BACKGROUND:Despite strong evidence supporting exercise in oncology, real-world data on its feasibility and effectiveness across cancer types remain limited. The CHOiCE (Choose Health: Oncological patients Centered Exercise) study aimed to evaluate a flexible, patient-centered exercise program in routine clinical practice. MATERIALS AND METHODS:This prospective cohort study enrolled 180 adult patients undergoing treatments. Participants completed a 12-week program combining aerobic and resistance training, delivered in person, at home, or hybrid. Primary outcomes were recruitment rate, adherence, dropout, and safety. Secondary outcomes included physical fitness, quality of life, and physical activity. Subgroup analyses explored responses by cancer type, stage, treatment, and delivery mode. RESULTS:Recruitment rate was 82%, with a median attendance of 88%. The dropout rate was 32%, mainly due to personal reasons or disease progression. No serious adverse events were reported. Significant improvements were observed in the six-minute walk test (+39 m, P < .001), leg press strength (+7.1 kg, P < .001), handgrip strength (+1.0 kg, P = .003), and flexibility tests (P < .05). Quality of life improved in physical, role, emotional, and social functioning. Fatigue, nausea, dyspnea, insomnia, and appetite loss were significantly reduced. Patients with gastrointestinal cancer, stage III-IV disease, or undergoing chemotherapy showed the largest gains. CONCLUSION:A patient-centered exercise program for patients with cancer is feasible and effective in a real-world setting. These findings support integrating tailored exercise into routine oncology care. TRIAL REGISTRATION:NCT04226508.

Background/Objectives: Hematological cancers encompass a collection of heterogeneous conditions. The need for repeated treatments and prolonged hospitalization leads to a decrease in health-related quality of life. This systematic review and meta-analysis evaluate the effect of exercise interventions on functioning scales, global health status, and symptoms in patients with hematological cancers. Methods: PubMed, Web of Science, and Scopus databases were systematically screened, and randomized controlled trials were included. The primary outcome was health-related quality of life assessed through the European Organization for Research and Treatment of Cancer Quality of Life questionnaire. Meta-analysis was performed using a random-effects model and 95% confidence intervals. Results: A total of 14 trials involving 837 patients with mixed cancer types were included. Most studies evaluated exercise interventions during hospitalization, with aerobic and resistance training at moderate intensity being the most common modalities and adherence rates ranging from 28% to 100%. Exercise programs significantly improved physical (SMD 0.23; 95% CI: 0.06 to 0.40; p = 0.008), emotional (SMD 0.19; 95% CI: 0.03 to 0.36; p = 0.020) and cognitive functioning (SMD 0.20; 95% CI: 0.02 to 0.37; p = 0.026), and global health status (SMD 0.24; 95% CI: 0.03 to 0.46; p = 0.027). Significant reductions were observed in fatigue (SMD −0.33; 95% CI: −0.52 to −0.14; p = 0.001), pain (SMD −0.34; 95% CI: −0.53 to −0.15; p = 0.000), and insomnia (SMD −0.22; 95% CI: −0.41 to −0.03; p = 0.024). Heterogeneity was minimal across most domains, suggesting consistent findings. Conclusions: Exercise interventions are effective in enhancing functioning scales and global health status and reducing symptom burden in patients receiving intensive treatments. Future research is required to explore the long-term effects of exercise and develop tailored programs for specific hematologic malignancies and treatment settings.

Whereas an exercise intervention effectively improves patients’ quality of life, little information is available about the contribution of each physical fitness component. This study aims to explore the association between physical fitness components and the quality-of-life domain in patients with cancer. Between September 2021 and August 2023, 160 patients with mixed cancer types visiting the Oncology Unit were selected on a consecutive basis according to selection criteria. They underwent a comprehensive baseline assessment including the six-minute walking test, the handgrip strength test, the isometric leg press test, the back scratch, sit and reach tests, their waist–hip ratio, and their body mass index. The European Organization for Research and Treatment of Cancer Quality of Life and Core Questionnaire was used to measure the quality of life. The sample size was based on the use of regression models to study associations between clinical characteristics and fitness outcomes. All of the analyses were performed using the SPSS v.25 statistical package. Patients had a mean age of 58 years, 68% were female, 42% were affected by breast cancer, and all were receiving anticancer treatments. Higher functional capacity was associated with better global health status (p < 0.0001) and physical (p < 0.0001), role (p < 0.0001), emotional (p = 0.026), and social function (p = 0.016) and inversely linked with fatigue (p = 0.001). Lower-limb flexibility was significantly associated with all of the domains except for role and social functions. The waist–hip ratio was inversely associated with physical function (p < 0.0001) and positively related to fatigue (p = 0.037). Exercise programs aiming to improve the quality of life in cancer should be addressed to optimize these fitness components.

BACKGROUND:Pediatric obesity represents one of the most important public health challenges and its prevalence significantly increased during the COVID-19 pandemic. Our prospective study aimed to assess the feasibility of a remote adapted physical activity (PA) intervention and its effectiveness in improving anthropometric indices, metabolic health parameters, as well as cardiopulmonary function and fitness in adolescents with obesity. METHODS:A PA intervention involving synchronous online lessons combined with asynchronous sessions and promotion of independent PA and "active breaks" to interrupt prolonged sedentary behaviors was proposed to 20 adolescents aged 11-17 years with obesity over a 4-month period. Clinical and anthropometric parameters (weight, height, waist, body composition, blood pressure), metabolic parameters (glycemia, insulinemia, glycated hemoglobin, oral glucose tolerance test [OGTT], lipid profile, presence of hepatic steatosis), cardiopulmonary function and fitness indices (VO2max, six-minute walking test [6MWT], upper and lower limb strength test) were evaluated before and after the intervention. RESULTS:Twenty adolescents with obesity were enrolled (11 male [55%], aged 14.1±1.5 years, BMI SDS 3.1±0.5). Eighteen participants (90%) successfully completed the project, and no adverse events were reported. We observed an increase in cardiovascular and muscle fitness [higher VO2peak, maximal workload, better performance at limb strength and 6MWT (all P<0.05)], increased lean body mass (P=0.005), and an improvement of glucose metabolism response with a reduction of insulin concentrations during OGTT (P=0.043). CONCLUSIONS:Participation in the training program was feasible and effective in improving cardiovascular fitness, glucose metabolism, body composition, strength, and endurance in adolescents with obesity during the COVID-19 pandemic.

PURPOSE:Exercise improves quality of life and reduces the side effects of cancer therapies. Nevertheless, attendance to exercise programs remains a challenge for patients. This study explored the feasibility of an exercise program in which women with breast cancer may be allowed to choose among three exercise delivery modalities. METHODS:Forty-seven patients with breast cancer (stage I-IV) participated in a 12-week combined aerobic and resistance training program. The exercise modality was chosen by patients according to their preferences and needs among three options: the personal training program, the home-based program, or the group-based program. Exercise prescription was similar between the three modalities. Whereas the primary endpoint was feasibility, assessed through recruitment rate, attendance, adherence, dropout rate, tolerability, and safety, secondary endpoints included health-related skills and quality of life. RESULTS:Out of 47 recruited patients, 24 chose the home-based program, 19 the personal training program, and four the group-based program. Six dropouts (13%) were registered, and no severe adverse events were recorded. The median program attendance was 98% for personal training programs, 96% for home-based programs, and 100% for group-based programs, whereas compliance resulted in more than 90% in each modality. At postintervention, a significant increase in cardiorespiratory fitness, lower body flexibility, and body weight was observed. Different quality-of-life domains were improved following the intervention, including physical and social functioning, fatigue, and appetite loss. No significant changes in other parameters were detected. CONCLUSIONS:An exercise prescription based on a patient-preferred delivery modality showed high feasibility in women with breast cancer.

BackgroundGross motor coordination (GMC) development could be influenced by age, gender, weight status, geographical area, living setting, home environment, socio-economic status, sports practice.PurposeTo verify whether practicing sports and practicing different sports could influence children's GMC level.MethodsA total of 295 children aged 8–11 years were involved in the study and divided into 5 groups in relation to the sport they practiced: gymnastics group (n = 67; 51F, 16M), cycling group (n = 64; 15F, 49M), athletics group (n = 47; 22F, 25M), swimming group (n = 35; 20F, 15M), control group (n = 82; 42F, 40M). The four subtests of the Körperkoordinations Test für Kinder (KTK) assessed children's GMC level. The scores from each of the four subtests were summed into the KTK total raw score (RS) and then converted into a gender- and age-specific motor quotient (MQ).ResultsChildren practicing sports showed significantly higher RS and MQ score than children of control group (203.14 ± 38.55 vs. 163.63 ± 43.50 and 98.56 ± 15.79 vs. 83.01 ± 16.71, respectively; p < 0.001). Children practicing gymnastics had a significantly higher RS and MQ than children of cycling, swimming, and control groups (p < 0.05), children of control group had a significantly lower RS and MQ than children of all other groups (p < 0.05). Children practicing gymnastics performed better walking backwards subtest than all other children's groups (p < 0.001). Children of control group performed worse jumping sideways subtest than children of gymnastics, athletics and swimming groups (p < 0.01). Children practicing gymnastics performed better moving sideways subtest than children of athletics, cycling and control groups (p < 0.01); children of control group performed worse than children of all other groups (p < 0.01). Children of control group performed worse hopping for height subtest than children of gymnastics, athletics and cycling groups (p < 0.05); children practicing gymnastics performed better than children of swimming and control groups (p < 0.05).ConclusionsThe performance model and therefore the specialized training that each sport discipline required, could justified the differences in children's GMC level among sports groups. Thus, coaches should plan individualized interventions and choose activity contents to support children's GMC development.

Purpose Physical activity is associated with a reduction in mortality and recurrence risks in patients with cancer. Despite the well-recognized benefits of exercise, patients’ adherence to an exercise program remains a challenge. The present study aimed to assess the experiences of patients with cancer participating in a 12-week exercise program. Methods A total of 21 survivors participated in focus group discussions after the conclusion of the exercise intervention. Semi-structured interview questions were developed according to the theory of the Health Belief Model. Data were analyzed using thematic analysis and categorized into perceived benefits, barriers, and cues to action. Results Patients described a series of benefits achieved during the exercise program, from physical to psychological domains. Treatment-related side effects and logistic factors, including distance from the gym facility, were the most commonly reported barriers to adherence. Concerning cues to action, expected benefits from exercise were the most important reason to participate, while a patient-center program, supervised by skilled experts, highly stimulated patients to complete the program. Conclusion Overall, patients with cancer reported a positive experience participating in a supervised exercise program. A variety of factors influencing participation and adherence were individuated. This study may help design and develop effective and sustainable programs addressing individuals’ needs.

IntroductionGross Motor Coordination (GMC) is crucial for the adequate development of motor competence. Our purpose in this semi-longitudinal study was to evaluate the influence of BMI on GMC in children and pre-adolescents of both sexes, across school years (classes).MethodsWe evaluated 117 subjects (aged 8–13 years) belonging to three different cohorts for 4 consecutive years, providing data over 6 years (classes). GMC was assessed through the Körperkoordinationstest für Kinder (KTK) test. Class and weight status effects were then evaluated by dividing the subjects into a normal weight group and an overweight group based on their weight status.ResultsA significant increase across classes was found for BMI (p < 0.001) and KTK raw score (p < 0.001) and a decrease was found for KTK normalized score (MQ) (p = 0.043). Significantly lower MQ values were found for girls. Absolute GMC increased across the years and there was no difference between boys and girls. Correlations between GMC scores and BMI were negative and significant in 5 of 6 classes. It was confirmed that overweight subjects had lower MQ and RAW values than normal-weight subjects, with no class-by-weight status interaction.DiscussionThe level of competence and its development are strictly dependent on weight status during childhood and pre-adolescence. The present investigation suggests that the adequate development of GMC requires not only targeted physical education programs but also the promotion of healthy habits aimed at maintaining a normal weight status during childhood and pre-adolescence.

e24045 Background: Growing evidence suggests that physical exercise (EX) may reduce mortality and recurrence risk in patients (pts) with cancer, as well as help in managing cancer treatment side effects and improve quality of life (QoL). Despite these well-recognized benefits, most pts are insufficiently active, and compliance with the EX intervention is often challenging. This pilot study aimed to evaluate the safety, feasibility, and preliminary efficacy of a 3-month EX-intervention in pts with cancer. Methods: A pilot, two-center randomized controlled trial was conducted on pts with different cancers at early stages. Pts allocated in the 3-month EX intervention participated in bi-weekly aerobic and resistance training tailored to the patient's baseline condition and preferences. The duration of aerobic training progressively increased over weeks, whereas the resistance component consisted of body weight or elastic-bands exercises performed in 2-3 sets of 8-12 repetitions. EX intensity was moderate and monitored using the 10-point Borg Rating of the Perceived Exertion Scale. Pts randomized to control received usual care. Primary study endpoints were safety, monitored through the Common Terminology Criteria for Adverse Events (AEs), and feasibility, evaluated through recruitment rate, adherence, and withdrawals. Secondary endpoints included functional capacity, using the Six minutes walking test, and muscle strength, with the handgrip and leg press test. European Organization for Research and Treatment of Cancer Quality of Life and Core Questionnaire (EORTC- QLQ-C30) was used to assess the QoL. Descriptive statistics was applied, and repeated-measures analysis of variance was used to evaluate within- and between-group differences. Results: With a 38% recruitment rate, 57 pts were randomized (56 years; 68% breast, 14% colorectal) to the EX-intervention (n = 37) and controls (n = 20). Five dropouts occurred, n = 3 in the EX-group (leukemia onset n = 1, psychiatric disorder n = 1, gonarthrosis n = 1), and n = 2 in the controls (lack of interest n = 2). Adherence to EX-sessions was high, 93%. Concerning safety, three AEs were reported: worsening in the lymphedema, Grade 1 (n = 2), and elbow inflammation, Grade 1. Compared to the controls, EX-group reported a significant increase in functional capacity (within group, p < 0.01), and lower limb strength (within and between group, p < 0.01). Regarding QoL, EX produced enhancements in social function (within group, p < 0.05), fatigue (within group, p < 0.05), nausea and vomiting (within group p < 0.01), dyspnea (within group, p < 0.05), insomnia (within group, p < 0.05), and loss of appetite (within group, p < 0.01). Conclusions: Preliminary findings support the feasibility of a combined aerobic and resistance EX in pts with cancer with minimal AEs. Moreover, improvements in physical parameters and some domains of QoL were detected. Clinical trial information: NCT04226508 .

To assess the psychometric properties of the consideRATE questions, a measure of serious illness experience.We recruited people at least 50 years old via paid panels online, with US-Census-based quotas. We randomized participants to a patient experience story at two time points. Participants completed a series of measures, including the consideRATE questions. We assessed convergent (Pearson's correlation), discriminative (one-way ANOVA with Tukey's test for multiple comparisons) and divergent (Pearson's correlation) validity. We also assessed intra-rater reliability (intra-class correlation) and responsiveness to change (t-tests).We included 809 individuals in our analysis. We established convergent validity (r = 0.77; p < 0.001); discriminative validity (bad/neutral stories [mean diff=0.4; p < 0.001]; neutral/ good stories [mean diff=1.3; p < 0.001]) and moderate divergent validity (r = 0.57; p < 0.001). We established sensitivity to change in all stories (bad/good [mean diff=1.52; p < 0.001]; good/bad [mean diff= −1.68; p < 0.001]; neutral/bad [mean diff= −0.57; p < 0.001]; good/neutral [mean diff= −1.11; p < 0.001]; neutral/good [mean diff= 1.1; p < 0.001]) but one (bad/neutral [mean diff= 0.4; p < 0.07]). Intra-rater reliability was demonstrated between time points (r = 0.77; p < 0.001).the consideRATE questions were reliable and valid in a simulated online test.the consideRATE questions may be a practical way to measure serious illness experience and the effectiveness of interventions to improve it.

Delivering physical activity in cancer care requires knowledge, competence, and specific skills to adapt the exercise program to the patients’ specific needs. Kinesiology students could be one of the main stakeholders involved in the promotion of physical activity. This study aims to investigate the knowledge, perception, and competence about exercise in patients with oncological disease in a sample of students attending the Sports Science University. A total of 854 students (13% response rate) from four Italian universities completed the online survey between May and June 2021. About half of the study participants identified the correct amount of aerobic (44%) and strength (54%) activities proposed by the American College of Sports Medicine for patients with cancer. Almost all the students recognized the importance of physical activity in cancer prevention (96%), in the management of cancer before surgery (96%), during anticancer treatments (84%), and after therapies completion (98%). On the contrary, they reported a lack of university courses dedicated to cancer diseases, psychological implications, and prescription of physical activity in all types of cancer prevention. Overall, few students felt qualified in delivered counseling about physical activity and individual or group-based exercise programs in patients with cancer. Logistic regression revealed that the students attending the Master’s Degree in Preventive and Adapted Physical Activity were more likely to have knowledge and competence than other students. The present study suggests that kinesiology universities should increase the classes and internships about exercise oncology to train experts with specific skills who are able to adequately support patients in their lifestyle modification.

This study was aimed (i) to examine the effect of living setting (rural vs. urban), geographical area (North vs. Center vs. South), and gender (boys vs. girls) on weight status, motor coordination, and physical activity (PA) level of Italian school-age children; (ii) to examine differences in the neighborhood walkability of different school areas from different geographical areas and living settings; and (iii) to examine whether motor coordination, PA level, geographical areas, living setting, neighborhood walkability, and gender could predict children's weight status. We assessed anthropometric parameters, gross motor coordination, and PA level in 1,549 children aged between 8 and 13 years. Results revealed that Central children had higher BMI than Northern and Southern children (η2 = 0.01). Moreover, Northern children showed the highest motor quotient (η2 = 0.148) and PA level (η2 = 0.02), followed by Southern and Central children, respectively. Children from the South of Italy attended schools located in neighborhoods with the highest Walk Score®. Urban children attended schools located in neighborhoods with a higher Walk Score® than rural children. Lower motor quotient (MQ), lower PA level, and living in a rural setting and in a car-dependent neighborhood were associated with a higher relative risk for obesity. Being a girl was associated with a lower relative risk for obesity. The alarming high percentage of overweight and obesity in children as well as motor coordination impairments revealed the urgent need of targeted PA interventions in pediatric population.

Assessment of motor competence (MC) is crucial to finding deficiencies in children's motor development. Because of the need to ensure validity, reliability, and feasibility, the selection of contemporary testing batteries is a difficult task. Many papers report the validity of the KTK test in describing MC in school aged children. KTK consists of 4 four separate items: walking back, jumping sideways, moving sideways, and hopping for height. Some authors suggested the use of a short version of KTK that includes 3 items excluding one subtest: hopping for height. This study aimed to evaluate the effectiveness of short versions of Körperkoordinationstest für Kinder (KTK). A sample of 2,231 participants (boys: n =1,188; girls: n = 1,043; age range: 6–12 years) were recruited from Italian schools between January 2019 and February 2020 and they performed the complete version of KTK. Stepwise linear regression was performed on the dataset to evaluate the ideal number of variables to describe the KTK short form version. Data for both the sexes and all ages indicated that considering the item combinations of each short version, the highest R squares were obtained in those that included exactly the deleted subtest (ranging from 0.881–0.979). The adoption of a short form does not seem to provide a fully satisfactory condition for measuring MC in children 6–12 years.

Coronavirus disease (COVID-19) infection has caused morbidity and mortality at an unprecedented scale [1]. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel beta coronavirus responsible for new respiratory infections with mild-to-severe presentations in humans. At the beginning of the pandemic, major attention was directed to investigate the acute effect of COVID-19, as well as to identify potential therapeutic and preventive strategies to control the virus spread. More than a year after the first case was described in Wuhan, China, the scientific community faces the long-term impact of this disease. Indeed, subjects affected by COVID-19 may experience various symptoms, such as fatigue, weakness, dyspnea, physical deconditioning lasting more than one month [2]. This condition, recently defined as post-acute COVID-19 syndrome, is characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset symptoms [2]. Patients with cancer receiving systemic anti-cancer treatments are more susceptible to COVID-19, and across the oncological population, patients with lung cancer are the most vulnerable, resulting in higher morbidity and mortality rates [3]. Recent reports found that the mortality rate in patients with cancer affected by COVID-19 was 22.4% [4], whereas, in thoracic malignancies, such percentage increased to 33% [3]. Moreover, oncological patients with COVID-19, particularly those with lung cancer, may be more predisposed to long-term complications and to the development of post-acute syndrome [2]. A recent review advocates the need to expand the knowledge about interventions to manage post-acute COVID-19 syndrome, highlighting that care for patients with COVID-19 does not conclude at the time of the swab negativity but should also be proposed in the outpatient setting, especially for those patients considered more susceptible [2].

Introduction Due to important achievements in terms of diagnostic and therapeutic tools and the complexity of the disease itself, lung cancer management needs a multidisciplinary approach. To date, the classical multidisciplinary team involves different healthcare providers mainly dedicated to lung cancer diagnosis and treatments. Nevertheless, the underlying disease and related treatments significantly impact on patient function and psychological well-being. In this sense, supportive care may offer the best approach to relieve and manage patient symptoms and treatment-related adverse events.Areas covered Evidence reports that exercise, nutrition, smoking cessation, and psychological well-being bring many benefits in patients with lung cancer, from both a physical and socio-psychological points of view, and potentially improving their survival. Nevertheless, supportive care is rarely offered to patients, and even less frequently these needs are discussed within the multidisciplinary meeting.Expert opinion Integrating supportive care as part of the standard multidisciplinary approach for lung cancer involves a series of challenges, the first one represented by the daily necessity of specialists, such as kinesiologists, dietitians, psycho-oncologists, able to deliver a personalized approach. In the era of precision medicine, this is an essential step forward to guarantee comprehensive and patient-centered care for all patients with lung cancer.

Background: The prevalence of overweight and obesity in childhood is increasing at an alarming rate worldwide, particularly in industrialized countries. Walkability measurements can be collected using the free open software Walk Score® that permit the measure of estimating neighbourhood walkability in many geographic locations. This study was aimed i) to investigate whether differences between rural and urban settings in the North, Centre and South of Italy could influence body-weight status, motor competence and physical activity (PA) level in school-age children; ii) to analyse the walkability of different school areas, and iii) to examine the relationship of motor competence, PA level, geographical areas, living setting, and neighbourhood walkability with children’s body-weight status. Methods: We assessed anthropometric parameters, gross motor coordination and PA level in 1549 children aged between 8 and 13 year. Three geographical areas (North, Centre, South of Italy), two settings (urban and rural) and neighbourhoods’ walkability (Walk Score®) were considered in the analysis. Results: The prevalence of overweight and obesity was 22.0% and 9.9%, respectively; 47.9% of the total sample showed motor impairments and 29.0% was inactive. Central children had higher BMI than Northern and Southern children. Northern children showed the highest MQ and PA level, followed by Southern and Central children. Children from the South of Italy attended schools located in neighbourhoods with the highest Walk Score®. Urban children attended schools located in neighbourhoods with a higher Walk Score® than rural children. Lower MQ, lower PA level, living in rural setting and in a car-dependent neighbourhood were associated with a higher relative risk for obesity. Being a girl was associated with a lower relative risk for obesity. Conclusions: The alarming high percentage of overweight and obesity in children as well as motor coordination impairments revealed the urgent need of targeted PA interventions in paediatric population.

Introduction: Cachexia represents a relevant issue in oncological care, which is still lacking effective therapies. Although the incidence of cancer cachexia varies across cancer types, it is responsible for approximately a quarter of cancer-related deaths. The pathophysiology of this syndrome is multifactorial, including weight loss, muscle atrophy and impairment of the pro-/anti-inflammatory balance.Areas covered: Diagnostic criteria and optimal endpoints for cachexia-dedicated trials are still debated, slowing the identification of interventions counteracting cachexia sequaele. The multifaceted features of this syndrome support the rationale for personalized therapy. A multimodal approach is likely to offer the best option to address key cachexia-related issues. Pharmacologic agents, physical exercise, nutritional and psycho-social interventions may have a synergistic effect, and improve quality of life.Expert opinion: A personalized multimodal intervention could be the best strategy to effectively manage cancer cachexia. To offer such a comprehensive approach, a specialized staff, including health professionals with different expertise, is necessary. Each specialist plays a specific role inside the multimodal intervention, with the aim of delivering the best cancer care and access to the most effective therapeutic options for each patient.

Educational health materials may be important tools to increase physical activity in cancer patients. Nevertheless, most of the available resources regarding physical activity for cancer patients were found not suitable, had a low grade of readability, and thus, represent a significant barrier to behavior change. To date, little data about development criteria and evaluation of physical activity resources for cancer before their spread exist. The purposes of this study were (i) to describe the development of a physical activity guidebook designed for cancer patients and (ii) to test its readability and suitability. The guidebook was developed through multi-step passages, including group discussions, a literature review, identification of a motivational theory, and using previous research on exercise preferences, barriers, and facilitators to target the information. Two validated formulae were used to assess the readability, whereas thirty-four judges completed the Suitability of Assessment Materials questionnaire to evaluate the suitability of the guidebook. The guidebook was found readable for patients having at least a primary education, and the judges scored it as "superior" material. Our guidebook, following a rigorous method in the development phase, was considered to be suitable and readable. Further evaluations through clinical trials could investigate its effectiveness for behavior change and its impact on cancer patients.

Although numerous evidences reported a negative correlation between motor coordination (MC) and overweight/obesity in children and adolescents, the interrelationship between age, gender, and weight status is still debatable. Hence, the aim of this cross-sectional study was to examine the association between MC and weight status according to age and gender across childhood and early adolescence in a large sample of Italian elementary and middle school students. A number of 1961 Italian school students (1,026 boys, 935 girls) was stratified in three consecutive age groups (6–7, 8–10, and 11–13 years) and four weight status categories (underweight, normal weight, overweight, and obese) according to Cole's body mass index (BMI) cut-off points for children. MC performance was assessed measuring motor quotient (MQ) with the Körperkoordinationstest für Kinder (KTK). Results showed significantly lower MQ levels in children in overweight (OW) and with obesity (OB) in both sexes for all age groups than peers in normal weight (NW), except in 6–7-year-old boys. Girls in OW and with OB had similar MQ levels across all age groups, while younger boys in OW and with OB showed higher MQ levels than older ones ( p < 0.05). The 6–7-year-old boys showed better MQ levels than girls peers in NW, OW, and with OB, while 8–10-year-old boys in underweight (UW), NW, and OW; and 11–13-year-old boys only in NW ( p < 0.05). No interaction effect was found between age, gender, and weight status on MQ levels. These outcomes showed the negative impact of higher weight status on MC performance according to age and gender, pointing out the importance of planning targeted motor programs that consider these variables to improve MC performance.

The main goal of our cross-sectional research was to determine the current values of gross motor coordination (GMC) of Italian boys and girls between 6 and 13 years of age. Secondary goals were to study gender differences, and the four subtests trend with ages. Results were compared with the references proposed by KTK authors and with similar searches. Anthropometric measurements and KTK data from 2,206 schoolchildren (girls: n = 1,050; boys: n = 1,156) were collected. The KTK raw score (RS) increased with the age of the subjects (r = 0.678; p < 0.001). In 11–13-year-old subjects, the increase in results is less than in younger subjects. RS showed differences by gender (F = 5.899; p = 0.015) and age (F = 269.193; p < 0.001) without interaction gender × age. Motor quotient (MQ) tended to decrease with age (r = −0.148; p < 0.001); it showed differences by gender (F = 79.228; p < 0.001), age (F = 14.217; p < 0.001), and an interaction gender × age (F = 2.249; p < 0.05). Boys showed better performance than did girls in the raw scores of three of four subtests (JS: F = 24.529; MS: F = 9.052; HH: F = 11.105). Girls show better performances than did boys in the WB (F = 14.52). Differences between genders make us believe it appropriate to maintain a differentiated standardization. RS increased with age, and it seems reasonable, therefore, to maintain a GMC age-based normalization. On the contrary, MQ tended to decrease. All this makes us speculate that today's young people accumulate less significant motor experiences over the years compared to those achieved by their peers in the 1970s. Italian data were lower than German references and Belgian results but slightly higher than the Brazilian ones. The comparison among these four searches confirmed a worrying downward trend in GMC and its characterization by geographical and sociocultural areas. Updated parameters of the KTK can provide helpful references to improve policies to support physical activity, sport, and physical education in youth.