title: Influences and Barriers on Physical Activity in Pediatric Oncology Patients.
abstract: OBJECTIVE
  To determine the influence of family, peers, school, and physicians on exercise in pediatric oncology patients and evaluate the barriers to physical activity (PA) levels in this population.
  
  
  METHODS
  A search of PubMed and Google Scholar resulted in 12 related articles. The articles were assessed for the influence of school systems, family, peers, self-efficacy, and physicians on exercise. Additionally, barriers and interventions to PA were also assessed. Limitations and research methodologies of each article were also evaluated.
  
  
  RESULTS
  Many school systems were unsure of expectations in regards to PA for their returning students with cancer. Most schools acknowledged willingness to increase exercise for these students; however, there is a communication gap between the medical field and the school system on what expectations should be. Family is associated with increased PA levels and healthier diets in this population with children preferring mothers as exercise partners more than fathers. While physician interventions have been shown to positively impact PA, it has been reported that physicians are not engaging in exercise counseling with their patients.
  
  
  CONCLUSIONS
  Several issues and barriers related to PA in pediatric oncology population were identified. Studies have demonstrated that it is feasible to increase PA and self-efficacy in this population. Further research is needed to better understand and quantify these issues as well as further test the interventions that have been suggested in this review and have been successful in other pediatric populations.
authors.affiliation: Boonshoft School of Medicine, Wright State University , Dayton, OH , USA.
authors.forename: Larrilyn
authors.initials: L
authors.lastname: Yelton
authors.affiliation: Boonshoft School of Medicine, Wright State University , Dayton, OH , USA.
authors.forename: Shalini
authors.initials: S
authors.lastname: Forbis
keywords: childhood cancer; exercise; influence; intervention; pediatric oncology; perspective; physical activity