Limited Walking Abilities and Impaired Ankle Dorsiflexion Function in Children After Intense Cancer Treatment

Abstract

Background With improved survival rates in pediatric oncology, the detection of adverse side- and late-effects is gaining increased interest. This cross-sectional study investigated walking abilities and ankle dorsiflexion function in children with cancer.

Patients Study participants included 16 children with various cancers (4–20 years, patient group) after completion of the intense treatment and 16 age- and gender-matched healthy peers (comparison group).

Method Walking speed (10-meter-walking-test, treadmill test assessing preferred transition speed), walking capacity (2-minute-walk-test), walking balance (Timed-Up-And-Go-Test), active/passive ankle dorsiflexion range of motion (ROM) (goniometer) and ankle dorsiflexion strength (hand-held dynamometer) were comprehensively assessed.

Results Significant lower values in the patient group were found for walking capacity, maximum walking speed, ankle dorsiflexion ROM and strength. No significant differences between the groups were found for preferred walking speed and walking balance.

Discussion Limited walking abilities and ankle dorsiflexion dysfunctions are prominent in children with cancer; having the potential to impact children’s community mobility and physical activity.

Conclusions To provide holistic care, the development of specific supportive strategies such as exercise interventions and its translation into clinical practice needs to be accelerated.

Zusammenfassung

Hintergrund Mit verbesserten Überlebensraten in der Kinderonkologie wird es immer wichtiger, Nebenwirkungen und Spätfolgen zu identifizieren. In dieser Querschnittsstudie wurden die Gehfähigkeit und die Funktion der Sprunggelenksdorsalflexion bei onkologisch erkrankten Kindern untersucht.

Patienten Insgesamt nahmen 16 Kinder verschiedener Krebserkrankungen (4–20 Jahre), die ihre intensive Krebstherapie abgeschlossen hatten (Patientengruppe), sowie 16 gesunde Kinder, die in Alter und Geschlecht einem onkologisch erkrankten Kind entsprachen (Kontrollgruppe), an der Studie teil.

Methode In verschiedenen Gehtests wurden die Parameter Geschwindigkeit (10Meter-Gehttest, Laufbandtest zur Erfassung der Geschwindigkeit beim Übergang vom Gehen ins Laufen), Distanz (2 Min-Gehtest) sowie das Gleichgewicht im Gehen (Timed-Up-And-Go-Test) erfasst. Zudem wurden das aktive/passive Bewegungsausmaß im Sprunggelenk (Goniometer) und die Kraft der Sprunggelenksdorsalflexoren (Dynamometer) umfassend analysiert.

Ergebnisse In der Patientengruppe wurden signifikant niedrigere Werte für die Gehdistanz, die maximale Gehgeschwindigkeit, das Bewegungsausmaß im Sprunggelenk sowie in der Kraft der Sprunggelenksdorsalflexoren festgestellt. Für die frei gewählte Gehgeschwindigkeit und das Gleichgewicht im Gehen wurden keine signifikanten Unterschiede zwischen den Gruppen identifiziert.

Diskussion Einschränkungen in der Gehfähigkeit und der Sprunggelenksdorsalflexion stellen relevante Spätfolgen bei Kindern mit Krebs dar, die das Potential haben, die Alltagsmobilität und körperliches Aktivitätsverhalten negativ zu beeinflussen.

Schlussfolgerung Um eine ganzheitliche Versorgung gewährleisten zu können, müssen die Entwicklung von spezifischen supportiven Therapiemaßnahmen wie Bewegungsinterventionen sowie deren Translation in die klinische Praxis vorangetrieben werden.

Key words

pediatric oncology - adverse effects - walking ability - gait - dorsiflexion

Schlüsselwörter

Kinderonkologie - Spätfolgen - Gehfähigkeit - Gang - Dorsalflexion

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