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Decrease in peripheral muscle strength and ankle dorsiflexion as long-term side effects of treatment for childhood cancer

Authors

  • Annelies Hartman MSc,

    Corresponding author
    1. Department of Pediatric Oncology/Hematology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
    2. Department of Pediatric Physiotherapy, Erasmus MC Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands
    • Department of Pediatric Physiotherapy, Erasmus MC Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands.
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  • Cor van den Bos MD, PhD,

    1. Department of Pediatric Oncology, Emma Children's Hospital Academic Medical Center, Amsterdam, The Netherlands
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  • Theo Stijnen PhD,

    1. Department of Epidemiology and Biostatistics, Erasmus MC, Rotterdam, The Netherlands
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  • Rob Pieters MD, PhD

    1. Department of Pediatric Oncology/Hematology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
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Abstract

Background

This study investigated muscle strength, passive ankle dorsiflexion, and their association with motor performance in children after treatment for acute lymphoblastic leukemia, Wilms tumor, B-non-Hodgkin lymphoma, and malignant mesenchymal tumors.

Procedure

Muscle strength was assessed with a hand-held dynamometer and ankle dorsiflexion with a goniometer in 92 and 64 survivors, respectively. Motor performance was measured with the Movement Assessment Battery for Children (movement-ABC). Age at testing: 6.1–12.9 years. Mean time since completing treatment: 3.3 years. Results were compared to 155 healthy controls.

Results

Muscle strength of the survivors was reduced in ankle dorsiflexors on both sides (P < 0.001), wrist dorsiflexors on the non-dominant side (P < 0.001), and pinch grip on the non-dominant (P = 0.001) and dominant side (P = 0.01). Passive ankle dorsiflexion of the survivors was significantly less on both sides (P < 0.01). Movement-ABC percentile score was affected by pinch grip strength on the non-dominant (P < 0.004), and dominant side (P = 0.024) but not by strength of other muscle groups or by passive ankle dorsiflexion.

Conclusion

Peripheral muscle strength and ankle dorsiflexion are reduced in the long-term in children treated for cancer with chemotherapy. However, neither decreased muscle strength nor reduced ankle dorsiflexion could completely explain reduced scores on the movement-ABC. Pediatr Blood Cancer. Pediatr Blood Cancer 2008;50:833–837. © 2007 Wiley-Liss, Inc.

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