Bridging Borders in Pediatric Oncology: Cross-Regional Insights into Physical Exercise Program Perceptions in Europe, North Africa, and Arab Countries

Abstract Structured physical exercise programs (PEPs) in pediatric oncology have shown benefits for physical, psychosocial, and cognitive outcomes, yet their integration into routine care varies globally. This study explores health care professionals' perceptions of PEPs across European, North African, and Arab pediatric oncology centers, comparing attitudes between centers with and without established programs, based on findings from an international survey. A validated, 14-item, multilanguage questionnaire was distributed to health care professionals involved in pediatric oncology care, including physicians, nurses, physiotherapists, and sport therapists. Responses from 575 professionals (367 European; 208 North African/Arab) were analyzed, comparing perceptions according to region, profession, and PEPs availability at their centers. Overall, 97% of respondents with PEPs experience and 91% without considered PEPs beneficial. Perceived benefits extended beyond endurance and strength to mood, self-esteem, and quality of life, particularly among those with prior PEP exposure. European centers without PEP prioritized physical rehabilitation, whereas North African/Arab centers emphasized psychosocial benefits. Significant differences emerged regarding timing, setting, and relationship to physiotherapy. Most favored integrating PEP into standard care, with stronger support among experienced respondents. Across regions, health care professionals recognize PEP as a valuable adjunct in pediatric oncology. Cultural norms and resource availability shape program focus, with European centers leaning toward physical rehabilitation and North African/Arab centers prioritizing psychosocial support. Findings highlight the need for balanced, context-sensitive strategies that integrate both physical and psychosocial elements, ensuring equitable access and optimized patient outcomes in diverse health care settings.