Effectiveness of exergaming in reducing cancer-related fatigue among children with acute lymphoblastic leukemia: a randomized controlled trial

Figures & data

Figure 1. Procedure of data collection.

Table 1. Demographic and clinical characteristics.

Characteristics	Total	Group-I	Group-II	p
N (%)	45 (100%)	22 (48.90%)	23 (51.10%)
Gender
Boys	25 (55.60%)	12 (26.70%)	13 (28.90%)	1.00
Girls	20 (44.40%)	10 (22.20%)	10 (22.20%)
Age (year)	9.00 ± 2.35	9.04 ± 2.29	9.04 ± 2.47	.99
Weight (Kg)	31.65 ± 9.18	31.91 ± 9.11	31.40 ± 9.44	.85
Height (cm)	134.91 ± 13.77	135.04 ± 13.75	134.78 ± 14.09	.95
BMI percentile	52.80 ± 27.68	56.00 ± 27.27	49.74 ± 28.33	.45
BMI percentile categories
(˂5th) Under-weight	2 (4.4%)	0 (0%)	2 (4.40%)	.02*
(5th to ˂ 85th) Healthy-weight	37 (82.2%)	18 (40%)	19 (42.20%)
(85th to ˂ 95th) Overweight	4 (8.90%)	4 (8.90%)	0 (0%)
Obese	2 (4.40%)	0 (0%)	2 (4.40%)
Diagnosis
HR ALL	32 (71.10%)	17 (37.80%)	15 (33.30%)	.37
SR ALL	13 (28.90%)	5 (11.10%)	8 (17.80%)
Chemotherapy Phase (all phases included the use of Methotrexate and/or Vincristine)
Induction	6 (13.30%)	2 (4.40%)	4 (8.90%)	.45
Consolidation	10 (22.20%)	3 (6.70%)	7 (15.60%)
IM	13 (28.90%)	7 (15.60%)	6 (13.30%)
DI	1 (2.20%)	1 (2.20%)	0 (0%)
Maintenance	15 (33.30%)	9 (20%)	6 (13.30%)

Group-I: Intervention group; group-II: control group; N: number, %: percent; BMI: body mass index; HR: High Risk ALL; SR: Standard Risk ALL; IM: Interm-maintenance; DI: Delayed-intensification. Data were presented as Mean ± SD for continuous variables (age, height, and weight), and frequency and percentage for categorical data. The significance level p < .05 was considered. Chi-Square (χ²) p-value was recorded for diagnosis, and Fisher exact test p-value was recorded for BMI percentile and Chemotherapy Phase.

Table 2. Comparison between groups at baseline.

	Variables	Total	Group-I	Group-II	p
CRF	General fatigue	58.19 ± 17.54	61.71 ± 16.98	54.83 ± 17.77	.19
	Sleep/rest fatigue	61.45 ± 18.29	60.42 ± 18.39	62.43 ± 18.54	.71
	Cognitive fatigue	67.10 ± 20.88	68.90 ± 21.07	65.36 ± 20.02	.56
	Total fatigue	62.23 ± 11.45	63.63 ± 11.93	60.90 ± 11.07	.43
Functional capacity/endurance		349 ± 48	357.35 ± 84.09	341.96 ± 45.79	.44
PA		8.55 ± 6.00	9.77 ± 6.44	7.39 ± 5.44	.19
PA level	Active	0 (0 %)	0 (0 %)	0 (0 %)	.19
	Sufficiently active	5 (11.1%)	4 (18.18%)	1 (4.34%)
	Insufficiently Active/Sedentary	40 (88.9%)	18 (81.81%)	22 (95.65%)

Group I: Intervention group; the group-II: control group; N: number; %: percent, Data were presented as Mean ± SD for continuous variables (PA, functional capacity/endurance, CRF including all dimensions) and as frequency and percentage for categorical data (PA level). The significance level p < .05 was considered. The p value of Fisher’s exact test was recorded for the PA level.

Table 3. Between – Within subjects’ ANOVA, on CRF, functional capacity/endurance, and PA (n = 45).

			Intervention effect			Time effect				Interaction effect (time*intervention)
		F	p	η^2	Power	F	p	η^2	Power	F	p	η^2	Power
CRF	General fatigue	16.57	.00***	0.27	0.97	2.41	.11	0.05	0.41	6.68	.00***	0.14	0.84
	Sleep and rest fatigue	2.26	.02*	0.10	0.61	7.81	.00***	0.15	0.94	15.07	.00***	0.26	0.99
	Cognitive fatigue	1.59	.21	0.03	0.23	2.39	.10	0.05	0.42	4.76	.01**	0.10	0.71
	Total fatigue	12.41	.00***	0.22	0.93	16.38	.00***	0.27	0.99	30.82	.00***	0.41	1.00
Functional Capacity/endurance		3.23	.07	0.07	0.42	15.10	.00***	0.26	0.96	16.06	.00***	0.27	0.97
PA		10.10	.00***	0.19	0.87	0.34	.63	0.01	0.09	1.42	.24	0.03	0.24

F: magnitude of effect; Partial eta square (η²) = Effect size conventions: small effect = 0.01, moderate effect = 0.06, and large effect = 0.14. significance level set at <0.05. p = .05*, .01**, .001***.

Table 4. The results of post-hoc comparisons using the Bonferroni test for CRF and functional capacity/endurance over the 3 periods (T1, T2, and T3) within the groups.

	CRF								Functional Capacity/Endurance
	General fatigue		Sleep/rest fatigue		Cognitive fatigue		Total fatigue
	Mean difference		Mean difference		Mean difference		Mean difference		Mean difference
	Group I	Group II	Group I	Group II	Group I	Group II	Group I	Group II	Group I	Group II
T1 vs T2	−7.96	4.65	−10.93***	5.02	−2.65	−4.52	−7.58***	1.91	−17.70***	0.27
T1 vs T3	−14.95***	3.78	−18.89***	2.85	−8.52*	0.88	−14.20***	2.20	−35.40***	0.54
T2 vs T3	−6.98*	−0.87	−7.96*	−2.17	−5.86	5.40	−6.62***	0.29	−17.70***	0.27

Group I: Intervention group; group-II: control group; T1: time at baseline (1^st week); T2: 3rd week; T3: 5^th week. Mean difference between T1 vs T2 = mean score in 1st week – mean score of measurement taken in 3rd week, the mean difference between T1 vs T 3= mean score in 1^st week –mean score of measurement taken in 5^th week, the mean difference between T2 vs T3 = mean score of measurement taken 3^rd weeks – mean score of measurement taken at 5^th week. The significance level was set at <0.05. p = .05*, .01**, .001***. *Refers to pairwise comparison within groups.

Data availability statement

The data supporting this study’s findings are available on request from the corresponding author [A.S]. The data are not publicly available due to their containing information that could compromise the privacy of research participants.