Exploring physical activity experiences among children and adolescents during and beyond cancer treatment: a meta-synthesis of qualitative research.

Children and adolescents diagnosed with cancer experience negative effects during and beyond treatment that span physical, psychosocial, and cognitive domains. Physical activity (PA) is a feasible, safe, and recommended strategy to mitigate many of the negative effects. As PA continues to gain attention as a positive health behaviour, systematic synthesis and integration of the accumulating body of qualitative research is necessary to gain a deeper and more nuanced understanding of this population’s experiences with PA and to support future intervention/program design and implementation efforts. The objectives of this meta-synthesis were to: (i) identify and describe findings from articles qualitatively exploring PA experiences among children and adolescents diagnosed with cancer, (ii) integrate, compare, and contrast findings to clarify patterns and develop an overarching narrative, and (iii) identify knowledge gaps to inform recommendations for future research and practice. A meta-study methodology was adopted, and three electronic databases were searched (initial search on May 19, 2023, search update on April 7, 2025). Two researchers screened citations against pre-defined eligibility criteria and extracted data from included articles. Reporting completeness was assessed using a standard qualitative reporting checklist and data were analyzed using meta-method, meta-theory, and meta-data analyses. Database searching identified 5061 unique references, of which 27 met eligibility criteria and were included herein (n = 798 participants; range = 3-128 participants). Reporting completeness ranged from ‘poorly reported’ to ‘well-reported’. Most articles were experimental (n = 14), few specified the qualitative methodology used (n = 8), and fewer reported adopting a guiding theory/model (n = 7). Interviews were the most common data collection approach (n = 20). Across articles, six themes (with additional subthemes) were identified and organized into two overarching categories to highlight dominant ideas: (i) PA experiences and (ii) influencing factors. Summarized data collectively highlighted the varied influences that can shape motivation for and engagement in PA, the complex interplay between cancer and PA experiences, and the range of potential benefits–spanning physical, emotional, and social domains–that PA may confer. Future efforts should prioritize methodological rigor, theoretical integration, and co-designed approaches to ensure that PA opportunities are accessible, meaningful, and feasible for this population.