2.1 Participants
This preliminary study reports on 12 childhood cancer patients or survivors (ages 5–17, 5 female) recruited from the Children’s Hospital of Michigan Hematology/Oncology clinic (Detroit, MI) and from local cancer support groups and organizations (e.g., Kids Kicking Cancer, Gilda’s Club of Metro Detroit). Data were collected from August 2017 through January 2019 as a part of a larger prospective study examining the effects of a martial arts-based program, Kids Kicking Cancer (www.kidskickingcancer.org), on pain, emotional distress, and health-related quality of life among children with cancer (Supplemental Methods 1.1). Eligible participants were ages 5–17 (inclusive), English-speaking, and previously diagnosed with any form of pediatric cancer that did not include the central nervous system. Youth were excluded if they had MRI contraindications (e.g., claustrophobia, braces, non-MRI compatible port), major sensory impairments (e.g., severe vison loss), comorbid neurological disorders (e.g., epilepsy), gross neuropathologies (e.g., ventriculomegaly), pervasive developmental disorders, or other severe psychopathology (e.g., schizophrenia). The study was approved by the Wayne State University Institutional Review Board. Written informed consent and assent were obtained from participating primary caregivers (i.e., parent or legal guardian) and youth, respectively. Participant demographics and clinical characteristics are provided in Table 1 .