title: Effects of a home-based exercise program on metabolic risk factors and fitness in long-term survivors of childhood acute lymphoblastic leukemia.
abstract: BACKGROUND
  Long-term survivors of childhood acute lymphoblastic leukemia (ALL) have increased risk of cardiovascular disease (CVD). The prevalence of insulin resistance and other cardiometabolic risk factors is increased in ALL survivors, and insufficient physical activity (PA) and low cardiopulmonary fitness are common. The purpose of this study was to evaluate the effects of a simple, inexpensive home-based exercise program on cardiometabolic risk factors and fitness in long-term ALL survivors.
  
  
  METHODS
  Seventeen 16- to 30-year-old survivors of childhood ALL (age at diagnosis ≤16 years) were recruited to a 16-week home-based exercise program. Peak oxygen uptake (VO(2 peak)), muscle strength, and metabolic risk factors were studied before and after the exercise program.
  
  
  RESULTS
  Fasting plasma insulin (P = 0.01), HOMA-IR (homeostasis model assessment, insulin resistance) (P = 0.002), waist circumference (P = 0.003), waist-to-hip ratio (P = 0.002), fat percent (P = 0.04), and supine diastolic blood pressure (P = 0.03) decreased during the program, while weight and body mass index remained unchanged. VO(2 peak) and maximal work load (W/kg) improved by 5% (P = 0.01 and P = 0.02, respectively) during the exercise program. The results of the Sit-Up test, Back extensor test, and Full Squatting test improved as well (P = 0.01, P = 0.002, and P = 0.0004, respectively).
  
  
  CONCLUSIONS
  A simple home-based exercise program was effective in improving cardiometabolic risk factor status and fitness in young adult survivors of childhood ALL. Simple exercise programs should be recommended to this population with increased risk of CVD to improve metabolic risk factor status and fitness.
authors.affiliation: Department of Pediatrics, Turku University Hospital, Turku, Finland. liisa.jarvela@utu.fi
authors.forename: Liisa S
authors.initials: LS
authors.lastname: Järvelä
authors.forename: Jukka
authors.initials: J
authors.lastname: Kemppainen
authors.forename: Harri
authors.initials: H
authors.lastname: Niinikoski
authors.forename: Jarna C
authors.initials: JC
authors.lastname: Hannukainen
authors.forename: Päivi M
authors.initials: PM
authors.lastname: Lähteenmäki
authors.forename: Jukka
authors.initials: J
authors.lastname: Kapanen
authors.forename: Mikko
authors.initials: M
authors.lastname: Arola
authors.forename: Olli J
authors.initials: OJ
authors.lastname: Heinonen
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D015444:Exercise; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D053580:Muscle Strength; D010100:Oxygen / Q000097:blood; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma; D012307:Risk Factors; D017741:Survivors; D013997:Time Factors
chemical_list: D007328:Insulin; D010100:Oxygen