The current study was designed to investigate how physical exercise affected postural stability and coordination in children with posterior fossa tumors. during the maintenance phase of treatment, aiming to create a clear and precise understanding of their impairments. The present study included posterior fossa tumor that constitutes a major classification among brain tumor types. This was supported by Packer (1999)19 who stated that Medulloblastoma is the most common malignant brain tumor in pediatric patients and is a significant cause of cancer morbidity in children.
In the current study, choosing the age of children between 5 and 12 years old was in agreement with Eccles (1999)20 who reported that child starting to have a good performance like adult between the age of 5 and 12 years. More attention had to be paid to understand the potentially presenting side effects resulting from the administrated treatment or the disease itself, especially postural stability and coordination problems which were one of the least investigated problems among posterior fossa tumor patients.21
Participation of children with posterior fossa tumor in the rehabilitation program was associated with improved postural stability, coordination, and indirectly affect their overall physical performance of their daily living activities. The current study found improvements in the control group's HUMAC balance and tilt system and BOT-2 scores before and after therapy; that was supported by Mix et al. (2017)22 who revealed evidence that completed rehabilitation programs increase mobility function in patients with brain tumors at a rate equivalent to motor function rehabilitation treatment in those with benign neurological disorders. Participation in a rehabilitation process is also linked to improved execution in day-to-day personal activities in patients with brain tumors.
Core stability exercises improve abdominal muscle workouts which have been suggested as a way to improve spine stability. Using the clinical Pilates approach improves abdominal muscle activation and increases intra-abdominal pressure, which leads to better functional outcomes and overall general activity.23
Regular exercise, in general, may be useful prior to, during, and after cancer treatment. Exercise improves the performance of body and mind, fatigue can be reduced, which can help with depression and anxiety. Exercise maintains or strengthen physical abilities to complete tasks. Muscle strength, bone health, and range of motion can all be improved. Exercise can help achieve and maintain a healthy weight by boosting your immune system and appetite. It also reduces treatment adverse effects and improve quality of life.24
The considerable improvement in the post treatment mean values of the measured variables of the postural stability group was attributed to the influence of postural stability exercises conducted on the HUMAC balance and tilt system. This may be due to the fact that proper balance demands multisystem feedback as well as healthy cerebellar and cognitive functions. The more challenging the work, the more cerebellar control and cognitive ability are assumed to be required.9 HUMAC balance and tilt system workouts are statistically proved to improve postural stability, according to the current study. Balance exercises are safe and useful for developing both static and dynamic balance, as well as enhancing motor skills, kinesthetic awareness, proprioception, and core muscles in youngsters, according to research. Finally, it improves the psychological well-being of cancer patients' children.25
In order to beat cancer, a patient must not only beat the disease, but also deal with the therapy's side effects.26 In the current study, physical activity appears to have beneficial impacts on numerous elements of the disease, its sequelae, and the therapy's side effects, according to emerging research. For example, weaker muscles can be successfully strengthened, and there have been reports of good benefits on fatigue syndrome, a typical side effect of cancer treatment.27
The considerable improvement in the post-treatment mean values of the evaluated variables of the coordination group was attributable to the influence of the Bruininks-Oseretsky Test of Motor Proficiency coordination exercises. This might be due to the fact that coordination training provides a lot of health and well-being benefits for children. It helps them improve their technique and form, as well as their emotions and mental health, and reduces the risk of injury in the future. Coordination exercises can assist in the development of muscle, boost daily energy levels, increase flexibility and agility, improve memory and concentration, and stimulate the release of endorphins (called happy hormones).28,29
Somatosensory, visual, and vestibular information, as well as a completely coordinated neuromuscular system from the motor brain to the spinal cord, are all necessary for inducing a coordinated response. The muscles' speed, distance, direction, timing, and precision are all features of coordinated action. They also have comparable synergistic effects (muscle recruitment), easy reversal between opposing muscle groups (the proper contraction and relaxation sequence), and proximal fixation, which can help with distal movement or posture maintenance.30
From the obtained results of the current study, it can be concluded that Postural stability and coordination improve physical activity in children with posterior fossa tumors.