Physical activity, health-related fitness, and physical performance in children with acquired hypothalamic dysfunction

Purpose: Survivors of a pediatric suprasellar tumor may suffer from hypothalamic-pituitary dysfunction (HD), which may result in hypothalamic obesity (HO). The first step in HO treatment is lifestyle intervention (e.g. exercise). Our aim was to assess physical activity (PA), health-related fitness (HRF) and physical performance (PP) in a cohort of children with a suprasellar tumor. Methods: Retrospective study on a national cohort including all children with a suprasellar tumor who were referred to the physiotherapy department 2018—2022. Data was collected on: PA defined as minutes of Moderate-to-Vigorous Physical Activity (MVPA) and number of steps per day, HRF defined as body composition, VO₂peak percentage of predicted, mean power, and muscle strength, and PP based on the 10-m walk and run test, time up and down the stairs, and time to rise from the floor. Results: Seventy-three children (mean age 11.09, mean body mass index SDS 2.36) were evaluated. In total, 24.1% reached the guideline of ≥ 60 min MVPA per day. The VO₂peak percentage of predicted was 71.0% [IQR 57.0 – 82.8] and in 58.3% mean power was ≤ -2 SDS. Muscle strength was not decreased (median of -0.5 SDS). PP was found to be better than the norm. Conclusion and key findings: PA and HRF are decreased in children with HD, however PP was not decreased. This implies that no PP restrictions are present to engage in PA and that a lifestyle coach can be involved to improve PA and HRF in these children.