Long-term gross motor performance following treatment for acute lymphoblastic leukemia

Abstract

Background The primary purpose of this descriptive study was to determine the long‐term effects of cancer treatment in childhood on musculoskeletal function and gross motor skills. Procedure. Musculoskeletal and gross motor function were assessed in a cohort of 36 survivors of acute lymphoblastic leukemia (ALL) seen in a pediatric tertiary care referral centre, compared to 36 age and gender matched comparison subjects. Basic gross motor skills were assessed using dimensions D: standing, and E: walking, running, and jumping of the Gross Motor Function Measure (GMFM). Strength, balance, and running speed and agility were assessed using the Bruininks‐Oseretsky Test of Motor Proficiency (BOTMP). Hand grip strength and ankle dorsiflexion range of motion were also measured. Findings in the children with ALL were compared by dependent (paired) t‐tests to those in age and gender matched children. Results. The GMFM scores for standing were 98.7% and for walking, running, and jumping were 99% of normal. The mean standard scores for the BOTMP were significantly lower than those of the comparison group: strength 11.5 vs. 19.4, balance 9.4 vs. 15.5, and running speed and agility 9.9 vs. 16.6. The ALL subjects had less hand grip strength 156.3 vs. 190.2, and less ankle dorsiflexion 7.5 vs. 16.1° than the comparison group. The survivors of childhood leukemia were able to perform most basic gross motor functions. However, musculoskeletal impairment was evident and levels of motor proficiency were significantly poorer than those of age and gender matched children. Conclusions. Programs to promote physical activity and limit disability may improve gross motor function and increase overall quality‐of‐life in survivors of leukemia in childhood. Med. Pediatr. Oncol. 31:86–90, 1998. © 1998 Wiley‐Liss, Inc.

Motor performance in children and adolescents with cancer at the end of acute treatment phase

“…Other studies that determined motor performance in the oncological aftercare revealed impairments in motor performance even years after cessation of treatment [4,10,37,38,41].…”

Exercise in adult and pediatric hematological cancer survivors: an intervention review

“…Child survivors of ALL have lower levels of physical activity than their healthy referents, 8,[23][24][25] leading to worse cardiorespiratory fitness, 7,[26][27][28][29][30][31] physical function, 30 balance and coordination. 32 Identifying the effects of regular physical activity in adult and pediatric survivors of hematological cancer is thus of medical interest. Liu et al 33 recently performed a systematic review on exercise interventions conducted in hematological cancer patients, including studies published up to September 2007.…”

Visuomotor control in survivors of childhood acute lymphoblastic leukemia treated with chemotherapy only

“…This has resulted in an increasing interest in the late effects of disease and treatment on physical, mental and social well-being of the survivors. Several elements of therapy for ALL may affect the function of the central and peripheral nervous system, and cognitive deficits (e.g., Anderson et al, 2000;Brown et al, 1992;Butler et al, 1994;Moleski, 2000;Ochs et al, 1991) as well as gross and fine motor impairments (Galea et al, 2004;HarilaSaari et al, 2001;Lehtinen et al, 2002;Reinders-Messelink et al, 1996;Vainionpaa, 1993;Wright et al, 1998) have been reported in survivors of childhood ALL. CNS-directed treatment is a standard component of therapy for ALL.…”