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Reviews without quantitative synthesis, those including only observational studies, or interventions where the isolated effect of exercise could not be determined were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>19 systematic reviews with meta-analyses, including 53 primary studies (n=2361 participants), were identified, yielding 80 effect estimates. Attending to the most comprehensive meta-analyses, exercise induced significant benefits on cardiorespiratory fitness (mean difference (MD) 6.92% (95% CI 1.01% to 12.82%)), cognitive function (standardised mean difference (SMD) 0.26 (95% CI 0.08 to 0.44))\u2009and cognitive performance (SMD 0.41 (95% CI 0.17 to 0.65)), with moderate certainty of evidence. Exercise also induced significant benefits on muscle strength (SMD 0.81 (95% CI 0.05 to 1.57)), functional mobility (MD \u22121.17\u2009s (95% CI \u22121.86 to \u22120.49)) and cancer-related fatigue (SMD \u22120.62 (95% CI \u22121.21 to \u22120.03)), although the certainty was low or very low. These effects were observed across meta-analyses focused exclusively on studies conducted during treatment (n=26), after treatment (n=3) or both (n=51). In contrast, no significant effects of exercise were observed for depression, bone mineral density, health-related quality of life, anthropometry or other clinical outcomes (such as mortality, relapse risk and withdrawal rates).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Exercise appears to be a beneficial intervention in childhood cancer for improving some physical, cognitive and psychosocial outcomes. However, more high-quality research is warranted to strengthen clinical recommendations and inform personalised exercise prescriptions, given that the certainty of evidence remains variable and overall low across outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD420251031412.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2025-110756","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T19:40:15Z","timestamp":1773862815000},"page":"738-747","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Grading the evidence on the effects of exercise interventions in children and adolescents during and beyond cancer treatment: an umbrella review of systematic reviews with meta-analyses"],"prefix":"10.1136","volume":"60","clinical-trial-number":[{"clinical-trial-number":"isrctn85913225","registry":"10.18810\/isrctn"},{"clinical-trial-number":"nct04070131","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5544-887X","authenticated-orcid":false,"given":"Samuel","family":"Ruiz-Campos","sequence":"first","affiliation":[{"name":"Department of Education, Faculty of Education Sciences, University of Almer\u00eda, Almer\u00eda, Spain"},{"name":"SPORT Research Group (CTS-1024), CIBIS (Centro de Investigaci\u00f3n para el Bienestar y la Inclusi\u00f3n Social) Research Center, University of Almer\u00eda, Almer\u00eda, Spain"},{"name":"Biomedical Research Unit, Torrecardenas University Hospital, Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2368-1772","authenticated-orcid":false,"given":"Joaquin","family":"Sanchez-Gomez","sequence":"additional","affiliation":[{"name":"SPORT Research Group (CTS-1024), CIBIS (Centro de Investigaci\u00f3n para el Bienestar y la Inclusi\u00f3n Social) Research Center, University of Almer\u00eda, Almer\u00eda, Spain"},{"name":"Biomedical Research Unit, Torrecardenas University Hospital, Almer\u00eda, Spain"},{"name":"Department of Nursing, Physiotherapy and Medicine, Universidad de Almeria, Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9297-1028","authenticated-orcid":false,"given":"David","family":"Ruiz-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Education, Faculty of Education Sciences, University of Almer\u00eda, Almer\u00eda, Spain"},{"name":"SPORT Research Group (CTS-1024), CIBIS (Centro de Investigaci\u00f3n para el Bienestar y la Inclusi\u00f3n Social) Research Center, University of Almer\u00eda, Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3631-0310","authenticated-orcid":false,"given":"Ana","family":"Le\u00f3n-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Cell Biology, Genetics and Physiology, Faculty of Sciences, University of M\u00e1laga, M\u00e1laga, Spain"},{"name":"Biomedical Research Institute of M\u00e1laga - IBIMA BIONAND Platform, M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2507-6015","authenticated-orcid":false,"given":"Juan Luis S\u00e1nchez","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Institute of Aging, Toulouse University Hospital, Toulouse, France"},{"name":"IHU HealthAge, Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7125-4970","authenticated-orcid":false,"given":"Andrea","family":"Rodriguez-Solana","sequence":"additional","affiliation":[{"name":"Department of Education, Faculty of Education Sciences, University of Almer\u00eda, Almer\u00eda, Spain"},{"name":"SPORT Research Group (CTS-1024), CIBIS (Centro de Investigaci\u00f3n para el Bienestar y la Inclusi\u00f3n Social) Research Center, University of Almer\u00eda, Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4626-420X","authenticated-orcid":false,"given":"Alberto","family":"Soriano-Maldonado","sequence":"additional","affiliation":[{"name":"Department of Education, Faculty of Education Sciences, University of Almer\u00eda, Almer\u00eda, Spain"},{"name":"SPORT Research Group (CTS-1024), CIBIS (Centro de Investigaci\u00f3n para el Bienestar y la Inclusi\u00f3n Social) Research Center, University of Almer\u00eda, Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8783-1859","authenticated-orcid":false,"given":"Borja","family":"Mart\u00ednez-Tellez","sequence":"additional","affiliation":[{"name":"SPORT Research Group (CTS-1024), CIBIS (Centro de Investigaci\u00f3n para el Bienestar y la Inclusi\u00f3n Social) Research Center, University of Almer\u00eda, Almer\u00eda, Spain"},{"name":"Biomedical Research Unit, Torrecardenas University Hospital, Almer\u00eda, Spain"},{"name":"Department of Nursing, Physiotherapy and Medicine, Universidad de Almeria, Almer\u00eda, Spain"},{"name":"CIBER de Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1730-3369","authenticated-orcid":false,"given":"Pedro L","family":"Valenzuela","sequence":"additional","affiliation":[{"name":"Department of Systems Biology, University of Alcal\u00e1, Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3255-3246","authenticated-orcid":false,"given":"Javier S","family":"Morales","sequence":"additional","affiliation":[{"name":"Department of Education, Faculty of Education Sciences, University of Almer\u00eda, Almer\u00eda, Spain"},{"name":"SPORT Research Group (CTS-1024), CIBIS (Centro de Investigaci\u00f3n para el Bienestar y la Inclusi\u00f3n Social) Research Center, University of Almer\u00eda, Almer\u00eda, Spain"},{"name":"Biomedical Research Unit, Torrecardenas University Hospital, Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"2026050508050810000_60.10.738.1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21871"},{"key":"2026050508050810000_60.10.738.2","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1001\/jamaoncol.2019.5582","article-title":"Life Expectancy of Adult Survivors of Childhood Cancer Over 3 Decades","volume":"6","author":"Yeh","year":"2020","journal-title":"JAMA Oncol"},{"key":"2026050508050810000_60.10.738.3","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.critrevonc.2019.07.008","article-title":"Is health status impaired in childhood cancer survivors? 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