PURPOSE: Posterior fossa brain tumors (PFBT) survivors experience a plethora of disease- and treatment-related complications that can persist into adulthood. Therapeutic exercise programs can improve quality of survivorship; however, little is known about the feasibility and acceptability of therapeutic exercise in pediatric survivors of PFBT.

METHODS: PFBT survivors, aged 5-17 years (N = 9, mean age = 10.9 ± 3.8 years; 77% male), who underwent surgery at least 12 months earlier and completed radiation and/or chemotherapy at least six months prior, received weekly individualized, goal-directed exercise therapy delivered face-to-face for 12 weeks, supplemented by a home-based program. Adherence was assessed as the percentage of planned exercise sessions completed within a 16-week intervention window. Acceptability was assessed using an online survey and semi-structured interviews with children and parents. Interview transcripts were imported into NVivo for coding and analysis. Transcripts were coded by two independent coders, until agreement was reached. An inductive content analysis was undertaken.

RESULTS: The adherence rate for exercise sessions was 88%, with a study attrition rate of 5.3%. All participating families (100%) rated the face-to-face exercise sessions and the accompanying home-based program as “helpful” or “very helpful”, with 71% of participants reporting that the program was “not too burdensome”. In the semi-structured interviews, five content categories emerged: (1) participant changes, (2) duration, frequency, and location, (3) activity selection, (4) support to participate, and (5) options for technology. Overarching all findings was a general positive sentiment of the program. Specifically, children and their parents discussed preferring home- and community-based locations, valuing games- and sports-based exercise, and favouring in-person modalities. Children and parents were divided as to whether they preferred the exercise program closer to medical treatment or further into survivorship. All children reported improvements in movement skills or confidence.

CONCLUSION: The PACTS goal-directed exercise program is highly feasible and acceptable in pediatric survivors of PFBT and families. Supported by Children’s Hospital Foundation (CCABCR010)