title: Limitations in Ankle Dorsiflexion Range of Motion, Gait, and Walking Efficiency in Childhood Cancer Survivors.
abstract: BACKGROUND
  Improvements in survival rates in pediatric oncology have resulted in a growing need to identify adverse effects and improve rehabilitation in this population.
  
  
  OBJECTIVE
  This cross-sectional study aimed to investigate active ankle dorsiflexion (DF) range of motion (ROM), gait, walking efficiency, and motor performance in a mixed childhood cancer survivor population in comparison to healthy peers.
  
  
  METHODS
  Active ankle DF-ROM (goniometer), gait (Microgate Optogait 2D Gait Analysis), walking efficiency (6-minute walk test), and motor performance (German Motor Test 6-18) were assessed in a mixed childhood cancer survivor population after cessation of medical treatment (n = 13) in comparison to healthy children matched for age and gender (n = 13).
  
  
  RESULTS
  Active ankle DF-ROM, gait (stance, swing, and preswing phase), and walking efficiency were significantly impaired in survivors compared with control subjects. No significant difference between groups was found in motor performance.
  
  
  CONCLUSIONS
  Despite sufficient total motor performance levels, specific limitations in physical functioning were identified in a mixed childhood cancer survivor sample. This highlights the importance of the present findings.
  
  
  CONCLUSIONS
  The results from this study highlight the potential significance of limited ankle DF function, inhibited gait, and reduced walking efficiency as adverse effects of various types of childhood cancer. It is hoped this enhanced recognition by pediatric cancer patients, parents, and exercise professionals will initiate specific supportive strategies and potentially prevent further limitations.
authors.affiliation: Author affiliations: Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Institute of Cardiovascular Research and Sport Medicine (Mss Beulertz, Rustler, and Fitzen and Drs Bloch, Streckmann, and Baumann); Children's Hospital Amsterdamer Straße Cologne; Clinic for Children and Youth Medicine, Pediatric Oncology/Hematology (Dr Prokop); and Institute of Medical Statistics, Informatics and Epidemiology (IMSIE), University of Cologne (Dr Herich), Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Beulertz
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Bloch
authors.forename: Aram
authors.initials: A
authors.lastname: Prokop
authors.forename: Vanessa
authors.initials: V
authors.lastname: Rustler
authors.forename: Christina
authors.initials: C
authors.lastname: Fitzen
authors.forename: Lena
authors.initials: L
authors.lastname: Herich
authors.forename: Fiona
authors.initials: F
authors.lastname: Streckmann
authors.forename: Freerk T
authors.initials: FT
authors.lastname: Baumann
mesh_terms: D000293:Adolescent; D000843:Ankle Joint / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000451:nursing / Q000503:physiopathology* / Q000628:therapy; D016059:Range of Motion, Articular / Q000502:physiology*; D017741:Survivors / Q000706:statistics & numerical data*; D016138:Walking / Q000502:physiology*