Functional Capacity of Children with Leukemia

 

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Abstract

The purpose of this study was to determine if the functional capacity and quality of life of children receiving treatment against acute lymphoblastic leukemia (ALL) is decreased compared to healthy age and gender-matched children. Functional capacity was assessed with a number of measurements as the peak oxygen uptake (V·O_2peak) and ventilatory threshold determined during a ramp treadmill test, functional mobility (Timed Up and Down Stairs test [TUDS]) and ankle dorsiflexion passive and active range of motion (passive and active DF‐ROM, respectively). Quality of life (QOL) was determined with the Spanish version of the Child Report Form of the Child Health and Illness Profile-Child Edition (CHIP‐CE/CRF). Fifteen children (9 boys, 6 girls; mean [SD] age: 6.8 ± 3.1 years) receiving maintenance therapy against ALL were studied and fifteen, nonathletic healthy children (9 boys, 6 girls; 6.9 ± 3.3 years) were selected as controls. The mean values of V·O_2peak and active DF‐ROM were significantly (p < 0.05) lower in patients (25.3 ± 6.5 ml · kg^-1 · min^-1 vs. 31.9 ± 6.8 ml · kg^-1 · min^-1 in controls and 19.6 ± 8.0° vs. 24.1 ± 5.0°, respectively). Children's self report of satisfaction (with self and health) (p < 0.05), comfort (concerning emotional and physical symptoms and limitations) (p < 0.01) and resilience (positive activities that promote health) (p < 0.01) were significantly decreased in patients with ALL. In summary, children receiving treatment against ALL have overall lower functional capacity and QOL than healthy children. However, their physical condition and health status are sufficiently high to allow them to participate in physical activities and supervised exercise programs.

References

• 1 Argüelles B, Barrios V, Buño M, Madero L, Argente J. Anthropometric parameters and their relationship to serum growth hormone-binding protein and leptin levels in children with acute lymphoblastic leukemia: a prospective study.  Eur J Endocr. 2000;  143 243-250
  PubMedGoogle Scholar
• 2 Aznar S, Webster A L, San Juan A F, Chamorro-Viña C, Maté-Muñoz J L, Moral S, Pérez M, García-Castro J, Ramírez M, Madero L, Lucia A. Physical activity during treatment in children with leukemia; a pilot study.  Appl Physiol Nutr Metab. 2006;  31 407-413
  CrossrefPubMedGoogle Scholar
• 3 Blair S N, Kampert J B, Kohl 3rd H W. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women.  JAMA. 1996;  276 205-210
  CrossrefPubMedGoogle Scholar
• 4 Corbin C B. The “untracking” of sedentary living: a call for action.  Pediatr Exerc Sci. 2001;  13 347-356
  PubMedGoogle Scholar
• 5 De Caro E, Fioredda F, Calevo M G, Smeraldi A, Saitta M, Hanau G, Faraci M, Grisolia F, Dini G, Pongiglione G, Haupt R. Exercise capacity in apparently healthy survivors of cancer.  Arch Dis Child. 2006;  91 47-51
  PubMedGoogle Scholar
• 6 Dworzak M N, Froschl G, Printz D, Mann G, Postchger U, Muhlegger N. Austrian Berlin-Frankfurt-Munster Study Group. Prognostic significance and modalites of flow cytometric minimal residual disease detection in childhood acute lymphoblastic leukemia.  Blood. 2002;  99 1952-1958
  CrossrefPubMedGoogle Scholar
• 7 Ewart C K, Taylor C B, Reese L B, DeBusk R F. Effects of early postmyocardial infarction exercise testing on self-perception and subsequent physical activity.  Am J Cardiol. 1983;  51 1076-1080
  CrossrefPubMedGoogle Scholar
• 8 Habib Z, Westcott S. Assessment of anthropometric factors on balance tests in children.  Pediatr Phys Ther. 1998;  10 101-108
  PubMedGoogle Scholar
• 9 Hauser M, Gibson B S, Wilson N. Diagnosis of anthracycline-induced late cardiomyopathy by exercise-spiroergometry and stress-echocardiography.  Eur J Pediatr. 2001;  160 607-610
  CrossrefPubMedGoogle Scholar
• 10 Herrero F, San Juan A F, Fleck S J, Pérez M, Cañete S, Earnest C P, Lucia A. Combined aerobic and resistance training in breast cancer survivors: a randomized, controlled pilot trial.  Int J Sports Med. 2006;  27 573-580
  Article in Thieme ConnectPubMedGoogle Scholar
• 11 Lucia A, Earnest C, Perez M. Cancer-related fatigue: how can exercise physiology assist oncologists?.  Lancet Oncol. 2003;  4 616-625
  CrossrefPubMedGoogle Scholar
• 12 Lucia A, Ramirez M, San Juan A F, Fleck S J, Garcia-Castro J, Madero L. Intrahospital supervised exercise training: a complementary tool in the therapeutic armamentarium against childhood leukaemia.  Leukemia. 2005;  19 1334-1337
  CrossrefPubMedGoogle Scholar
• 13 Malina R M. Tracking of physical activity and physical fitness across the lifespan.  Res Q Exerc Sport. 1996;  67 S1-S10
  PubMedGoogle Scholar
• 14 Marchese V G, Chiarello L A, Lange B J. Strength and functional mobility in children with acute lymphoblastic leukemia.  Med Pediatr Oncol. 2003;  40 230-232
  CrossrefPubMedGoogle Scholar
• 15 Marchese V G, Chiarello L A, Lange B J. Effects of physical therapy intervention for children with acute lymphoblastic leukemia.  Pediatr Blood Cancer. 2004;  42 127-133
  CrossrefPubMedGoogle Scholar
• 16 Marchese V G, Ogle S, Womer R B, Dormans J, Ginsberg J P. An examination of outcome measures to assess functional mobility in childhood survivors of osteosarcoma.  Pediatr Blood Cancer. 2004;  42 41-45
  CrossrefPubMedGoogle Scholar
• 17 Matthys D, Verhaaren H, Benoit Y, Laureys G, De Naeyer A, Craen M. Gender difference in aerobic capacity in adolescent after cure from malignant disease in childhood.  Acta Pediatr. 1993;  82 459-462
  PubMedGoogle Scholar
• 18 McKenzie D C, Coutts K D, Rogers P C, Jespersen D K, Pretula A. Aerobic and anaerobic capacities of children and adolescents successfully treated for solid tumours.  Clin Exerc Physiol. 2000;  2 39-42
  PubMedGoogle Scholar
• 19 Meyer T, Lucia A, Earnest C P, Kinderman W. A conceptual framework for performance diagnosis and training prescription from submaximal gas exchange parameters-theory and application.  Int J Sports Med. 2005;  26 (Suppl 1) S38-S48
  Article in Thieme ConnectPubMedGoogle Scholar
• 20 Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood J E. Exercise capacity and mortality among men referred for exercise testing.  N Engl J Med. 2002;  4 793-801
  PubMedGoogle Scholar
• 21 Norkin C C, White (eds) D J. Measurement of Joint Motion: A Guide to Goniometry. 3rd edition. Philadelphia; FA Davis Company 2003
  Google Scholar
• 22 Oeffinger K C, Buchanan G R, Eshelman D A, Denke M A, Andrews T C, Germak J A, Tomlinson G E, Snell L E, Foster B M. Cardiovascular risk factors in young adult survivors of childhood acute lymphoblastic leukemia.  J Pediatr Hematol Oncol. 2001;  23 424-430
  CrossrefPubMedGoogle Scholar
• 23 Rajmil L, Serra-Suton V, Estrada M D, Fernández De Sanmamed M J, Guillamon I, Riley A, Alonso J. Adaptación de la versión española del perfil de salud infantil (Child health and illness profile-child edition, CHIP‐CE).  An Pediatr. 2004;  60 522-529
  CrossrefPubMedGoogle Scholar
• 24 Rajmil L, Berra S, Estrada M D, Serra-Suton V, Rodríguez M, Borrell C, Riley A S, Starfield B. Spanish version of the Child Health and Illness Profile-Child Edition Parent Report Form [CHIP‐CE/PRF].  Gac Sanit. 2004;  18 305-311
  PubMedGoogle Scholar
• 25 Riley A W, Forrest C B, Rebok G W, Starfield B, Green B F, Robertson J A, Friello P. The child report form of CHIP-Child edition: reliability and validity.  Med Care. 2004;  42 221-231
  CrossrefPubMedGoogle Scholar
• 26 Riley A W, Forrest C B, Starfield B, Rebok G W, Robertson J A, Green B F. The parent report form of the CHIP-Child edition: reliability and validity.  Med Care. 2004;  42 210-220
  CrossrefPubMedGoogle Scholar
• 27 Shephard R J, Allen C, Benade A J, Davies C T, Di Prampero P E, Hedman R, Merriman J E, Myhre K, Simmons R. The maximum oxygen intake. An international reference standard of cardiorespiratory fitness.  Bull World Health Organ. 1968;  38 757-764
  PubMedGoogle Scholar
• 28 Spirduso (ed) W W. Physical Dimensions of Aging. Champaign, IL; Human Kinetics 1997: 95-121
  Google Scholar
• 29 Taylor C B, Bandura A, Ewart C K, Miller N H, DeBusk R F. Exercise testing to enhance wives' confidence in their husbands' cardiac capability soon after clinically uncomplicated acute myocardial infarction.  Am J Cardiol. 1985;  55 635-638
  CrossrefPubMedGoogle Scholar
• 30 Van Brussel M, Takken T, Lucia A, Van Der Net J, Helders P J. Is physical fitness decreased in survivors of childhood leukemia? A systematic review.  Leukemia. 2005;  19 13-17
  PubMedGoogle Scholar
• 31 Vizinova H, Malincikova J, Klaskova E, Wiedermann J. Exercise cardiorespiratory indexes in children motivated to physical activity after treatment for acute lymphoblastic leukemia.  Cas Lek Cesk. 2002;  141 491-493
  PubMedGoogle Scholar
• 32 Warner J T, Bell W, Webb D K, Gregory J W. Relationship between cardiopulmonary response to exercise and adiposity in survivors of childhood malignancy.  Arch Dis Child. 1997;  76 298-303
  PubMedGoogle Scholar
• 33 Warner J T, Bell W, Webb D K, Gregory J W. Daily energy expenditure and physical activity in survivors of childhood malignancy.  Pediatr Res. 1998;  43 607-613
  CrossrefPubMedGoogle Scholar
• 34 Wright M J, Halton J M, Martin R F, Barr R D. Long-term gross motor performance following treatment for acute lymphoblastic leukemia.  Med Pediatr Oncol. 1998;  31 86-90
  CrossrefPubMedGoogle Scholar
• 35 Wright M J, Halton J M, Barr R D. Limitation of ankle range of motion in survivors of acute lymphoblastic leukemia: a cross-sectional study.  Med Pediatr Oncol. 1999;  32 279-282
  CrossrefPubMedGoogle Scholar
• 36 Wright M J, Hanna S E, Halton J M, Barr R D. Maintenance of ankle range of motion in children treated for acute lymphoblastic leukaemia.  Pediatr Phys Ther. 2003;  15 146-152
  CrossrefPubMedGoogle Scholar

Prof. Alejandro Lucia

Universidad Europea de Madrid
Exercise Physiology

28670 Villaviciosa de Odón, Madrid

28670 Madrid

Spain

Phone: + 34 9 16 64 78 00

Fax: + 34 9 16 16 82 65

Email: alejandro.lucia@uem.es