title: Do childhood cancer survivors with physical performance limitations reach healthy activity levels?
abstract: BACKGROUND
  The extent to which physical performance limitations affect the ability of childhood cancer survivors to reach healthy activity levels is unknown. Therefore this study aims to describe the effect of different types of limitations on activity levels in survivors.
  
  
  METHODS
  Within the Swiss Childhood Cancer Survivor Study we sent a questionnaire to all survivors (≥16 years) registered in the Swiss Childhood Cancer Registry, who survived >5 years and were diagnosed 1976-2005 aged <16 years. We measured healthy activity levels using international guidelines and assessed different kinds of performance limitations (visual impairment, weight and endurance problems, cardiorespiratory, musculoskeletal, and neurological problems, pain and fatigue syndromes).
  
  
  RESULTS
  The sample included 1,560 survivors (75% response rate), of whom 209 (13.5%) reported they have performance limitations. Forty-two percent of survivors with limitations reached healthy activity levels, compared to 57% of survivors without limitations. Least active were survivors with vision impairments (25% active), weight and endurance problems (27.3%), cardiorespiratory problems (36.4%), and musculoskeletal problems (43.1%). After adjusting for socio-demographic variables and type of cancer, we found that survivors with limitations were 1.4 (95%CI 1.0-2.0; P = 0.047) times more likely to be inactive.
  
  
  CONCLUSIONS
  Although many survivors with physical performance limitations maintain healthy activity levels, there is room for improvement. Adapted and targeted physical activity counseling for survivors with performance limitations might help them to raise level of activity and pursue a healthy lifestyle.
authors.affiliation: Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. crueegg@ispm.unibe.ch
authors.forename: Corina S
authors.initials: CS
authors.lastname: Rueegg
authors.forename: Micòl E
authors.initials: ME
authors.lastname: Gianinazzi
authors.forename: Gisela
authors.initials: G
authors.lastname: Michel
authors.forename: Nicolas X
authors.initials: NX
authors.lastname: von der Weid
authors.forename: Eva
authors.initials: E
authors.lastname: Bergstraesser
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Kuehni
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009043:Motor Activity; D009369:Neoplasms; D011795:Surveys and Questionnaires; D017741:Survivors; D013557:Switzerland
keywords: childhood cancer cohort study; healthy activity levels; physical activity recommendations; physical performance limitations; questionnaire survey; survivors