title: Skeletal, neuromuscular and fitness impairments among children with newly diagnosed acute lymphoblastic leukemia.
abstract: This study describes skeletal, neuromuscular and fitness impairments among 109 children (median age 10 [range 4-18] years, 65.1% male, 63.3% white) with acute lymphoblastic leukemia (ALL). Outcomes were measured 7-10 days after diagnosis and compared to age- and sex-specific expected values. Associations between function and health-related quality of life (HRQL) were evaluated with logistic regression. Children with ALL had sub-optimal bone mineral density (BMD) Z-score/height (mean ± standard error: - 0.53 ± 0.16 vs. 0.00 ± 0.14, p < 0.01), body mass index percentile (57.6 ± 3.15 vs. 50.0 ± 3.27%, p = 0.02), quadriceps strength (201.9 ± 8.3 vs. 236.1 ± 5.4 N, p < 0.01), 6 min walk distance (385.0 ± 13.1 vs. 628.2 ± 7.1 m, p < 0.001) and Bruininks-Oseretsky Test of Motor Proficiency scores (23 ± 2.5 vs. 50 ± 3.4%, p < 0.01). Quadriceps weakness was associated with a 20.9-fold (95% confidence interval 2.5-173.3) increase in poor physical HRQL. Children with newly diagnosed ALL have weakness and poor endurance and may benefit from early rehabilitation that includes strengthening and aerobic conditioning.
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital , Memphis, TN , USA.
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.forename: Sue C
authors.initials: SC
authors.lastname: Kaste
authors.forename: Liang
authors.initials: L
authors.lastname: Zhu
authors.forename: Ching-Hon
authors.initials: CH
authors.lastname: Pui
authors.forename: Sima
authors.initials: S
authors.lastname: Jeha
authors.forename: Paul C
authors.initials: PC
authors.lastname: Nathan
authors.forename: Hiroto
authors.initials: H
authors.lastname: Inaba
authors.forename: Karen
authors.initials: K
authors.lastname: Wasilewski-Masker
authors.forename: Durga
authors.initials: D
authors.lastname: Shah
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Wells
authors.forename: Robyn E
authors.initials: RE
authors.lastname: Karlage
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Cox
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D015519:Bone Density; D002648:Child; D002675:Child, Preschool; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009048:Motor Skills / Q000502:physiology; D015999:Multivariate Analysis; D053580:Muscle Strength / Q000502:physiology; D009469:Neuromuscular Junction / Q000502:physiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D011788:Quality of Life; D016037:Single-Blind Method; D016138:Walking / Q000502:physiology
keywords: Acute lymphoblastic leukemia; muscle strength; pediatric; physical endurance; quality of life