LONG-TERM GROSS MOTOR-PERFORMANCE FOLLOWING TREATMENT FOR ACUTE LYMPHOBLASTIC-LEUKEMIA

Background. The primary purpose of this descriptive study was to deter mine the longterm effects of cancer treatment in childhood on musculos keletal function and gross motor skills. Procedure. Musculoskeletal an d gross motor function were assessed in a cohort of 36 survivors of ac ute lymphoblastic leukemia (ALL) seen in a pediatric tertiary care ref erral centre, compared to 36 age and gender marched comparison subject s. Basic gross motor skills were assessed using dimensions D: standing , and E: walking, running, and jumping of the Gross Motor Function Mea sure [GMFM]. Strength, balance, and running speed and agility were ass essed using the Bruininks-Oseretsky rest of Motor Proficiency (BOTMP). Hand grip strength and ankle dorsiflexion range of motion were also m easured. 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 we re 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 v s. 16.6. The ALL subjects had less hand grip strength 156.3 vs. 190.2, and less ankle dorsiflexion 7.5 vs. 16.1 degrees than the comparison group. The survivors of childhood leukemia were able to perform most b asic gross motor functions. However, musculoskeletal impairment was ev ident and levels of motor proficiency were significantly poorer than t hose of age and gender matched children. Conclusions. Programs to prom ote physical activity and limit disability may improve gross motor fun ction and increase overall quality-of-life in survivors of leukemia in childhood. (C) 1998 Wiley-Liss, Inc.