Heroes in motion - a six-year quality report and patient evaluation of a real-world exercise therapy program in pediatric oncology.

Introduction: Rising survival rates in pediatric oncology underscore the importance of interventions that support short- and long-term bio-psycho-social health. Exercise therapy is now recognized as a key component of tertiary prevention and provides survival benefits. In 2020, the "Heroes in Motion" (HIM) program was established at the Department of Pediatric Hematology and Oncology in Freiburg to provide exercise interventions for patients and their families. This real-world service-based evaluation summarizes six years of program implementation, monitoring, and quality improvement, including patient- and parent-reported satisfaction data. Methods: This multi-method evaluation integrates (a) quantitative data on exercise therapy details combined with structured program documentation and continuous process monitoring (2020-2025) and (b) findings from two satisfaction surveys conducted in 2020 and 2025. Results: A total of 457 patients (age range: 1-24 years) participated in the HIM program over six years. During the evaluation period, 3.860 inpatient and 813 outpatient sessions were completed. Participation covered diverse diagnoses, with increasing family involvement following the introduction of the family-centered outpatient exercise program in 2023. Satisfaction remained consistently high, with 74% ( Discussion: The HIM program proved feasible, safe, and well accepted in a real-world pediatric oncology setting. Ongoing structural development and increasing family involvement emphasize the relevance of exercise therapy within supportive care. Future efforts will focus on establishing a multimodal, family-centered program as part of routine clinical practice.