Differences in activities of daily living performance between long‐term pediatric sarcoma survivors and a matched comparison group on standardized testing

Abstract

BACKGROUND: In a cross-sectional study examining late effects of pediatric sarcoma therapy, long-term survivors were evaluated on their activities of daily living (ADL) performance. PROCEDURE: Thirty-two persons with Ewing sarcoma family of tumors, rhabdomyosarcoma, and non-rhabdomysarcoma-soft tissue sarcoma enrolled an average of 17 years after treatment. Participants were evaluated using the Assessment of Motor and Process Skills (AMPS) [1], a standardized observational evaluation of ADL task performance. Means and 95% confidence intervals for ADL motor and ADL process ability measures were calculated for four groups: 1) sarcoma survivors, 2) “well” adults matched for age and gender, 3) “well” adults matched for gender that were 10 years older; and 4) “well” adults matched for gender that were 20 years older. RESULTS: ADL motor ability was significantly lower for sarcoma survivors than for the age and gender matched comparison group (p<0.05). There was no significant difference between ADL motor ability of sarcoma survivors and the comparison group 10 years older, but sarcoma survivors had significantly better ADL motor ability (p<0.05) than the oldest comparison group (20 years older). Sarcoma survivors had significantly worse ADL process ability than the age matched group (p<0.05). There was no difference in ADL process ability between the sarcoma survivors and comparison groups that were 10 and 20 years older. CONCLUSIONS: This first report of a clinical evaluation of ADL limitation in pediatric sarcoma survivors treated with intensive multimodal cancer therapy suggests that influences on performance of daily life activities are more common than previously reported.

A Brief Historical Perspective of Cancer Rehabilitation and Contributions From the National Institutes of Health

“…Most frequently, the outcomes included some impairment measures such as weakness, limb swelling, energy requirements and expenditures, pain, activities of daily living, and psychosocial adjustment to illness. The studies provided the basis for performing randomized trials for which primary or secondary treatment outcomes that included measures of symptoms likely to relate to function as well as functional measures were selected [23‐27]. This research has also applied functional measures to determine which risk factors (proteomics, performance measures, or patient‐reported outcomes) were associated with poor or good functional outcomes.…”

Activities of Daily Living in Survivors of Childhood Brain Tumor

“…ADLs are defined as essential activities for self-care, such as washing and feeding, and for independent living, such as home management and meal preparation (Lawton, 1987). Research that objectively measures ADL performance in survivors of childhood cancer is rare in the literature (Parks, Rasch, Mansky, & Oakley, 2009). In addition, little research has been conducted to examine how survivors of childhood BT cope with everyday living, and descriptions of their ADL performance are not available.…”

Assessment of Fundamental Movement Skills in Childhood Cancer Patients

“…Additional research among school‐aged children indicates an important correlation between high levels of FMS and higher levels of physical activity, cardiorespiratory fitness, and lower levels of obesity . Unfortunately, FMS are thought to be adversely affected both during and post‐cancer treatment due to excessively sedentary behaviour throughout cancer treatments and the toxic effects of the chemotherapeutic drugs used, particularly vincristine . This is particularly concerning as physical activity levels in CCSs are already reported to decline during and after treatment completion and be lower than their “healthy” peers or sibling equivalents .…”