title: Decrease in peripheral muscle strength and ankle dorsiflexion as long-term side effects of treatment for childhood cancer.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatric Oncology/Hematology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands. j.hartman@erasmusmc.nl
authors.forename: Annelies
authors.initials: A
authors.lastname: Hartman
authors.forename: Cor
authors.initials: C
authors.lastname: van den Bos
authors.forename: Theo
authors.initials: T
authors.lastname: Stijnen
authors.forename: Rob
authors.initials: R
authors.lastname: Pieters
mesh_terms: D000842:Ankle / Q000502:physiology*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000187:drug effects*; D053580:Muscle Strength / Q000187:drug effects*; D053581:Muscle Strength Dynamometer; D018482:Muscle, Skeletal / Q000187:drug effects; D009369:Neoplasms / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage; D016059:Range of Motion, Articular / Q000187:drug effects; D013995:Time; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000970:Antineoplastic Agents; D014750:Vincristine; D003907:Dexamethasone; D011241:Prednisone