A Nationwide Children's exercise program aides in recovery for pediatric-cancer survivors.

Ryan Hardy was diagnosed with a brain tumor in 2002 when he was 2 years old. During the next six years, he underwent chemotherapy, radiation and steroid treatments and had three surgeries to remove portions of the tumor as it grew. Then, in late 2008, doctors discovered he had leukemia, which required more than three years of chemotherapy.

It's more than any child should have to endure, but the story has a happy ending. Ryan had his final chemo treatment at Nationwide Children's Hospital in April 2012. After 10 years, his cancers are in remission. Ryan can get on with his life.

Getting on with life, though, is no small task after spending all those years fighting cancer. Ryan's body is playing catch-up.

"Our average person who's been on treatment for many months or years, they come off of that treatment with their weight higher than they should be," said Dr. Randal Olshefski, section chief of Hematology, Oncology and Bone Marrow Transplantation at Nationwide Children's Hospital. "They haven't had much exercise or activity. It's been quite a sedate lifestyle for quite a long time. So they're just de-conditioned when it comes to getting back into typical sports-related activities."

When a child is diagnosed with cancer, the last thing on anyone's mind is recovery. Initially, say the experts, it's about coming to grips with a devastating diagnosis, then figuring out how to treat it. The goal is to beat the cancer.

Fortunately, more and more kids like Ryan are beating cancer. Recovery, while cause for celebration, presents its own set of challenges. Acclimating to life as a survivor is no walk in the park. In fact, even for a cancer-free child, a literal walk in the park may not be possible for some time.

"A fair number of our patients want to get back involved in sports," Olshefski said. "Most of them want to high jump and run up and down the court, and most of them just aren't physically ready to do that."

Travis Gallagher, an athletic trainer in the Sports Medicine department at Nationwide Children's, saw the need for a program to help pediatric-cancer survivors like Ryan drop weight and regain balance and agility. Through a partnership with the Oncology department, he helped develop an eight-week exercise program called Play Strong.

Since February 2012, Gallagher has worked with nearly 10 kids in the Play Strong program. At the Nationwide Children's Westerville facility, you'll see kids working with dumbbells and stability balls, but Gallagher also mixes up the workouts with a variety of exercises using balloons, elastic bands, heavy ropes and even a TV equipped with a Kinect for Xbox 360.

"I try to disguise working hard with play and games," Gallagher said. "How many kids you know want to get on a treadmill?"

Gallagher worked with Ryan for two eight-week sessions last year. During Ryan's medical treatment, the disease and drugs had taken away much of his strength, balance and agility. He had also gained weight, at one point going from 60 to 120 pounds in one year. But like any kid, Ryan wants to play sports. He loves lacrosse, basketball and names football as his favorite. So Gallagher used that interest to motivate Ryan and make his workouts more fun. They threw and caught the football, crouched like quarterbacks, and moved from side to side like linemen.

Ryan, Gallagher said, didn't need much motivation. If anything, Gallagher had to hold him back. He recalled holding Ryan's hand as the boy walked up steps, jumped and tried to stick the landing.

"Then [Ryan] goes, 'Can you not hold my hand on the next one?'" Gallagher said.

Play Strong builds confidence for the parents as much as the kids. After taking care of a sick child for so long, parents "just want to wrap them in bubble wrap and hold them tight," Gallagher said.

Ryan's mother, Laurie Hardy, said Play Strong helped her to see what physical activities her son was capable of doing.

"Usually I would sit at the window and watch him if he's playing basketball across the street," she said. "Now I'm like, 'Go play basketball,' and I don't feel like I have to be right there watching to make sure he's OK."

Play Strong isn't the end of the road for survivors like Ryan. But it points them in the right direction, Gallagher said.

"Coming here once or twice a week isn't going to do it," Gallagher said. "A lot of what I'm doing is giving them homework. At home, they have their habits of not being active. It takes time to change any habit. It takes a conscious effort."

In the old days of pediatric cancer, Olshefski said, "the primary goal was to cure the child, and anything that happened after the fact, you just let the parents figure it out on their own."

Now, with a program like Play Strong, Ryan and his family don't have to walk down that recovery road alone.

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