitation strategy for every result, (iii) monitoring the market needs and the target users, and (iv) establishing a good communication channel among industry, academia and market. The host institution will consider open source exploitation strategies in order to gain visibility. The Research and Knowledge Transfer office (OTRI) (http://otri.ugr.es/), provides professional support for researchers, evaluating the research and outputs and managing the University research’s strategy. iBoneFIT will promote Open Access publications, according to the 2003 Berlin Declaration. Publications will be uploaded to the Universities open access repositories.
IPD sharing statement:
The datasets generated during and/or analysed during the current study are not expected to be made available due to confidentiality.
Intention to publish date
Participant level data
Available on request
Basic results (scientific)