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Introduction: Engaging in physical activity (PA) during cancer treatment benefits a child’s physical and mental well-being (McLaughlin et al., 2021). However, engaging in PA may be challenging due to treatment and disease-related pain (Uhl et al., 2020). Pediatric cancer research has primarily focused on management of procedural and chronic pain, with fewer studies examining how pain may interfere with PA during treatment (Clews et al., 2022). The current study qualitatively investigated the impact of pain on PA using a biopsychosocial framework in a sample of youth with acute lymphoblastic leukemia (ALL).

Method: Caregivers (N=17) of a child diagnosed with ALL within the last 12-months and on active treatment completed a semi-structured interview about perceptions of their child's health behaviors during ALL treatment. This analysis focused specifically on discussion of their child’s PA and sedentary time. Thematic analysis followed Braun and Clark’s 6-step framework (2006) to identify themes of caregiver-reported barriers to engaging in PA through a biopsychosocial lens.

Results: Caregivers identified several ways pain impacted PA across the biopsychosocial framework. Key pain-related barriers included: reliance on child’s motivation to be active (psycho/social), distress around seeing their child in pain when resting and being active (social), and fear of interfering with medical equipment (bio/psycho/social). Despite these barriers, caregivers discussed finding creative solutions to adapt activities for their child (e.g., playing with bubbles in bed) (bio/social). Notably, caregivers readily adhered to advice from their medical team. However, caregivers reported that medical advice around PA was highly variable.

Conclusions: The relationship between pain and PA during ALL treatment is complex and influenced by biological, psychological, and social factors. Future directions include understanding factors influencing medical advice on safe and appropriate levels of PA during treatment and supporting caregiver distress to promote child PA during ALL treatment.

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Exploring the Role of Pain on Physical Activity among Youth with Acute Lymphoblastic Leukemia using the Biopsychosocial Model